Senate Standing Committee on Agriculture and Environment

Calling the HHS Ag and Environment, Energy and Intergovernmental affairs joint referrals, 1pm Calendar. I'm present. Chair Gabard for Agriculture. Environment is also present. Chair Wakai is also present. For my Committee, I have Senator Keohokalole. And would you like to introduce your Committee Members? Senator Richards and also Senator DeCoite. And Senator Wakai. Would you like to introduce your.

Sure. I have the esteemed Stanley Chang and Linda DeCoite for my Committee here. Okay. And Tim Richards. I'll do that.

Okay. Thank you. Yes. Okay. So. Good afternoon. This meeting is being streamed live on YouTube. In the unlikely event that we must abruptly end this hearing due to technical difficulties, the Committee will reconvene to discuss any outstanding business at 1:10pm Wednesday, February 4, 2026 in room 225.

And a public notice will be posted on the legislator's website to facilitate this here in a timely manner. We will be enforcing my one minute rule. I will be reading a list of individuals who submitted written testimony for each measure. We apologize if the closed captioning is not accurately transcribing the names.

If you're interested in reviewing the written testimony, please go to the legislator's website. You will find a link on the status page for the measure. We appreciate your understanding and remind you that the Committee does have your testimony, that we review them. So I encourage you to use your time. It's only one minute.

To either add additional comments or you can stand on your written testimony. First up. And we have Senator McKelvey. My Committee.

You got. You've got a bit of a log jam. Here we go.

And Senator Awa, for I don't know. Your Committee? Okay, so first up, SB 2262 relating to pollution. First up, we have Department of Health providing comments. Please proceed.

Good afternoon. Chairs, vice chairs, Committee Members, Glenn Haae on behalf of the Department of Health. The Department stands on its written testimony and we're available to answer any questions. Thank you.

Okay, thank you very much. Next we have Johnny Mae Perry in support. And those are the only written testimony. Anybody else wishing to testify? SB 2262 Members, any questions? Oh, excuse me. Okay, Angela, you have one minute.

Angela Melody Young testifying on behalf of CARES and wishing to comment. So I'd be very supportive of this measure if it included a few amendments. So, for example, if you read line, page 1, line 10B. The Department shall establish standardized responses. I think it should be amended to include working with the counties.

So the Department shall work with the four counties to establish an action plan for the standardized responses. And because when I go to the county to pay. At least in Honolulu county, they always say, oh, the state always tells us what to do.

So I think ordering by mandate to include the counties in the communication process to really help, especially with the new landfill location coming up as a big debate. And then also page two, line 17, it focuses on the violations of persons that are causing pollution.

Thank you, Angela. Okay, we have. I see. J.A. Chang on Zoom. Please identify yourself. This for SB2262, Mr. Chang. Could you unmute yourself and please proceed. You have one minute.

Yep. Hi, this is Jason Chang with Queens and wanted to provide my testimony in support of the Bill, the CIP money. We have been in regular conversations with HHSC and the Kona Community Hospital leadership team.

I believe that's the wrong Bill. You're talking about an HHS only Bill. This is a triple joint SB2262 relating to pollution.

My apologies. I'm here for 2702.

Thank you, Dr. Chang. Anybody else wishing to testify in SB 2262, seeing none. Members, any questions? Oh, and we now also have Senator Rhodes and Senator Fevela. So any questions? Let's do a short recess for decision-making. Oh, go ahead Senator Wakai.

Is it Glenn? Is that? I noticed this Bill has a lot of pretty significant fines, but it's not clear to me where do those fines go?

For the administrative fines? I believe they go to the General Fund now. And there are criminal fines that I believe the AG's office collects. I don't know where those fines would go.

Yeah, you're mumbling. Please stop on the mic so everyone else can hear you.

I heard you. So would it be proper for us to have these fines put into a special fund and use those funds to help perpetuate your operational costs rather than just kind of disappear into the General Fund?

I guess that could take place. Yeah, for this program. That might help.

Right, because to me, then it's balanced, right. Because if, for whatever reason you're issuing no fines, then there's no need for us to even continue this operation. But if you're actually going out there and keeping our community safe and getting fines from bad actors, that that will help perpetuate your existence. Right. Versus right now. Just kind of.

We're going to create. You never find out if there's actually people that are getting busted and still pay for kind of an enforcement arm that might not necessarily need to be in existence.

Yeah, well, we would report any fines that we collect as to whether which fund they would go to. Yeah, it would really depend on what the legislator wishes.

Okay, thank you. Thank you, Chair.

Any other questions?

Chair, question.

Okay, Senator DeCoite.

Department of Health. So what are you guys currently doing right now to address the situation? Let's just take the axis deer that are dying on the side of the road or at people's residency on their doorsteps.

So under our current rules, for any, any carcasses, those are our rules, allow them to be buried with under 2ft of soil and so within, usually within the location that they're found somewhere within there that they can be buried, so long as they're covered with two feet of soil.

So who does the burying of it and where does that burying take place? If the surrounding is private property.

As far as I know, it's the landowner, wherever that carcass is found.

So in this case, the animal is not owned by the landowner. Why should the landowner be responsible to now bury that carcass?

Well, yeah, we really don't have control over that portion of it. A lot of times that's how it's treated.

On the solid waste side, any solid waste found on a property, if we can't determine, you know, where it came from, essentially, even for the illegal dumping, a lot of times the landowner ends up being the responsible party to take care of it. So in that case, same thing.

If an axis deer is found dead on their property, that landowner would be responsible, likely to dispose of.

So would it be axis deer, feral pigs and dog?

Yep. Yeah. So like if the city and county, you know, there, there, or any of the counties, if there are any carcasses found on streets, on the side of streets on any other properties, they tend to be the responsible party to take care of it.

So no plan on behalf of DOH to say this is a sanitation issue. That landowner said it. Resident is now saying, okay, this is not mine. What they do, drag them to the neighbors and leave them over there or like.

Well, we hope not. We hope they wouldn't do that. I think in terms of some of the issues with that, the access deer and any diseases and things that are related to that, that is not our purview. I believe it's under the Department of Ag for those kinds of things.

But you get sanitation.

We regulate the solid waste. Essentially, the counties take care of this.

So what it would be. Would you guys plan be to redirect on the different departments and counties? Is that the plan?

That is normally what we would do. We would try to find a solution whether the landlord can take care of it or Whether the counties can assist with that.

Are you guys in talks right now with the Department of DLNR or Department of AG?

We have been in the past regarding some of these issues. They normally just ask us what our regulations allow, and then we tend to discuss that issue.

But what is the most recent conversation you've had with those two departments?

I couldn't say for sure in our Department, I'm aware of us having spoken to someone at least within the last two years, maybe.

Well, it's kind of long.

Okay. So I'd like to point out that there is. You have this Bill establishes a task force that requires state and county illegal dumping task force. We can add in DLNR if you want that amendment in there. Okay.

And I also like to point out that according to the Bill, a restitution for reimbursement of the full cost of cleanup and community service for pollution cleanup. Totally more than 40 hours is going to be found on the offender. And that's also part of the Bill.

Should the landowner decide to do the cleanup, he's going to be entitled to reimbursement. Looks like it to me. Okay. So any other questions?

Oh chair this clarification. Okay. Who's gonna. Who's gonna reimburse the landowner if you guys don't catch anybody?

Yeah, there probably won't be a reimbursement. I mean, there's a responsible party. Other than.

That's why we have a task force, and that's why Senator Wakai wants this special fund to possibly be used for reimbursement if necessary or. I don't know. Okay. Okay. But it seems to me. Okay, since you're here. Any other questions? Okay.

It seems to me that since this is also solid waste, it also looks like it's a pretty high first offense for littering. Yeah, it is. Okay. It's $5,000.

Yeah. We have a recommendation in there rather than to have that tiered structure to have a maximum. Increase the maximum, and then we have authority or we have discretionary discretion for less than.

Yes, because it's for first offense. Not less than 5,000.

Right.

So if someone is caught littering like an Waikiki, you know.

Well, in General, littering doesn't fall under the solid waste. It tends to be a cubic yard or more of waste would fall under our regulations. Except I believe there's a portion of this Bill that mentions solid waste in any amount.

Yeah.

Has a consequence. So that. In that case, that would.

So. Okay. So would you recommend a amendment to allow a court for littering. For should a court determines that it is a littering offense rather than that an offense could be less than 5, that a fine could be less than $5,000.

Yes. Well. Or there are also other types of infractions that fall under our regulations. So we permit facilities, they need to submit reports to us from time to time.

If they fail to submit a report, that single initial offense could be a $5,000 fine, which seems unfair, versus someone who has done illegal dumping and they're getting a fine within that.

That should be commensurate with the kind of dumping that they're doing. Like, if they're doing massive amounts of concrete dumping, that they should be fined more than $10,000 or something? Possibly.

Yeah.

Okay. Any other questions? Let's go. Recess work. Go ahead Senator Wakai.

I'm just curious, like, in the past two years, how many fines have you issued and what's the amount of those fines?

I'd have to look it up. We don't find very often. Mainly we've been. The fines have been for the permitted facilities that we have, solid waste facilities that we issue permits for and but for illegal dumping, it's very difficult again, to determine who the perpetrators are. So we just strive to get the. Get it cleaned up.

And that's basically how it's worked out. So his answer, Nothing possibly impossibly, could be, at least for illegal dumping.

Okay. Senator Fevella.

You know, I understand you guys, like, do the centralized reporting system. You know, it's great and everything there. You can show that it doesn't create, you know, duplications and layer of, you know, between the counties and investigators and slowing the taking of the, you know, catching the people that are doing the dumping.

How are you guys going to ensure the obligation of services not being duplicated?

I can only assume that we'd have to work out the details with the counties. Once this system gets. If this Bill passes and we have to implement the system, we'll bring the counties together.

Are you guys connected in any way on the enforcement part?

Not officially. What we do now is if we have a complaint or for a potential violation, we'll try to determine, like, what other agencies might be able to have jurisdiction over and then we'll contact those agencies, whether it's the counties or whether it's other state agencies. That's how it's working now.

Thank you. Okay, Any. Any other questions? Okay, we're going to do a short recess for decision.

Recalling the joint session calendar of HHS, E G E A E N of AG and E I O Energy. Okay. For decision-making on SB 2262. Chair's recommendation is to pass 2262 with substantial amendments.

First off, we are going to add DLNR to the task force. We are also going to add in a provision that all fines in this Bill be deposited into a special fund to ensure continued enforcement of the program described herein.

We're also going to add in an amendment, another provision to allow for fines of less than $5,000 for littering as defined by the Hawaii Penal Code, and also to allow for fines of more than those stated in this Bill for illegal dumping that are considered excessive or chronic. Any comments?

Oh, and add in a defective date of 2050 to ensure continued discussion. And also accept Department of Health's proposed amendments to their rules as necessary. Okay.

Date, Date, Certain. No, not date. January. What? 20th.

January 30, 2050.

My effective date knows my defective date.

Okay. January 30, 2050. Any comments? Questions? Comments?

Because we're have to work on the definitions of those terms.

Okay. Seeing none. Vice Chair for the vote passed with amendment.

[Roll Call]

Members of EIG or not eig EIA Same recommendation. Any discussion? If not Senator Chang? I vote yes.

[Roll Call]

And with that, we are adjourned for the HHS AEN EIG joint hearing.

Calling the Health and Human Services 105 calendar; present with me, meet my Vice Chair, Senator McKelvey, and Senator Fevella. So, first up, SB 2087 relating to health insurance. We have Doctor Lewin in support. Dr. Lewin, are you ready to testify regarding SB 2087? You can also stand on your written testimony regarding health insurance.

Madam Chair and Vice Chair, I would like to just make a couple comments. We will stand on a written testimony. I just want to say that there are multiple ways we could go about doing this. We do need to find ways to find ancillary coverage for the rising numbers of uninsured that we expect to occur.

This is one novel way. We would thoroughly support it. But if it's not something that we can bring forward, we'll look for other approaches to this because we're going to have to solve it. So. Yeah. Thank you very much.

Okay, next up, Department of Human Services providing comments on Zoom. Meredith, please identify yourself and please proceed.

Aloha, Chair, Vice Chair, members of the committee, Meredith Nichols from Department of Human Services. And we stand on our written testimony.

Okay, next up, we have Insurance Division, DCCA, providing comments.

Good afternoon, Chair, Vice Chairman of the committee. DCCA stands on this written testimony, providing comments.

Okay, thank you very much. Next up, we have Deputy Attorney General providing comments. Martha M? Okay, please proceed.

Good afternoon, Chair and members of the committee. The department has comments on the bill, and we'd just like to point out the appropriations language that should be in the bill. And we would just stand on the rest of our testimony.

Thank you very much. Next up, we have Jay Butai, Department of Labor, providing comments. Department of Labor? Okay, moving on. Next, Maui Indivisible member in support. Dr. Troy? Doris Matsunaga of Indivisible in support. Doris Matsunaga. Are you present on Zoom? Okay, we're going to move on.

Yes, I am, Chair. Yes, I am, Chair.

Okay, go ahead. I'm sorry.

Yes. Thank you for - thank you for giving us an opportunity to testify. From Indivisible Hawaii. We strongly support the bill, and we'll stand on the rest of our testimony. Okay, thank you. Aloha.

Thank you very much. Next, we have Lisa Diaz of Indivisible Kona in support. Next we have Dr. Robert Carlile, Hawaii Academy of Family Physicians Legislative Committee in support. Eric Abe, Hawaii Primary Care association in support. Elizabeth Ignacio, Hawaii Medical Association in support. Deborah - Farrah Marie Gomes, Vice President of University of Hawaii in support. Universe. Please proceed.

Come on up.

Aloha Chair, Vice Chair, members of the committee. Debora Halbert, Vice President for Academic Strategy for the OH system and online for questions regarding our work on student basic needs is Associate Vice President Farrah Marie Gomes; will stand on our written testimony. Thank you.

Okay, thank you very much. Next we have Jody Robinson, Hawaii Alliance of Nonprofit Organization in support. Barbara Tom, Waipahu Safe Heaven Center in support. And then we have 13 other people, 14 other people, all in support. Anybody else wishing to testify on SB 2087, come on up. Identify yourself.

Aloha. My name is Ellen Awai. I am a recipient of Medicaid and I'm the only one I think can really testify on this kind of things because it doesn't work. Medquest: you have how many people in there sending you? How many pages?

Are you in support?

No, I'm opposing it because I think it should be immediate already. It shouldn't have to take, what, three years for a pilot program. The system is broken and it has to be fixed. That's what needs to be worked on. Not by all these other organizations and nonprofits. That is not a recipient of Medquest. Thank you.

Okay, thank you very much. Anybody else wishing to testify on SB 2087? Members, any question?

Aloha, Chair. I'm testifying.

Okay. Angela, you have one minute.

On behalf of CARES. So in strong support, I would support it if you could put in an amendment to also include on page 3, line 15, "The department shall target individuals with disabilities, kupunas, and mothers." These are the most vulnerable demographics and needs to receive health care insurance.

Disabilities is an important demographic to recognize as in need of quest integration, especially for those people who have chronic physical and mental health conditions and need health care access provided to them. For example, those with degenerative disc is very common joint pain, disc pain, temporomandibular joint disorder, anxiety, panic attack, PTSD, and then also health insurance to comprehensively cover kupunas and seniors is crucial because medical care for protecting them from high out of pocket costs for seniors can create financial stability when they have to manage at least one of these chronic conditions.

Mothers, of course, need more women's healthcare services when in stages of motherhood.

So I think if you put specificity in the statute, then it helps the department and the office -

Thank you very much. Thank you, Angela.

Okay, anybody else wishing testifying SB 2087? Okay. Seeing none. Members, any questions? Okay, I have a question, Doc. Okay, you, you have a question?

No, no, no, no. There's just so many.

Yeah, I know, I know, I know, I know. Okay. Dr. Lewis, come on up. Okay, so the reason I heard this bill is because I like the three year continuity, basically requiring people to have already a skinny plan. It's a bronze. It requires them to pay the premium for bronze or catastrophic, which is low bar. Okay.

So it's immediate. It's not great. But the only question, the biggest question really is whether or not we have the money for the deductibles. And it doesn't...according to Deparment of Human Services, it's huge. We're talking hundreds of millions, which we cannot afford.

Ten grand per person. So, do you know whether or not the Rural Health Transformation Program would allow for like a limited deductible, which is like instead of the entire 10 grand, to at least have a pot of like 1,000 dollars per person. So that, that way it'll cover almost all preventives. Right.

Which is what we talked about at the informational briefing and the clinical visits. It won't cover the big catastrophic stuff, but that's what catastrophic is supposed to cover. So, what do you think? Do you think the Rural Health Transformation Program will have the ability to have a very skinny deductible, like $1,000 per person instead of the $10,000?

Thank you for the question, Chair. For both you, Chair, Vice Chair, members: I think it's unlikely that the Rural Health Transformation will permit a coverage cost like this. I think it's not in - we did not request it and I don't - it would have to be something CMS would come around to and I have very sincere and real doubts that they will agree to that. However, we could use Rural Health Transformation funds to help these individuals in a variety of ways in our rural areas.

But I still think we are better off if we provide a very low cost prevention and primary care coverage for people who are displaced at this point. And I just don't know how we afford the other kind of coverage given that Congress hasn't even really fixed the tax credit issue yet.

No. Okay, thank you very much.

Thank you.

Any comments, questions? Okay, moving on. Next up, SB2089 expands services eligible for Medicaid prospective payment system. First up, Dr. Lewin in support.

Chair, Vice Chair. I stand on our written testimony.

Okay, thank you very much. Next we have Leonard Lay, Office of Hawaiian affairs and support Aloha.

Chair, Vice Chair, Members of the Committee, McKenna Woodward. On behalf of the Office of Hawaiian Affairs, we'll stand on our written testimony and support.

Okay, thank you very much. Next we have Brian Yamane, Director, dhs, providing comments. I see Meredith Please identify yourself. Proceed.

Aloha. Chair. Vice chair, Members of the Committee, Meredith Nichols for Department of Human Services. And we stand on our written testimony.

Okay, thank you very much. Next, we have Dr. Ignacio, Hawaii Medical association, providing comments. Next, we have Thomas Brady, individual in support. Anybody else wish and testify in SB2089? Okay, Ellen, come on up. Yes, Chair. Yes, Chair. Okay, wait a second, Angela, Ellen is here in person, then you're next. Okay.

Eleanor Y. I support the intent, but licensed mental health professionals, they know nothing about the individual. They don't have the time to take care, listen to them. I'm sorry. I'm a better peer specialist than most professions. Thank you.

Okay, thank you very much. Okay. Angela, Melody Young. You got one minute. Please proceed.

In strong support of mental health access in rural areas.

I think if there can be a policy created such as this, but to have flexibility to train high school and college students under the supervision of a licensed mental health practitioner to empower teenagers and students in their 20s transitioning from high school to college to graduate school in their studies of a mental health program, then this can really help to strengthen the pipeline and to build more bodies available for workforce development to work in this mental health industry.

And yeah, also I think there's a technical thing that I wanted to point out was that Chapter 57729 I don't know if it's the correct chapter because it talks about mental health services for minors. So. Yeah.

Okay, thank you. Okay, thank you very much. Next we have. Excuse me, anybody else wishing to testify on SB2089? Members. Any questions they see? None. Moving on. SB2106 relating to health. First up, we have Department of Health providing comments.

Chair, Vice chair, Members of the Committee, Matt Garama, Department of Health, Environmental Health Services Division.

And we stand on our written testimony for your answer.

Next, we have Hawaii team led for lead for Harvard, Striped in support, Kaden Fong. Okay, identify yourself and please proceed.

My name is Kaden Phan, a sophomore at Iolani School and the Hawaii team lead for Harvard Strife, an organization dedicated to raising awareness and also preventing eating disorders in youth. I'm testifying in Favor of Bill SB2106. 10,200 deaths occur nationally every year from eating disorders. That is one death every 52 minutes.

Eating disorders affect everyone at every age, but especially in the teen demographic. In the world of constant social media use, adolescents are surrounded by external pressures and forced insecurities. Following the latest trends and conventional beauty standards. These expectations are unrealistic and harmful to our generation.

About 9% of Hawaii residents will have an eating disorder in their lifetime, hurting over 120,000 individuals. It is vital that we take action to prevent this serious illness from harming our community. Today's Kiki will be our future generations. Doctors, lawyers and even legislators. As if the President is at our responsibility to protect and care for Hawaii's youth.

Thank you for your time and consideration.

Thank you very much. Next we have Lauren Zirbel, Hawaii Food Industry association, providing comments.

Thank you so much. I'll keep my testimony short. You know, we believe that there were good intentions behind this Bill, but, you know, the path to hell is paid with good intentions. And we're already really living in a hellish regulatory environment in our state which does drive up the cost of food and beverages.

You know, all of these little bills, they add up to what essentially is a staffing mandate for us to increase the definitions in this Bill. There's a lot of testimony that states that it's overly broad. It's really, really difficult to implement. The requirements placed on retailers are very difficult.

There are some amendments put in some of the testimonies that I think would be helpful. But overall, I think we should reduce the regulatory load and that will help us not have be rated the worst state in the nation for business regulation.

So anything we can do to improve that and not make it worse every year would be very appreciated. Thank you very much.

Okay, thank you very much. Next up, Carlos Gutierrez, Consumer Healthcare Products Association. Opposition Andrea Wong, Counsel for Responsible Nutrition, in opposition. Andrea, are you present on Zoom? Please proceed. Hi. Thank you.

I'm Dr. Andrea Wong, SBP and Chief Science Officer for the Council for Responsible Nutrition, the leading trade association for dietary supplements and functional food foods. As a scientist and a mother of a young daughter, I strongly sympathize with anyone impacted by eating disorders and respect the intent of this proposal.

Unfortunately, this Bill not only fails to help those suffering from eating disorders, but creates a false sense of hope. From a scientific standpoint, this Bill erroneously associates muscle building and weight loss dietary supplements with eating disorders among underage individuals despite no scientific evidence of a causal relationship with.

Rather than addressing the root causes of eating disorders, this proposal limits access to legal FDA regulated products for all consumers. It creates major compliance burdens for Hawaii's retailers, including store reconfiguration and training employees for age verification. Additionally, enforcement could result in a large financial cost burden for taxpayers.

Similar bills have been vetoed in other states and CRN is engaged in active litigation against New York based on First Amendment concerns. Legal, respectfully urge you to oppose SB2106. Thank you for your time.

Okay, thank you very much. Next we have Robert Windsor, Marriott, American Herbal Products association, opposition. And I see on Zoom we have Kyle Turk of Natural Products association in opposition. Please proceed.

You want me or Marriott to go first.

mention National Products Association, Kyle Turk. If you're not, then don't speak.

Well, that would be me, so I'll go. So great to meet everyone. I just want to be very clear. Dietary supplements are regulated extensively by the Fda. FDA writes the rules, inspects factories, reviews labels and ads. It collects safety reports. It can even recall products, seize products, and even shut down companies when necessary.

If something is unsafe, the FDA has more than enough power to deal with it, and it uses that power. So the idea that this Bill is filling a gap just isn't true, because there isn't a gap. We've seen supporters of this legislation say that eating disorders are directly correlated to the use of dietary supplements.

And that's a serious accusation. But thankfully, the FDA has never found any sort of indication that any dietary supplement causes an eating disorder. And if that were the problem, it would be found in.

Thank you very much, Mr. Turk. Next we have Coco Kim in support. Coco Kim, are you present?

I stand.

You sign your written testimony. Thank you. Sophia park in support. Are you present? Sophia, you also stand your written testimony. Thank you. Maya Maxim in support. Anybody else wishing to testify in SB2106? Ellen? Oy. Come on up.

Eleanor Y. I think I'm giving comments mainly. Anything you take into your body affects your whole system. And I was told 2005 that the medications given to us was killing us 25 to 35 years younger.

Anything you take in, whether you breathe it or what, Herbal I support more, but I remember my daughter being criticized by her doctor for being overweight. It's the doctors that need to be educated and the peer pressure. It's not about taking pills. It's about how society treats them.

And she's still overweight, but has a lot of anxiety, but she's cleaning up the accounting systems.

Zero, terrific. Anybody else wishing to testify on SB2106?

Okay.

Sure.

Sure.

Okay. Senator Favela has a question. To whom?

I just want to give a question. I know the ones that stand there on their testimony. Are you guys in high school?

Iolani. I think these are all Iolani students.

Okay, that's good to know, but I just wanted to make sure what the gentleman was saying to me. The area should be more regulated. Yeah. Okay. Thank you. Chair.

Thank you. Okay, anybody else switching Testify on SB2106. Okay. Members other than Senator Fevella, any questions? Okay, moving on. Okay, so next up is SB2108, which is, excuse me, relating to jurisdiction. First up, Leana Le of OHA in support.

McKenna Woodward and the Office of Hawaiian Affairs stands on its written testimony support.

Thank you very much. Next we have Darcia Forrester, Office of Public Defender, in support.

Aloha, Deputy Public Defender Darcia Forester. I'm here in my capacity as the supervisor of our Juvenile Division. And I apologize, I did submit late testimony early this morning. So thank you for receiving it.

I just want to highlight, because we did have comments on different parts, but I just want to highlight that we did submit some proposed changes to subsection J so that we are using the correct language that's used in the juvenile court system. We don't call them cross criminal proceedings. We call them proceedings for law violations.

I just want to make sure that you understand why we change that. And if you have any questions, I'm available. And that's all I've got for today. Thank you.

Thank you very much. Next we have Daniel Hugo, prosecuting attorney, providing comments. Prosecuting attorney, are you on zoom? Okay, we're moving on. Teresa Kominos, Human Rights for Kids, in support. Teresa Kominos, please proceed. You have one minute.

Good afternoon. Chairman of the Committee, Teresa Kominos, on behalf of Human Rights for Kids in support of 2108. This measure would ensure that a child's lived experience is considered by a court before their case can be waived to adult court by adding additional factors for the court to consider at a waiver hearing.

That would allow the court to consider a child experiences more extensively and in a trauma-informed way before making such an important jurisdictional decision. Research done by Human Rights for Kids has shown that nationally, more than 70% of children tried as adults experienced both physical and emotional abuse prior to their offense. Another 45% experienced sexual abuse.

The average Adverse Childhood experience score was 6.31 out of 10, and the average onset age of abuse was 6 years old. Further, approximately 30% of the people we surveyed who were tried as adults for crimes they committed as children were trafficking survivors.

Type of trauma impacts a child's brain development, particularly the prefrontal cortex, which means that beyond what we already understand about developing adolescent brains, for kids who've experienced significant trauma in their homes and communities, their brain development has been further impacted in a way that includes.

Thank you very much. Okay, anybody else wishing to testify on SB2108 Members, any questions? Okay, moving on. SB2111 relating to licensure. First up we have Young M. Wilson from DCCA Marriage and Family Therapist Program in opposition.

We stand on our testimony in opposition.

Thank you. Next we have Adrian Stinardo, DCCA Mental Health License and Social Workers Program in opposition.

Good afternoon. We also stand on our listening testimony in opposition. And we're available to answer any questions you may have.

Thank you. Next we have Christopher Fernandez, DCCA Board of Psychology, providing comments.

Christopher, thank you. Christopher Fernandez, Executive Officer of War Psychology Board is offering comments and understanding this.

Thank you very much. Next we have John Kurmitz Kaiser providing comments. John, please proceed.

Afternoon, Chair, Vice Chair, thank you for opportunity to testify. Kaiser stands on his testimony expressing concerns. Thank you.

Okay, John, could you please, although I know who you are, please identify yourself.

John Kiramitsu for Kaiser Permanente.

Okay, thank you.

Standing on our testimony. Thank you.

Thank you very much. Next we have Dr. Lichten, Hawaii Psychological association in opposition. Randy Perera of HGA providing comments. Anybody else wishing to testify in SB2111? Okay, Ellen, come on up.

Ellen. Ay. Regarding. Yes. Taking the courses. Yes, they definitely should take domestic violence courses because they have no idea what people are going through. They're doctors, they're hired, socio economically, you know, so just. That's my understanding.

Thank you very much. Okay, anybody else wishing testifying? SB 2111 seeing none. Members, any questions? Okay, seeing none. Moving on. SB2047 relating to pharmacy benefits managers. First up, we have Dr. Lewin in support.

Madam Chair, Vice Chair, I just want to make a comment or two about this. It's a very important issue for local pharmacies and for rural areas in General. We think that this safeguards around this kind of issue of this thing, maximal allowable cost issue and so forth, will help stabilize independent contracting pharmacies and the beneficiaries there.

And so we respectfully ask for your support of this Bill. There's a lot of detail in our testimony. We stand by that. Thank you.

Thank you very much. Next we have Insurance Division, State of Hawaii providing comments.

Afternoon Chair, Vice Chair Justin Chu for the DCCA.

Okay. Next we have OHA for Liana Lay providing support.

Well, hello, Chair, vice chair, Members, McKenna Woodward, the office of Hawaiian Affairs.

Supports this measure and stands on his written testimony.

Thank you very much. Eric Abe, Hawaii Primary Care association, providing comments. Corey Sanders, Hawaii Pharmacist association, in support. Corey, are you.

We'll stand on our.

Thank you very much. Next we have Lori of Watanabe Inc. On behalf of Cbs, providing comments. Lori Lum. Okay. Ronald Taniguchi in support. Anybody else wishing to testify on SB2047 Members, any questions? Okay, seeing none. Moving on, SB847, relaying to psychologists. First up, we have Dr. Lewin in support.

Thank you, Madam Chair, Vice Chair and Members. I'm gonna speak to this a little bit because it's such a controversial topic. I know my fellow physicians in the ama, the Hawaii Medical association, psychiatrists, colleagues, all think this is a dangerous step forward.

This is the first time I've seen this measure, though it's been raised many times where the psychologists have to take a master's degree in a limited pharmacopoeia. They're supervised by psychiatrists. And that supervision creates what I think is a healthy thing, which is a team led by the psychiatrist to manage the psychologists who want to do this.

Very few psychologists are going to pursue this because there's medical malpractice risks. There are other issues associated with it. But I think this measure is thoughtfully done, trying to give the psychologists a chance to move this. It's really a way to extend our limited workforce in mental health, and it's appropriate that it be supervised by psychiatrists.

Thank you very much.

Thank you very much. Okay. There are a number of people, and I know Mayor Kawakami has a meeting, but he is also monitoring this. So when, when Mayor Kawakami is available on Zoom to just let us know. Otherwise, I'm going to keep reading the list of individuals. DCCA Board of Psychology providing comments.

Thank you. Chair the board.

Thank you. Next. Again, we said Mayor Kawakami, county of Kauai in support. He's going to be present on Zoom Later on. Steve Tevez, Hawaii Mental Health Coalition, in support.

Good afternoon, Chair, vice chair, Members, Steve Tevis for the Mental Health Coalition. Real quick, as you do at the Legislature, I would like to adopt Dr. Lewin's confidence comments as my own and with support. Thank you very much.

Thank you very much. Next we have Joe Velasquez of Inetmed RX2 in support. Joe Velasquez, are you present? Please proceed.

Yes, I am. Greetings, Madam Chair, Vice Chair, Members of the Committee. I'm a prescribing psychologist practicing in the state of New Mexico. I've been prescribing since 2015, and I would just like to add to my written testimony, which I stand by in support of, of this measure.

I think it's wonderful opportunity for Hawaii to be introduced to the benefits of extending their workforce under the supervision of practicing psychiatrists in the very structured environment of a federally qualified healthcare agency. We are very well trained, 450 didactic hours, one year residency, two year fellowship and a national examination.

And I think with creating the team, as the other gentleman has said, I think it would be a great benefit to the people of Hawaii. Thank you so much for the opportunity.

Thank you very much. Next we have Dr. Blaisdell Brennan of HPMA in opposition. Hey, Dr. Brennan.

Vice Chair. I'm Dr. Blaisdell Brennan, native Hawaiian psychiatrist, graduate of the John Byrne School of Medicine, who spent most of my career at the Rural Health center at Waianae. I've worked closely with our colleagues who are psychologists and think they are wonderful at counseling.

I've also worked closely with our colleagues who are advanced practice nurses, and they're troubled by this Bill. In fact, it was the nurses who brought up to me that when APRNs are added to psychiatry, numbers actually needs are met on all islands.

I'd like the Committee respectfully to consider the legacy of John Burns, who believe that we can have doctors born and raised in Hawaii who can serve our people.

Because I also stand for the 30 residents who are now training in psychiatry and who are worried about the downstream effects of this Bill on their profession and their ability to work. I'm so grateful for this time, and I'm willing to answer any questions.

Thank you very much for your service. Dr. Blazon. Vernon. Okay, now we have Mayor Kawakami. Mayor Kawakami, please proceed.

Thank you, Chair. Vice chair. For the record, Mayor Kawakami and I just want to thank this Committee and the introducer of the Bill for taking this up. I stand in strong support of this measure. I'll stand on my testimony. But I also want to add that. You know.

I have taken a look at the testimony in opposition, and I'm not going to argue the points because they know that realm better than I would. But all I can say is that this issue is very near and dear to my heart.

Just in my own family alone, I can count about 10 people that I'm either related to or close enough that I would say were related that have sadly died by suicide.

And I'm not saying that this measure would have saved them, but all I'M saying is that for rural communities, Kauai being the smallest community in the state of Hawaii, something like this, I have to believe, would help. Thank you very much, Chair.

Thank you very much, Mayor Kawakami. And I see Dr. Ignacio. Dr. Ignacio, please proceed. In opposition of Hawaii Medical Association.

Aloha Chair and vice chair Committee Members, I'm Dr. Elizabeth Ignacio, a Maui physician speaking for Hawaii Medical Association. You have our written testimony. And I'd like to add Hawaii physicians are opposed. This is not for historical reasons or perceived old scope feuds. We do have serious concerns for fragmented care of behavioral health.

Hawaii needs a balanced, holistic approach to mental health care, especially for our keiki, for our kupuna, for our pregnant persons. The approach should value the full strengths of the mental health care team and emphasize collaboration, not fragmentation or piecemeal quick fixes.

We do encourage the state to increase investment in proven solutions, including shared infrastructure, so that all healthcare professionals can communicate and coordinate our care and safely support patients together across settings and in all of our islands. Mahalo, Committee for the opportunity to testify. I'm available for questions. Thank you.

Okay, thank you very much. Next we have PI' Imauna Kakele of Hawaii Psychiatric Medical association in opposition. Please proceed. Come on up.

Madam Chair, Vice chair, Members of the Committee, My name is Pimanukakli. I am a psychiatrist training in addiction psychiatry at the University of Hawaii. I'm here representing as the President of Hawaii Psychiatric Medical association, standing on my written testimony in opposition for this Bill.

We at Hawaii Psychiatric Medical association feel as Dr. Ignacio and Dr. Blazo have already stated, that there are other proven solutions to to address the mental health crisis in our state. Appreciate what the Legislature has done so far.

I personally am actually a recipient of the Hawaii Education Loan repayment program, and I plan to stay in the state for the rest of my career. I know there are other Members, other psychiatric Members in my community that are also taking advantage of that plan.

Would like to encourage the state to look at expanding telehealth access and looking at the collaborative care model as other proven solutions for this issue. Thank you.

Thank you very much. Okay, next we have Hawaii association of Professional Nurses in opposition. Is anybody on zoom from Hawaii association of Professional Nurses? Okay, moving on. Brian Talisayan, Mental Health America of Hawaii. And support Rachel C. Layu, Hawaii Council on Child and Adolescent Psychiatry Psychiatry, in opposition. Okay, Dr. Mark Rapoport. I see that you're on Zoom.

American Psychiatric association President elect, in opposition. Please proceed.

Thank you very much. Good afternoon, Madam Chair and Members of. The Committee, I'm Dr. Mark Rapoport, the President elect of the American Psychiatric Association. On behalf of the APA and as practicing psychiatrists, I want to urge the Committee to oppose sbe. Let me tell you a couple of reasons.

One is I am a fellow of the American College of Neuropsychopharmacology. And the report discussed there was written in 1998, and it was commissioned to address both the strengths and weaknesses of the 10 person Department of Defense Psychopharmacology demonstration project. The implication that the American College of Neuropsychopharmacology supports this Bill is spurious.

The second point is patient safety. Physicians and Psychiatrists spend over 12,000 hours in training. They see supervised four years worth of patients.

Thank you so much, Dr. Rappaport. Okay, we have your written testimony. Okay, next up, we have Melissa Pavlicek in support. I see Melissa on zoom. Please identify yourself and proceed.

Aloha, Senators. My name is Melissa Pavlicek. I'm here today in my personal capacity. This has become a very important issue to me and my family. I grew up in Maui. I lost two first cousins to suicide. Neither was seen by a mental health professional in time to save their lives. That's a reality for too many families.

Care is hard to access, delays are deadly, and people fall through the cracks. This Bill removes one barrier. It expands access to timely mental health care and gives patients a better chance to get help before it's too late. Every life matters. Please pass this Bill.

Okay, thank you very much. Next, we have Leila Kratovic in support. Please proceed.

Aloha chair, Vice chair. Members of the Committee, my name is Leila Kratovich. I am a, uh, clinical psychology graduate student and a student Member of the Hawaii Psychological Association. Um, I'm here to strongly support the Bill because I believe it increases access to underserved populations in state priority, particularly rural communities.

I believe that it could greatly reduce the wait times to access proper care. And I thank you for hearing this measure. I'm here for any questions.

Okay, thank you very much. Next, we have Philip Hughes providing comments. Philip Hughes, are you present?

I am. Thank you.

Please proceed.

Good afternoon. My name is Dr. Philip Hughes, and I'm an assistant professor in the School of Pharmacy and Pharmaceutical Sciences at Binghamton University. For the record, this testimony is my own and does not necessarily reflect the opinions of Binghamton University or the State of New York.

As a health services researcher, I've spent the last four years studying patient outcomes related to prescribing psychology. I've submitted Written testimony, which I stand by. And I want to highlight a few brief findings.

First, evidence shows that psychologists are safe prescribers, having safety and efficacy outcomes similar to psychiatrists over a 20 year span in New Mexico, in Louisiana. Second, prescribing psychologists improve population mental health, reducing suicide rates and improving access to underserved populations.

In conclusion, the current evidence shows prescribing psychologists are safe and an effective means to address population mental health concerns. And I'd be happy to answer any questions you may have about research on this policy.

Okay, thank you very much. Next, we have Gerald Bush in opposition. Gerald Bush, are you present on Zoom?

Not, President Zoom Chair.

Okay. Next we have Judy Steinman in support. Are you present on Zooms? Judy, please proceed. You have one minute.

Okay, mahalo. I just want to say this is not a quick fix. We have been prescribing in other states and at the in the military for. 30 years and we save lives. We have contributed to the decrease in. Suicide rate by 5 to 7% in the states that have been prescribing the longest.

I lost a friend to suicide from Hawaii island last year. And we need to stop that. We need to give people the opportunity. To have access to care. I stand by the rest of my testimony. I'm here for questions. Mahalo.

Okay, thank you very much. Next we have Paulette Phillips in support. Paulette Phillips, are you present on Zoom?

Not present in Zoom chair.

Okay, next we have three other individuals all in support. Excuse me. 345678. Nine individuals in support who provide written testimony. Fourteen individuals in opposition. 12345 6th789101112. And another 13 individuals in opposition.

And 123 4th, and another five individuals in support providing late testimony. Anybody else wishing to testify on SB847? Okay, Eleanor Y. Please. And then you can come up next, Eleanor Y.

Who has been lied to for 40 years that I am not have bipolar 1. This is lies because of cultural competency. People do not understand women, apparently. And psychiatrists like Dr. Akaka and Nami. Hawaii has brought this up 20 years ago. And Dr. Akaka became the head of American Psychiatry Psychiatric Association. I'm opposed. This is all bullshit.

The chemicals affected my liver and kidneys and damaged it. I had to find out from herbal supplements from a Chinese therapist to find out. But I was told in Cambridge, Massachusetts, go back to Hawaii and see a Chinese therapist. She will cure you.

And nine months, say, against the medication. Thank you. Definitely. Okay, come on. And the 440 other psychiatrists that saw me. Okay, thank you. Come on up. Please identify yourself.

Doreen Fukushima, Board certified psychiatrists have a prior practice in Pro City. I apologize about your experience as a psychiatrist. We have a stigma and we have medications that are also stigmatized. Opposition, opposition. And the reason is because these medications are deadly.

I understand the risk of suicide, but that is not the only thing that happens with our medications. Nobody wants to talk about tardive Dyskinesia, which is a permanent movement disorder, AKA seizure, diabetes, death. These all come from our medications and we have years of training behind them. And we make mistakes too. We acknowledge that.

But when you go and get a crash course, would you trust your loved one to go get that crash course medication or from one of us that has done this for years?

He said at least we know where to go and look when we have to research this and we collaborate with our colleagues to make sure we do the best we can. In Hawaii we have limited resources, but just gaining access is not the cause. It will cause more problems than it's going to be worth.

Thank you for your time.

Angela Melody Young, please proceed. You have one minute.

Aloha, Angela. Melody Young testifying on behalf of cares wishing to comment. So as chair of a statewide organization legislated into law by Hawaii Revised Statute Chapter 8, Hawaii Children and Youth Day, I've had to help provide instruction for the last four years to 100 students, teens and youth about mental health.

And a lot of what they are concerned with with their peers are for example, gang violence and how it leads to diminishing a student's mental health. And also when I talk to University of Hawaii students and students, I counsel combating suicide, battling anxiety disorders.

I have learned that sometimes medication isn't the best solution, especially for faith based practitioners who believe in more faith based ministry approaches.

Thank you very much, Angela. Anybody else wishing to testify on 2847? Excuse me, not 2847. Okay, come on up on SB847. Okay, identify yourself and you have one minute.

Hi, my name is Dr. Kyung Moo Kim. I'm one of the psychiatry residents training. At the University of Hawaii in the General Psychiatry program. And I'm like to strongly oppose SB847. And as a trainee I'm just learning about the intricacies of neuropsychopharmacology.

And while there are awesome benefits, there are awesome side effects to be aware of as well. And as Dr. Fukushima mentioned, crash course is not sufficient to give training and to monitor these patients adequately in terms of all the metabolic and fearsome side Effects that not only affect the mental, but also physiological.

And to that end, I'd like to heavily oppose SB847. And I've also provided written testimony on which I stand. Thank you so much.

Thank you very much. Okay, anybody else switching to testifying? SB847, seeing none. Members, any questions?

Okay, Senator Padela, I guess I don't know your name. What was her name?

Can you come up with Dr. Fukushima?

Dr. Fukushima. Thank you. No, no, no, no, no.

He doesn't want to talk to me anymore.

Do I have that kind of reputation? Anyway, the reason why I wanted to talk to one of the doctors that is opposing. Can you. Can you understand why, I guess us legislators and the community is trying to find different ways of trying to help people that have mental illness? Absolutely.

And what is the main thing that you know, since you're in the profession that you know that is a problem with mental illness?

Well, I guess my colleagues would probably understand this. A big part of it is insurance companies. We have to do a lot to get the right kind of medications for patients.

If it costs more than a penny, and that takes up hours of our time, I have to hire staff just to make phone calls and stay on hold, fill out prior arts to save people's lives.

And I just want to get to as many as I can, but I can't do that because I've got tons of paperwork and phone calls to make.

The reason why I asked that is because from the time I got into this building, we know mental illness is very serious. And I brought up previous testimony of my family.

But the reason why I say this is because they don't have access to, like how you just said you have a lot of paperwork, you want to see more patients, but because you cannot see more patients because of the paperwork.

So we had this come up, and I'm not sure how far it went, but even sampling with ketamine, I don't know if you guys ever looked into the treatment of ketamine treatment for patients. Ketamine?

Yeah. I used to give esketamine. It's a nasal spray form of it. And unfortunately, insurance companies stopped paying for it even though it did wonders.

So that's the reason why I bring them up, because I had a Bill to have the insurance companies, including Kaiser and other insurance companies, to cover ketamine, because, like I said, I had a family Member. I went through the whole treatment with them, turned their life around.

I don't know all the mechanisms of why, but it's a Very successful drug. And you know, we're experiencing a lot of these kinds of stuff. But I don't know why we're not really exploring or slowing ketamine, especially when we have the highest rate of teen suicides in the nation. Very true.

I actually offer a treatment called transcranial magnetic stimulation that is non medication based. And I'm one of 1,000 providers in the entire world that does it. There's maybe four other providers on this island that do it and it's non invasive and it's improved in 15 and up. I have done it even younger than that.

And the experiences and the outcomes are incredible.

Is it covered?

No. How sad. That's what's sad. Even though it's been around for years.

To me, I think the problem here today is not just about having this access or giving this access to patients is having the access to have these medical companies or these insurance companies don't pay. God.

If the doctor said that this is what their patient needs, then they should cover it because we paying for the, for the, for the. I mean we're paying for the coverage to tell us what we can and cannot take. And as to me is wrong. So we need to make some changes too. Appreciate. Yeah. Thank you.

Okay, anybody else wishing to testify on SB 847 or questions? Thank you. Okay, moving on. SB 2861, relating to Office of Wellness and Resilience. First up, Director Yamani providing comments. Meredith, are you present on Zoom? Oh, Director, come on in. So, you're resting on your written testimony. Okay, thank you very much, Director. Next, Tia Hartzell.

Come on up. Director of Office of Wellness and Resilience providing comments.

I'll just stand on our testimony. Thank you for introducing and I will be here for comments. Thank you.

Thank you very much. Next, we have Michelle Bartel, Aloha United Way, in support. Judith Clark, in support. Anybody else wishing testify on SB—Okay, come on up, Ellen.

Ellen Awai on SB 2861. Why does DHS have so much money left over for needy families? They should have been using it but you have incompetent state workers in there not doing their damn job. Office of Wellness and Resilience supposed to be reviving the peer specialist program, not doing all this other stuff because how come the state not doing their job?

Thank you very much. Okay, next up, anybody else wishing to testify on SB 2861? Okay, come on up, Dr. Lewin.

Thank you, Chair, Vice Chair. Shipta did not have time in the flurry of 40 bills this weekend that we were reviewing to make a testimony. We strongly support this.

Thank you. Thank you very much.

Thank you very much. Okay, anybody else wouldn't testify on SB 2861? Members, any questions? Okay, next up, SB 2701. Jason Chang, are you present on Zoom? Okay, this is the one you're supposed to testify to. Okay, first up, we have Jack Lewin, State Health Planning and Development Agency, in support.

Stand on our testimony. Thank you very much.

Okay, thank you. Dr. Kimo Alameda, Mayor, County of Hawaii. Oh, I see Jason Chang. Can we have Jason Chang, come on up.

I'm back. Thank you. So, Chair, we are in support of the bill. We stand behind our written testimony and I'll just provide a couple updates. So Queen's board, we've just allocated the first $30 million towards our part of the development. We have done an RFP. It's out for the architects so we can select the architect.

We've done that in partnership with the state procurement process and teams built from Kona, HHSC in Queens; we convened for a day last week to start working on timing so that we're synchronized in terms of the major milestones.

So we're excited and appreciative of both HHSC, Kona Community Hospital, the Governor, and then all the legislature that represent the Big Island. So thank you.

Okay, thank you very much. Next we have, like I said, Dr. Kimo, Alameda in support. Holeka Inaba, County Council, District 8 in support. Clayton McGhan, West Hawaii Region of Hawaii Health Systems Corporation in support. Clayton, please proceed. You have one minute.

Aloha, Chair, members of the committee. My name is Clayton again CEO of the West Hawaii Region Hawaii Health Systems Corporation, and I'm testifying in strong support of SB 2701. West Hawaii is facing significant challenges in access to care. As our population grows, ages and shifts northward, Kona Community Hospital is operating at capacity, leading to longer wait times and limited access to special services.

It many outpatient services remain spread across aging facilities that can no longer meet the needs of our community. SB 2701 supports planning and early development of a new outpatient care center on land donated by the Queen's Health System.

Adjacent to its new hospital campus, this modern facility will consolidate outpatient and specialty services, reduce wait times, improve patient access, and keep care closer to home. This project provides immediate solution while long term hospital planning continues and will strengthen our ability to attract and retain health care professionals in West Hawaii.

We respectfully ask for your strong support of SB 2701. Mahalo for the opportunity to testify, and I also submitted written testimony.

Okay, thank you very much. Next we have Hawaii Health Systems Corporation in support. Edward Chu, please proceed.

Good afternoon, Chair, Vice Chair, members of the committee. Edward Chu, President and CEO for Hawaii Systems Corporation. I'll stand on my testimony: strong support.

I did want to propose a technical amendment to the bill so that it changed the language in section 2 to match the funding that's in the currently in the governor's administration budget package from general funds of the state to general obligation bond funds. I'll be happy to answer any questions. Thank you.

Okay. Okay, thank you very much. Next we have Kamakana Kaimuloa of UPW in support. Glenn Kagamida in support. It's getting late. And Leakey in support. Anybody else wishing to testify on SB 2701? Members, any questions? Seeing none. Okay, can we move on to decision making?

Sure.

Okay, so for the first one, SB28, you have the voting sheets.

I got them right here.

So for SB2701, I'm going to defer this to the next hearing. Okay. I want to explore more the potential of a 2701 the first. 2087-2087-2087-2887.

Yeah. Does not repeat. Right. Okay. 2087.

2087. I'm going to defer this to sure. The what else? No, no, I did this. Okay, just go.

We're good.

No, cuz we got 13 minutes.

Yeah, let's go. Okay, so 27 times 30.

Okay, so so defer decision making for 2087 through February 4th at 1:00pm room 225. Okay. Next up, SB2089 relating to mental health. We're going to pass this with amendments. We're going to have a two year implementation date to allow for CMS administrative rules. We're also going to put in technical non substantive amendments.

Need for clarity and consistency and put in a detective date of January 30, 2050. Requires a lot of discussion.

Oh yes.

Any comments, questions, concerns? Seeing none. Vice Chair for both pass with substantial amendments.

Okay. Recommend.

Pass with substantial amendments. SB 2089.

Okay. Recommendation for 2089 is the Senate draft 112 year delayed implementation. A defective date as well on the measure. Chair and Vice chair vote aye, anybody who is present here voting with reservations or no. Good. All right. Seeing none, your recommendation has been adopted.

Okay. For SB2106, Chair's recommendation is to pass this with amendments. We are going to change line eight, page one to restrict supplements. So those marketed or labeled for weight loss and muscle building. We're also going to put in a defective date of December of January 30, 2050 to encourage further discussion to see whether or not. Yeah.

Whether or not more changes need to in order for this to be enforced. Any comments, questions, concern? Passed with amendments.

Chair, I'm gonna be going WR because I have concerns about retail.

Yes, I understand.

So work in progress. Okay. Defective date. Noting the redefinition. Passed with amendments. Besides my WR, anybody else voting for the reservations or. No, seeing none, your recommendation has been adopted.

So for SB2108, I'm gonna pass this with amendments. We're gonna accept the office. Office of Public Defenders proposed amendments. Any comments, questions, concerns? Seeing none. Sheriff Vice Chair for the vote. SB 2008, pass with amendments.

Okay. Recommendation: Pass with amendments. Adopting the amendments offered by the Public Defender. Public Defender's office. Anybody voting WR? No, seeing none, your recommendation has been adopted

For Senator, can you just clarify that? It's SB 2108. Oh, I'm sorry.

Oh, 2108. SB 2108.

Yes. Pass with public defenders. Okay. SB 2111. Okay. Chair's recommendation is to defer this based upon testimony that continued. There's already a requirement for continued education for all of these licensees. So we're moving on. Okay. That includes domestic violence and other violence training. So for SB2047, Sheriff's recommendation is to pass this with amendments.

We're going to add in a section with an appropriation section with a blank appropriation to DCCA Insurance Division to effectuate the Bill. We're also going to add in a defective date of January 302050 to encourage further discussion and specifically to determine how much Insurance Division needs to implement this Bill. Any comments, questions, concerns? But pass with amendments.

Okay. Pass amendments. Senate draft, one blank appropriation, defective date. Any noting Members of the Committee here? Any notes of WRs? Seeing none, your recommendation has been adopted.

Senator, can you go back to 21?

We're going to defer that one. That one's got deferred. Why do we need to go back? Oh, sorry, sorry. Need to talk directly. Okay. Okay. Now for SB847. Chair's recommendation is to pass this with amendments. We are going to be update sections 3 and 5 to reflect recent 2025 amendments. We're going to add in technical, non-substantive amendments.

Need for clarity and consistency. We're going to note that since the discussion of prescribing psychologists has occurred for over the past 10 years three other states have passed this with no substantial changes. This particular Bill is more than a conversation crash course. It requires the collaboration that's already being effectuated with the with us with a licensed psychiatrist.

And there has been no showing. New Mexico has had this for decades. So has the military. There has been no showing of any increase malpractice because of the psycho of prescribing psychologists.

And I'd like to point out what Mayor Karl Kami who was our colleagues way back when it was first originally that he had severe doubts about prescribing psychologists.

And for him who has had all the resources in the world like he told me, to be able to try to help his family and those resources continuing to fall short for him to change his mind to not fully support a Bill that he had severe doubts about shows how in the past 10 years we have not despite loan implementation, despite incentives of the psychiatric Department, we have not provided enough mental health services for the state of Hawaii and for those reasons to pass with amendments. Any comments, questions, concerns?

Just quick comments. I was actually chair with my former vice chair Derek Kawakami. We've seen this issue for years. Just one of I too was with Mayor Kawakami originally and have come to my position.

I guess the hardest thing I'm having a hard time reconciling is the very same arguments were used when Senator Ross Baker extended it to APRNs. And now it's being proffered in front of the Committee that things are better because of APRNs. And so I don't see this as a crash course.

I see it as you have to have a psychiatrist relationship. And I think that it provides a structure to where we can continue to work on this to provide mental health resources especially in the rural areas.

So yeah, and we keep seeing the same can testimony regardless of how much we made restrictions on the Bill. So any comments, other comments, questions, concerns? Seeing none. Vice chair will vote Pass with amendments.

All right. Recommendation is to pass with numerous amendments noting the Members of the Committee. Are there any WRs or no? WR. Okay, we got hold on a second there. Okay, anybody else going once, twice, if not your recommendation has been adopted.

Okay. And we have one more Bill relating to. No, two more.

Two more. Yes, we got two more.

Okay. For SB2861. Chair's recommendation is to pass with amendments. We are going to note to add the additional purpose to ensure needy families that are not Medicaid eligible to to receive wellness benefits.

This Bill is meant to is not meant to supplant the existing Medicaid benefits for wellness checks, which was my Bill before, but basically to increase the number of needy families who will get such benefits. Technical, non substantive amendments needed for clarity and consistency.

And on Section two, we're going to explicitly allow OWR officers, surveillance and resiliency to use these TANF funds for the CACO pilot program. And yes, we acknowledge what Ellen Awai has stated and basically what I had requested, DHS to go spend this money. And this is part of the money we're spending. Okay. Any comments, questions, concerns? Passed with amendments.

Okay. Recommendation on 2861 is to pass with numerous amendments. Members of Committee, any WRs or Noes, seeing none, your recommendation has been adopted.

SB2701 pass as is. Any comments, questions, concerns?

Okay. WRs or Noes. If not your recommendation has been adopted.

Okay. That's it, right? Yep, that's it. Okay. We are adjourned. The HHS 110 calendar, SB389.

We had previously passed this Bill. The request is to reconsider and defer because APRNs are already covered. Any comments, questions, motions, concerns? Saying none to reconsider and then defer.

Okay. Recommendation of the Committee. The first motion is to reconsider its previous decision on this measure. Anybody who wishes to vote no? WR? Seeing none of the Members present. Your recommendation to reconsider has been adopted. Now you make the motion to defer.

No. Well, we're just deferring it toward that.

No, I don't. But you think reconsideration motion, you adopt it, then.

Move to the U.S. yes. Got it. Bye Bye. You are deferring it. Thank you.

And now we are adjourned.