Senate Standing Committee on Health and Human Services

Calling the 1 o'clock HHS LDT joint calendar. We have Chair Elefante present as well as myself. And we have Senator Fevella for as Member of HHS. I would like this meeting is being streamed live on YouTube. Hold on, Monique. Can you guys help? I did not know we had a number of deaf bills.

I mean blind bills can. Excuse me, I'm sorry. Okay. Yes folks, we have number of blind individuals here. Can we accommodate them? Can we accommodate the. Do we have enough room for? We have a couple more.

You know, Monique, I'm sorry and I know I called it in, but we should have accommodated the blind before we had seated the general public. And I apologize. I apologize folks. Do we have enough? Okay.

And I also have Vice Chair McKelvey with me. And are we able to accommodate our blind Members constituents? Thank you very much, folks. Okay. And we also have Senator Lamosao here for LBT and Senator Moriwaki here also for LBT. Okay, now we're going to proceed. Thank you very much for accommodating our blind Members of the public. Okay.

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 p.m. Wednesday, Feb. 6 in Room 225. And a public notice will be posted on the legislator's website to facilitate this hearing in a timely manner.

We will be enforcing a one minute limit on testimony. I will be reading a list of individuals who submitted written testimony for each measure. We apologize that the closed captioning does not accurately transcribe the names. If you're interested in reviewing the written testimony, please go to legislators 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 reviewed them. So I encourage you to use your time to either add additional comments or you can stand on your written testimony. Thank you very much.

And my request is we are going to be hearing, as James Gastro knows, being a Member of the Deafblind Task force that there will be other bills that would be interested that the blind community will be interested in. My request is that you folks arrive on time.

I will do my best to have you folks see seated earlier than the General public so that we can accommodate you folks. Thank you very much. So first up we have SB 2281 relating to the use of artificial intelligence in health care.

First up we have SHPDA, Dr. Jack Lewin testifying for the State Health Planning and Development Agency in support. Anybody here from SHPDA? Okay, next we have, I see Lauren Kim here for Hawaii Department of Health providing comments.

Good afternoon, Chairs and Vice Chairs, members of the committees. Lauren Kim, the Planning and Policy Officer for the Department of Health. Happy to be here and as always, proud resident of Senate District 16. We're offering - it's the heart of Oahu. The Department offers comments.

We are in support of patients right to know when artificial intelligence is being used. But in lieu of standing up a regulatory program in an agency that still uses fax machines, we propose that healthcare providers be required to disclose the use of AI on their website and in individual private offices.

We think that will be much more expeditious and placing our trust in the highly self regulated healthcare industry. Thank you. I'm available for questions.

Thank you very much. Next we have Dr. Ignacio, Hawaii Medical Association in support. Next we have Paige Choy, Healthcare Association of Hawaii, providing comments. Paige, you have one minute. Please proceed.

Thank you. Thank you, Chairs. And we'll stand on our submitted comments. We've outlined some of our concerns with this measure. While understanding the intent, we agree that there should be transparency. We want to ensure that patients feel comfortable when they are interacting with our providers.

And we do look forward to the conversation and have suggested potentially a working group to work through a lot of these very, very complicated issues. Thank you.

Okay, thank you very much. Next we have, I see, Michael Robinson for Hawaii Pacific Health providing comments. Please proceed. Mr. Robinson, you also have one minute.

Good afternoon, Chair. Thank you, Chair Elephante, Chair San Buenaventura. We just provide comments. You have our written testimony. Our concerns really have to do in two areas. One is in position burden. We have taken - we basically have used AI to relieve physician burden. It's pretty benign right now. We use it for purposes of MyChart.

We also use it for note taking for physicians so that physicians don't have the additional burden of taking notes and having to do them afterwards. So to have a bill like this that would require notification in writing on top of that, we believe would negate those efforts. The second thing has to do with consumer burden.

The amount of notifications that a patient might receive as a result of this bill might have the other effect where they're getting too much information from us and might ignore what is truly important when we try and communicate. So you have our comments, but those are our. Thank you.

Okay, thank you very much. Next we have Hunter Young, State Government. ATA Action, providing comments. Robin Boyd of Tecknet providing comments. Shayla Taguin in support. Jacob Weinseck in support. Nancy Moser in support. Aretha Matsushima in support. Anybody else wishing to testify on SB 2281? Members, any questions? So, we also have Senator Kanuha also present.

I do have a question. Mr. Robinson or Ms. Choi, are you folks still present on Zoom?

Yes.

Okay. And we will address Mr. Robinson first and then Ms. Choi next, because he brought this up. But do you have any...

I understand that right now it's still pretty benign in HPHA, which is basically for note taking purposes, not being used for diagnosis and the like. But you heard that Department of Health position is that it's better to have these cons, the transparency of AI use in your website or in signage at the office.

Do you have any comments regarding that? And that same question will occur for you too, Paige.

Yeah, that would be something we would consider. I haven't had any conversations with DoH around this, but we would be open to entertaining that.

Okay, so instead of Department of Health having administrative rules, but basically requiring signage on your website saying that AI is being used for note taking or whatever it is you guys are using it for?

Yeah, And I'll defer to Paige. She can speak more broadly on this.

I understand. Okay. But right now you have no objection to that? What about you, Healthcare Association, Paige?

Yeah, I think one of the pieces of the bill that works really well is to have some recommendations for providers to have policies around the use of AI. And if those types of policies are something that DoH can work with us on, that we can have model policies.

And it's not just for hospitals, but also for clinics for independent physicians, for skilled nursing facilities. I think that's something we would be very interested in partnering with them on, because I think it would just go beyond disclosures about note taking applications.

But also as this technology goes forward, as more applications become available, then we can have an iterative process about how we're deploying it and how we need to disclose that to patients.

Okay, so here's the concern, and that's the reason I introduced this. And Dr. Lewin, maybe you can come on up, as my question is going to be for state policy. And by the way, Department of Health does not want to do administrative rules. Okay, regarding this so your SHPDA.

Because AI is so fast as far as implementation and as far as adoption, by the time we come back here next year, AI is going to be used. I suspect AI is going to be used for more than note taking. I mean, right now, a number of us, I mean, myself included would use ChatGPT.

I write down my symptoms and I see what's the potential illnesses that may, that may befall me regarding these symptoms. And then I check with my doctor, of course, after that. But that's the concern.

The concern is whether or not the patient should be informed of diagnosis or consequential decisions that are being AI produced rather than a physician actually consulting a specialist.

Yes. Madam Chair, that's absolutely - AI shouldn't be making the diagnosis, writing the prescription, or any of the decisions that are made. It can inform and, you know, I have recently I'm even considering bringing to Hawaii a virtual concierge type of person that really is an AI created being just on telephone voice.

But this person has access to all of your medical records. And then can answer - I mean, says, how are you doing with your new medicine? And remembers even if the last you had another conversation, remember that conversation. But person needs to know that is not a real person, because you cannot tell.

Okay, so you are in support of not necessarily maybe next year we may need to bring Department of Health in because it'll be hopefully we'll have more parameters nationwide and with the federal government saying that they want to go into this field also of trying to regulate AI.

But in the meantime, do you have any opposition to requiring physicians, healthcare providers, FQHCs to putting it on their website or at their offices as to what they are using AI for? Do you have any questions?

I would have no opposition to that. I think we should be notifying people if we're using AI, particularly if it's making, even getting close to advising around decision making of any kind. So, that's where we have to keep the human there. And we can go to the Starship Enterprise, right. We had Scotty and a nurse there.

We have people, even in that future world, they might have had great technology.

But computers didn't hallucinate in that.

Okay. Senator McKelvey.

We need the human being on the front line and we have to notify people if we're using AI for anything that gets close to that.

Okay, thank you very much. Any other questions? Thank you very much. Moving on. Next up, we have SB 2850. 2852. Yep, 2852 relating to civil rights. And I believe that's the reason we have our deaf partners here. First up, Hawaii State Council on Developmental Disabilities in support. Please proceed.

Aloha Chairs, Committee Members. My name is Che Silvert. I'm with the Hawaii State Council on Developmental Disabilities. We'll stand our written testimony in support. And we would just defer to Dean and the Civil Rights Commission for any comments or amendments to this Bill. Thank you so much.

Okay, thank you very much. Next, we have Heather McVay, Hawaii Civil Rights Commission, in support. Louis? Yes.

With the Hawaii Civil Rights Commission in support with comments. And we're here for questions. Thank you.

Thank you very much. Next we have Lewis Erczyk in support Hawaii Disability Rights Center. Next we have James Gashell, Hawaii National Federation for the Blind, in support. Please proceed.

Thank you. Thank you. Chair, vice chairs and Members. James Gashell here with the National Federation of the Blind of Hawaii. We strongly support this Bill. You know, the point of this Bill is access. Existing law makes physical access explicit. And, you know, the movement for physical access started.

I remember it when it started about 50 years ago, and that was when we were all about curb cuts. But the technology means we also have to have digital access. So this Bill is designed to make digital access explicit. Tech really can be an equalizer or it can be a divider.

It means access to get things done when it works, and it means a brick wall not to get things done or not to be able to get in when it doesn't work. So laws can help.

I remember when Senator San Buenaventura, probably in this room in the conference on the Bill about state technology, said, we've got a law. Well, we have that law, and it does work. I had a recent experience with this with the biosecurity form that we fill out when we come back to Hawaii, and they're just implementing that.

I can tell you this. If we didn't have a state law covering that, that wouldn't have worked for me. But when I came back from a European trip just recently, I was able to fill it out. And my wife, who can see perfectly well, didn't have to. Thank you. I did it.

So thanks, Senator, for making that law.

Okay. Thank you. Mr. Gashell, you need to wrap up. Thank you very much. Hope you pass the Bill. Okay. I appreciate that. Okay, I see. Okay. Marie Kouthoofd in support. Marie, I'm sorry if I screwed up your last name. Come on up.

You can hear me out. I'm not sure. Yeah. Aloha, everyone. Chair, vice chair and Committee Members. Thank you for hearing me. I am here in support of 2852. I stand on my written testimony, and I just.

I want to add, just shortly, on top of what Mr. Gashell had said, and this is gonna sound off the rails, but I was at the hairdresser the other day And I had talked. I was talking to her about a YouTube video that I absolutely loved. And she asked me what it was.

And I pulled my phone out and I flipped through with voiceover and I said, it's right here. And she said, oh, my God, is that a special phone? And I'm like, no, this is what accessibility looks right outside of the box. Right.

And so, like, Apple kind of really stepped out when the digital age came and we had accessibility right out of the box. In 2010, Hawaii state Legislature stepped it up. I get on my iPhone, I submit my testimony completely blind. I don't have to have my husband do it. Right. And so that's. I can be here.

And we have. When we talk about civil rights and barriers, we have on a 2019 census from AFB, there was 25,000 plus blind people in Hawaii alone. 18 and up is about 24,000. So when we block barriers, when we cut into digital access, that's happening today. We're talking about a major blocking. Right.

That is a 24,000 people are being blocked from being able to access.

Thank you very much.

Yes. So anyway, thank you for hearing me. And talking about my hairdresser. Thank you. But I am in support of. And I thank you for allowing me to speak.

Okay, I appreciate that. And Rodney, is this your. I see you also in support. And it sounds like you don't have to do anything for your wife.

Right.

The more access we give her. Next we have Tabitha Mitchell in support. Tabitha, are you present on Zoom?

Not present. Chair.

Okay. Jessica Faro Carcel in support. Donald Sakamoto, are you present on Zoom?

Not present either Chair.

In support. Annette Tashiro in support. And I see Kaili Swan. I see he is present on Zoom. Kaili, please proceed.

Assembly Chair, Vice Chair, my name is Kaili Swan and I'm a strong support of this measure because civil rights is more important for people with disparities. And I send strong support and I approve. And please pass this measure. And please, not the question. Thank you for listening to my testimony.

Okay, thank you very much. Kaili, are you on the airport?

No.

Yeah, it looks like it.

That's a train station. Yeah, for Japan.

Oh, train station. Okay, moving on. We have Joel Cho in support. And I see Mr. Fritz on Zoom. Please proceed. Peter.

My name is Peter Fritz. I'm an attorney. I've been an advocate for individuals with disabilities. I've written disability laws and I have drafting experience with the state as well as a private citizen. And I do support the intent of this law, but the execution is flawed.

The normal way that Disability Laws have worked since the Americans with Disabilities Act was passed is to say that there is discrimination against an individual with a disability, define the class, and then to offer guidance to businesses in regulations.

When this Bill was drafted, somebody didn't incorporate all of the points that are included in the Department of Justice's guidance to state and local businesses. There flaw are significant. There are no exceptions. Basically, this is the way it is. There's no exception for archived documents or other documents. I spelled this out in there.

The other problem is that there's no differentiation between a small business and a large business. They both have to comply at the same time. And not only that, the compliance is, I think, in July when it starts. Furthermore, everybody says, or at least some people are saying that we've addressed my comments last year regarding the standard.

This says that the standard will be the latest adopted standard by the Web Accessibility Guidelines Group. The latest standard, 2.2. The Department of Justice used 2.1. 2.1 was adopted in 2018 and wasn't brought in until recently with state and local governments until 2024.

So there needs to be a staggered point in time for businesses and consideration given to those particular issues. It shouldn't be the same for big business and little business. And furthermore, anybody who says there isn't a remedy right now for electronic and public accommodation.

Mr. Fritz, You've written lengthy written testimony, so thank you very much.

Well, I'd like to one closing comment. The proper way to do this, as I said in the conclusion of my testimony, is to delegate the authority to write regulations to the Hawaii Civil Rights Commission.

Yes, thank you very much. Thank you. Okay, next up we have, sorry, Ann Lempty in support. Virgil Stinnett. Are you present, Virgil?

No. Not present in Zoom, Chair.

Victor Ramos in opposition, Kristine Pagano. This is DCAB in support. Lynn.

Sorry, on behalf of DCAB will stand on our recent testimony and our suggested amendment to try and address some of those issues.

Oh, DCAB. Thank you very much. Next we have Christine. Excuse me, Linda Elento in support. Anybody else wishing to testify on SB2852? Okay. Seeing none.

This is Linda Elento.

Yes, Linda.

I am in support of this measure. I appreciate also Mr. Fritz's comments and my written testimony. I have asked for, or I've just provided two examples of negative experiences, including with Hawaiian Quests even going online. I gave an example of how it was still inaccessible to my son, in particular with disabilities.

So I appreciate your consideration of everyone's support on this Bill.

Thank you very Much. Okay. Anybody else wishing to testify in SB2852 Members, any questions? Okay, I do. Che Silvert, come on up. This is your Bill. Okay. You heard both Peter Fritz and DCAB. Basically. Are you, do you have any, any position regarding adopting DCAB's proposed amendments?

We would support all of DCAB's proposed amendments.

Okay, sounds good. And it, and I do agree with DCAB that a lot of what it is that Peter Fritz is stating should hopefully the concerns are addressed there. Any other comments, questions concerning? None. And I'm going to move it on to my co chair for the next hearing for the next Bill.

Thank you so much. Chair San Buenaventura. Our next item on our agenda is Senate Bill 2751. This is relating to workers compensation, defines compounded prescription drugs for the purposes of workers compensation law. First up on our list from the Director, the Director of Labor Industrial Relations, Director Butai or Representative after Director Butai, DHRD Director Hashimoto.

Good afternoon Chairs Vice Chair Members, Joann Vidinhar representing the Department. We strongly support Senate Bill 2751, which aligns Hawaii's workers' compensation law with federal Section 503 to define compounded drugs based on patient-specific prescriptions and recognized quality standards.

To strengthen the Bill though, we request a clarifying amendment that supports pharmacists as the primary professionals authorized to compound in state license pharmacies. If the intent is also to permit physicians to compound, their authority should be limited strictly to their own patient and not to patients of other providers.

This approach aligns with Chapter 461 which establishes that pharmacists must operate under pharmacies, must operate under pharmacists control and recognize compound as a regulated pharmacy function. Thank you for your opportunity to testify. Available for any questions.

Thank you so much, Director Hashimoto. Okay, thank you. In opposition with suggested language, we also have Dr. Gary Okamura from the WIMAH, Work Injury Medical Association of Hawaii in support. Malia Leong offering comments. Kris Kadzielawa, I apologize if I mispronounce your last name.

Thank you very much. I think you got it. Appreciate it. My name is Kris Kadzielawa. I'm the Managing Director of Solera Integrated Medical Solutions. We provide payment integrity programs to employers, insurers and government agencies. And we are in opposition to this Bill.

We believe that the current definition of compound medications is broad enough to encompass anything that we have now and anything that may come down in the future. And if so, if you decide so.

We're opposed to this measure, but if you do decide to move this measure forward, we have some recommended amendments to include, you know, additional entities and the definition of compounds. These are entities that manufacture compounds in bulk, so we suggest that you add those.

And also, I think I'd really like to float the idea of limiting physician dispensing to the first 30 days post injury. I think the whole physician dispensing industry has been very taxing on the workers comp system, both in terms of costs and disputes.

The language and the law that defines how drugs are going to be reimbursed is very, very simple.

Thank you. Kris, your time's up. We do have your testimony. Thank you.

I'll move on to Malia Keolanui from Island Elevation in support. Kyle Kabisan in support. The rest of the following individuals in support. Carol Ann Orr Kao Himanu Ledia K. Dang Akiona, Eileen Butcheller, Kathleen Plaque and Megan Tabor Rongel, all in support. That completes our list of registered testifiers for SB 2751.

Anyone else that wishes to testify on this measure, please. Please come forward if you're wishing to testify. And if you could state your name for the record, please.

Hi, my name is Kathy Wilson and I submitted written testimony. I don't think that got in, but I am in strong support. I work with drug manufacturers repackagers and so I know the difference between the two.

I have my attorney here with me if you guys have any legal questions and I'm available for any questions that you have about this Bill.

Okay, thank you so much. Anyone else that wishes to testify on SB2751, if not Members questions? I have a question for DLIR.

Thank you.

Thank you. So a few questions for you. The first one specifically has to do is your understanding for rural communities. Are there licensed pharmacists who can prescribe these type of drugs?

Not in every rural community.

Okay, my second question I have for you is, so for a 503 B product that has its own national drug code and average warehouse price, how does DLIR rule?

So if it has a national drug code code, it's at 140% reimbursement.

And then the last question I have is, did you have an opportunity to see. I believe It's Solera and IMS's testimony and their suggested changes.

Sorry, but I did not.

It was late testimony. But their suggested changes is to include a definition of 503A and 503B compounding facilities, limit physician dispensing to 30 days post injury, and then require pre-approval for non-FDA approved drugs.

I think the Department would have to come back to you that. But 503 is an issue. That's where we start to see some inflated pricing because in the 503 facilities they are with the ingredients, they inflate those prices and what we're seeing is a large inflation of those prices to come in.

And the 503B is really a bulk manufacturer. And what the intent of the work comp law was to have patient specific care. And so that's 503. And so when we get to 503B, we're separating out from the patient individualized care. And so I'm not sure that we could support the 503 proposal.

The post 30 day we'd have to take a look at that language.

Okay, thank you. Any further questions, Members? No. If not, go on to decision making. You want to roll into it or. Yeah, you want to roll into it?

Yeah, let's roll into decision making. I provide. Okay. So for first up, SB 2281, I know that Chair's recommendations to pass with amendments. We're going to narrow the definition of consequential decisions by removing line 7 through 9 on page 2 and remove the phrase in training data on lines 18 on line 18 on page 9.

Per Department of Health's request, we're also going to remove line 17 to 21 on page 10 and page 11. We will add an implementation date giving them a long runway of two years after the date becomes effective because they're going to need to do more signage.

And we're going to include a defective date of January 302050 to ensure further discussion on this and any technical and non substantive amendments need for clarity and consistency. Any comments, questions, concerns. Passing with substantial amendments. Vice Chair for the vote.

Okay, 2281. Recommendations passed with amendments. Chair votes aye. Vice Chair votes with reservations. Of all the Members being present here, is there anybody else wishing to vote? No with reservations, seeing none. Your recommendation has been adopted.

Okay. And for the Committee on Labor and Technology for Senate Bill 2281, same recommendation of Health and Human Services to pass with amendments. Chair votes Aye Vice Chair Lamosao for the vote.

[Roll Call]

Thank you.

Thank you very much. And for SB2852 Chair's recommendation is to pass this with amendments. We will accept DCAB's proposed amendment on their late testimony. We're also going to add in a defective date to ensure further discussion to review whether or not we need Civil Rights Commission involved. And that would be a January 302050 defective date.

Any comments, questions, concerns? Seeing none. Vice Chair for the vote pass with amendments.

Okay. Recommendation 2852 is to pass a Senate draft one noting the presence of all Members of the Committee. Any WRs or No? Seeing none recommendations have been adopted.

Okay. And for Labor and Technology, same recommendation as HHS to pass with amendments. Chair votes aye Vice Chair for the vote.

Members voting on SB 2852 recommendation of the Chair is to pass with amendments on noting the excused absence of Senator Ihara. Anyone voting no. Anyone voting with reservations? All other Members vote I Chair. Recommendation is adopted.

Thank you, Vice Chair. And our last item on our agenda, Senate Bill 2751. This is relating to workers compensation. Our Chair is going to recommend that we pass with amendments.

We're going to on page 2, line 15, deletes the words or a license a physician which would address the Hawaii Insurance Council's testimony and concerns regarding the leading references to licensed physician be deleted from who is able to produce the compound. And then also we are going to accept the testimony from Solera Ims, but slightly adjusted.

So in their testimony that's contained on page three, we're going to include 503A and delete 503B. So we're going to include that definition of 503A after hearing from DLIR's testimony, which would amend subsection F to read compounded prescription drug means a drug that is compounded in a 503A facility. FDA approved compounding facility.

Two, we're going to limit the physician dispensing to 30 days post injury as stated in their testimony. And three, require pre approval for non FDA approved drugs as stated in their testimony. And then to continue further discussion, we're going to change the effective date to January 1, 2077. Any further discussion?

Members if not Vice Chair Lamosao for the vote. Chair votes aye.

Voting on SB 2751 recommendation of the chairs to pass with amendments noting the excused absence of Senator Ihara. Anyone voting with reservations? Anyone voting no? All Members vote aye. Chair, your recommendation is so for hhs.

Same recommendation. Vice Chair for the vote. Chair votes Aye.

Okay, 2751 REC. Same recommendation. Chair Vice Chair vote aye noting the other Members of the Committee all present any W's r's or no seeing none.

and with that, we are adjourned for the joint. But HHS people, please stick around. We have a dm. Thank you.

Calling the SB2.8 the one o' clock calendar for decision making on HHS SB 28087 relating to health Insurance Chair's Recommendation is to pass with amendments on page two, lines 15 and 16, the three year health coverage Continuity Pilot Program within the DHS in consultation with DCCA will be established to assist individuals who have lost Medicaid health insurance and acquire high deductible health insurance plans.

Calling the SB2.8 the one o' clock calendar for decision making on HHS SB 28087 relating to health Insurance Chair's Recommendation is to pass with amendments on page two, lines 15 and 16, the three year health coverage Continuity Pilot Program within the DHS in consultation with DCCA will be established to assist individuals who have lost Medicaid health insurance and acquire high deductible health insurance plans.

On page two, we're going to remove lines 18 through 21. On page three, we're going to remove lines two through four.

Instead of authorizing, we are going to require the DHS to subsidize individuals with high deductible plans by paying for deductibles that focus on preventives like screenings, tests, wellness exams, et cetera, up to a maximum of $1,000 per year per plan.

On page 38 to 14 the purpose of the pilot program shall be to subsidize individuals who have lost Medicaid coverage and do not qualify for employer sponsored insurance under the Prepaid Health Care act or federal premium subsidies under the Affordable Care act and subsequently acquire bronze level or catastrophic health insurance plans.

On page three, line six through 17, the individuals targeted are those again who have lost Medicaid coverage and do not qualify for the Prepaid Health Care act instead of those who do not qualify for employer sponsored health insurance. On page 4, line 7 through 19 shall be removed.

On page 5, lines 15 through 16, the Department may issue subsidies or vouchers to eligible individuals enrolled in the pilot program. On page five, lines 17 to 18 are to be deleted.

On page six, lines three to four, we're going to insert language regarding the Department using funding from General appropriations that's going to be removed and instead have a blank appropriation amount. Technical, non substantive amendments needed for clarity and consistency on the Committee report.

We are going to note that at the informational briefing in December on the effects of OBBA and the expiration of the ACA premium tax credits, approximately 70,000 individuals may be affected with the Medicaid possible disenrollment as well as the ACA premium tax credits expiring.

Thus, $1,000 per person subsidy to pay for deductibles will require approximately $7 million in appropriation where over half of those affected individuals reside in rural areas. We believe that the Rural Health Transformation Grant could be a source of such funding .Any comments, questions or concerns seeing none pass with amendments vice chair

okay, 2087 recommendation as a Senate draft one noting that everybody is here. Any WR nos? No, none except recommendations adopted.

Okay, thank you very much. And with that, that hearing is adjourned. We're going to go directly into the HHS hearing. Adjourned.

Calling the continued 101 calendar on the Committee on Health and Human Services. First up, SB 2479, relating to criminal procedure. We have William Bento, Office of Public Defender, in support.

Good afternoon, Chair, Vice Chair, Members of the Committee. My name is William Bento. I'm an attorney from the Public Defender's Office and I am representing the Public Defender's Office. We are in strong support of this measure.

We believe that it finally recognizes the role that trauma has in folks who come before the criminal bench and that we need to take into consideration their past history when it comes to adjudication at trial as well as sentencing. And for those that may be already serving time, perhaps a chance to have their cases looked at again and consideration made for their past trauma.

We do have some comments and suggestions for the bill, but we're in strong support of the spirit of this measure. Thank you. And I'm available for questions.

Thank you very much. Next we have... Excuse me. Jennifer Awong, Judiciary, providing comments.

Good afternoon, Chair, Vice Chair, Members of the Committee. My name is Jennifer Awong. I'm the staff attorney for the Criminal Divisions of the First Circuit Court.

We will stand on our written testimony, which takes no position on the intent of the legislation and just provides comments regarding some of the conflicting drafting that is in the bill, including the provisions that conflict with the Hawaii rules of evidence.

There is no indication of whether or not the indeterminate, the terms of imprisonment to be imposed should be indeterminate or determinate. And there's some timing issues with respect to some of the provisions in Section 8. But I'm here to answer any questions.

Okay, thank you very much. Next we have Victor Ramos in opposition. Mark Morikawa providing comments. Maui County Deputy Prosecuting Attorney in opposition. Anybody else wishing to testify in SB 2479? Okay, come on up.

Aloha, Chair, Vice Chair. I'm Angie Mercado, Executive Director, Hawaii State Coalition Against Domestic Violence, representing 20 member programs. And we respectfully ask that this measure be deferred. One of the things that we saw missing in this is that it actually does not address sexual violence.

I mean, we appreciate the intent to include domestic violence and child abuse. And advocates in the community and partners in the community haven't had the opportunity to really take a close look at this. And so we would just like that opportunity and respectfully request that it be deferred. Available for any questions.

Thank you very much. Anybody else wishing to testify? SB 20... Come on up, Angela.

Angela Melody Young testifying on behalf of Kapalama Neighborhood Security Walk, where we work with District 1, 5, 6, and 8. And I've seen a lot of legislators in our walks, so really happy to be here to be contributing to the legislations. And I think so.

Inmates that have past traumas should be considered to be excused by this legislation. But then also inmates with disabilities. So for example, if they have mental health, anxiety, PTSD, they're combating suicide.

And the circumstances surrounding their childhood like were not that of a privileged lifestyle and they grew up in a poor neighborhood, they don't have resources provided to them. I think those circumstances that have caused them to have mental health disabilities should be excused in their court process for considering their sentence. Thank you.

Thank you very much. Any comments, any other testifiers for SB 2479? Members, any questions? Mr. Bento, come on up. I have a question. Okay, so according to your written testimony, the current rules of evidence already exempt sentencing hearings from the rules of evidence and that you folks are already able to provide these types of evidence in the course of sentencing. So why do we need this?

Well, the second part of the bill which would make it relevant for trial would be important because otherwise we may not be able to present that evidence as mitigation in a trial or in support of a defense.

And so the second part of the bill, which would allow us to introduce this type of evidence in a trial, it in a sense makes it relevant. The other parts of the bill, which would allow for sentencing mitigation when a person, a defendant, is suffering from these types of traumas, for the court to consider in sentencing is very important.

And lastly, for those people who have already been sentenced and never had the opportunity to present this evidence to a judge at sentencing or perhaps even at trial, should have an opportunity to have their cases heard. Yes.

And so the first part may not be necessary, but we do feel the rest of it is necessary and can be very helpful in a thorough adjudication, not just of a case, but of the person who is standing before the court.

Okay, thank you very much. Okay, any other questions? Because I have a question for Ms. Mercado. So, Ms. Mercado, you know, when I attended the graduation ceremony for Women's Court over in the Hawaii Supreme Court, invariably all of those women were victims of domestic violence.

And so it seems to me we should be able, you know, their trauma... I mean, it seems to me that their trauma should also be able to be used as evidence to minimize or at least make ensure that the sentence imposed upon them is justified upon their circumstances.

So I'm just pointing out that this isn't only against the domestic violence assailant, but a number of their victims are also being caught up in the system. So this is going to go through multiple hearings.

You know that because you testify in front of the Judiciary Committee. And when it crosses over, there's going to be multiple hearings there. Would you consider... Because, you know, like, you know, because I've said it many times before, I represented domestic violence victims as well as assailants accused of domestic violence.

Because I was a family court, family law attorney before I became a legislator. Should this move on, would you be able to at least provide the next committee with specific amendments that would help domestic violence victims both as defendants as well as victims?

Because like I told you, all of all of them at the Women's Court commencement, they were all domestic violence victims and it was because of their trauma that caused them to be caught up in this system. I mean, it was, it was really quite emotional, if you've ever watched their commencement.

Thank you for the question, Senator. And we're actually already in process of connecting with other states who have enshrined legislation for this specific reason in the event this measure passes that we're able to give meaningful feedback. Because you're absolutely right.

It is something that we are concerned about. It is about survivors who also have been criminalized. And so what we want to do is make sure that what we do, we try to do it as well as possible so that we don't have any unintended consequences. So thank you for the opportunity to do that.

Yeah. And I just want to point out there was that bipartisan coalition, right. With Linda Lingle I think last year who pushed through a number of domestic violence, you know, adjustments both in our Women's Court as well as women's prison. But thank you very much. Any other comments, questions?

Oh, just to follow what you had just said. So basically the thing that she said the Linda Lingle had tried to push through was for women whose victims or non-violent offenders that is incarcerated to not to be incarcerated because of the trauma it does on the household as being the female in the house.

So, you know, I was one of the supporters of that not having majority of the women in our women's prison incarceration was due to other person that caused the abuse. And then they ended up in prison. So I was 100% supportive in their non-violent offenders to not to be incarcerated and have treatment in incarceration. Thank you, Chair.

Okay. Thank you very much, Senator Villa. Okay. Any other questions? Okay, Seeing none. Moving on. SB 2505, we have this relaying to opioid use disorder treatment. We have Jack Lewin, State Health Planning Development Agency in support. He was here. He left. Next we have Department of Pel. zero, you're still here. You stand.

In support of your written testimony. Thank you very much and sorry I missed you. Okay. Next we have Department of Health providing comments. Tyler. Tyler Dos Santos Pam. Honolulu City Council, District 6. In support. Nahelani Parsons, Hawaii State Association of Counties, in support.

Hey, come on up. Aloha, Chair. Vice Chair. Members of the Committee, Nahelani Parsons, here on behalf of Hawaii State Association of Counties in support of SB2505. The counties are often front and center in, in our communities adjusting, addressing these opioid use disorders.

I understand Department of Health's concern in their testimony asking that when we ask them to do more, it may cost them more, but that is exactly what the Legislature is authorized to do. Opioid deaths may not be as prevalent as methamphetamine overdose, but they are still prevalent.

Paramedics can administer naloxone or Narcan after an overdose, but they cannot give buprenorphine currently, which is the, the drug that we're talking about here in this Bill to help them manage their withdrawal symptoms.

That would give them the time that they need in order to go back to a physician or into a treatment center or to get additional help. It helps bridge that gap in the delay and the time needed. And I also appreciate Dr. Lewin's testimony in support.

And I recognize Department of Health's concerns that we have to improve our treatment centers. But in the meantime, we respectfully ask you to continue, continue moving this measure on and allow us time to work with Department of Health to. Thank you very much.

Address their concerns. Next, if we have SB 2679 relating to youth mental health, we have Dr. Lewin, who's still present, in support. I'm sorry.

Yes, I was going to ask question.

Oh, I'm sorry. I'm sorry. Sorry, sorry, sorry. Let's go back to 2505. I forgot to ask my Members for questions. Okay. Okay, sorry. Why don't you testify one minute and then we'll have one minute. Okay. Please proceed. Aloha yourself. I apologize for moving too fast.

Angela Melody Young testifying on behalf of Cares, I'm wishing to comment. So for the, like the antagonist reversal effect, I think it's necessary and people shouldn't self medicate.

And I hope to testify for this legislation to make this pharmaceutical more accessible and available at the county of Honolulu because there were people who are, were overdosing, I think, like at bars and nightclubs. So you have to ask Councilmember Tyler about that. But I think it's a good Bill.

But I think there are certain amendments that can be made to it to help restrict access to the pharmaceutical by maybe perhaps creating a task force of public health and public safety professionals that know much better than I.

Thank you very much.

What's going on?

Any other people interested intestifying? SB 2505, ... Members, any question?

A quick question. So as this program rolls out, what would be the envisioned process from the counties on choosing the location for the pilot program?

That's a great question and I think we haven't had that yet. So. So we would love to do it in all counties, but understanding that might not be feasible. We'll have to find the funding.

But you guys ideally would amongst yourself choose that county. Right.

I think we could probably put something in the Bill that would help us figure that out or work with Department of Health to establish which one they would recommend.

Okay. Okay, thanks. Thanks, Chair.

Thank you. Any questions? Any other questions? Okay, moving on. SB 2679, relating to youth mental health. First up, Jack Lewin, State Health Planning and Development Agency, in support.

Sorry. Keli Acquaro, Administrator for the Child and Adolescent Mental Health...

We're not there. Your name hasn't been called yet. Okay, next up. Sorry. Okay, next up. Hawaii State Department of Health. Is that you, Hawaii State Department of Health?

Yes.

Okay. Now your name is called. Are you going to come up to testify or are you going to stand in your written testimony?

We stand on our written testimony. I'm available...

And please identify yourself.

I'm Keli Acquaro. I'm the Administrator of the Child and Adolescent Mental Health Division representing the Department of Health.

CAMHD. Thank you. Okay, next we have Bonnie Kahakui, State Procurement Office, providing comments. Next we have Hawaii State LGBTQ Commission in support. Okay, please identify yourself. All I have here is a commission.

Aloha. Good afternoon. Michael Golojuch Jr, Vice Chair of the Hawaii State LGBTQ Commission. We stand in strong support of this measure. We did ask in our testimony for there to be an amendment or may be added into the committee report to specifically make sure that the Māhū, LGBTQI, and gender nonconforming community is included in this platform. Because if it's not built into the DNA of this program, we tend to get overlooked.

And our community is facing a complete onslaught of attacks, especially at the federal level. And this is making its way down to our keiki, unfortunately. And so if you hadn't seen, Lemkin Institute issued a warning earlier this month, earlier this year, saying that we are the early stages of genocide here in the, here in the United States for our transgender community.

And to help fight back against this is one, this is one of the ways that we fight back against this is making sure our trans community, our Māhū community, gender nonconforming know that they are part and they can seek out mental health through this platform. Thank you.

Thank you very much. Next we have Brian Baker, Hina Mauka, in support. Malia Tsuchiya, Hawaii Children's Action Network Speaks, in support. Shellie Niles, Catholic Charity Hawaii, in support. Shellie Niles, are you present? Okay, thank you very much. Alan Johnson, Hawaii Substance Abuse Coalition, providing comments. Dr. Ignacio, Hawaii Medical Association, in support. Judith Clark, are you present? Judith Clark. Oh, I see you. You're not retired.

Stand in my, on my written testimony in strong support. I'm speaking today as a community advocate and not in any capacity that I previously appeared before this committee.

Okay, thank you very much, Ms. Clark. Next we have Blake Collier in support. Ashley de Coligny in support. Tia Pearson in support. Bethany Stetson in support. Kealakai Hammond in support. Andrew Isoda in support. Michele Mitsumori in support. Marissa Ornellas in support. Shay Chan Hodges in support.

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 other people, all in support. Anybody else wishing testify on SB 2679? Members, any questions? Okay. CAMHD? No, no, it's okay. Okay. It's okay. I figured it out. I don't have any questions. Any other... Any questions? Okay, moving on.

SB 2668, relating to Human Services. Department Human Services providing comments. Nobody's present for DHS. Bonnie Kahakui, Procurement Office, providing comments. No. Okay. Trisha Kajimura, Parents and Children Together, in support. Trisha. Okay, thank you very much. Venus Rosete-Medeiros of Hale Kipa in support. Venus, are you present on Zoom?

Not present, Chair.

Okay. Melissa Pavlicek, True Cost Coalition, in support. Okay. That looks like Cory.

It is.

Okay. Yeah, there you go.

Thank you. We will stand on our written... Cory Tanita, True Cost Hawaii Coalition. We'll stand on most for support in strong support. Just wanted to thank you, Chair, for hearing this. I know both, all of the Members here are very familiar with this issue. And just for the public's education, this is not really an increase.

This is a long standing issue and it's really just bringing our community based organizations up to ground zero, and it's just making it them able to serve, continue serving our most vulnerable populations. Thank you very much.

Thank you very much. Hawaii True Cost, Lisa Darcy, in support. Hawaii Substance Abuse Coalition in support, Alan Johnson. Brian Baker, Hina Mauka, in support. Jodi Robinson, Hawaii Alliance of Nonprofit Organization, in support. Erik Abe, Hawaii Primary Care Association, support. Laurie Tochiki, Domestic Violence Action Center, in support. Emily Lau, Goodwill Hawaii, in support.

Ellie Tsuchiya, True Cost Coalition, support. Deborah Spencer-Chun, Adult Friends for Youth, in support. Shawn Kana‘iaupuni, Partners in Development Foundation, in support. Nikos Leverenz, are you present on Zoom? Please proceed.

I am, Madam Chair. Thank you for hearing this bill. Hawaii Health and Harm Reduction Center is a proud member of Partners in Care and the True Cost Coalition.

We'll just briefly add that this is a long standing issue and that it's our experience that many of our employees, including those with valuable lived experience in homelessness, behavioral health issues, and with criminal legal system involvement, have taken additional jobs in the service sector to supplement their income if they're here.

And some have actually left our agency because service sector employment with gratuities is more beneficial for them financially. So mahalo for hearing this bill and passing this bill.

Okay, thank you very much. Next we have Shellie Niles in support. Okay, thank you very much. Judith Clark in support. Come on up.

Good afternoon, Chair, Members of the Committee. I'm Judith Clark, a community advocate with more than 50 years of experience in managing government contracts and grants. Our nonprofits struggle to attract and retain qualified staff when contracts do not cover the actual cost of providing services.

We cannot pay our workers a living wage, and they then move to higher paying jobs or even out of state where the cost of living is lower. It is shameful that so many of the staff of our community based organizations qualify for public assistance benefits because we are not able to pay them what they deserve.

Staff working with homeless persons are often worried about losing their own housing. One outreach worker shared with me, if my landlord raises my rent, I won't be able to afford my housing. We cannot take on grants and contracts and provide quality.

Thank you very much. Next we have Sarah Fairchild in support. Christina Mendonza in support. Malia Tsuchiya, Hawaii Children Action Network Speaks, in support. Connie Mitchell, IHS, in support. Michelle Kauhane, Hawaii Community Foundation, support. Mike Nguyen of AlohaCare, are you present? Mike Nguyen on Zoom.

Not present, Chair.

In support. Suzanne Skjold in support. Rona Fukumoto, Lanakila Pacific, in support. Michelle Bartell, Aloha United Way, in support. Anybody else wishing testify on SB 2668? Members, any questions? Okay. Seeing none. Moving on. SB 2589, relating to Alzheimer's. We have Jack Lewin in support.

Madam Chair, Vice Chair, we stand on our testimony in strong support. Thank you.

Thank you very much. Caroline Cadirao, Executive Office on Aging, providing comments.

Good afternoon, Chair, Members of the Committee. I'm Caroline Cadirao, Director of the Executive Office on Aging, and we're providing comments on establishing the Hawaii Assistance for the Navigation of Alzheimer's Intervention HANAI Program within the Executive Office on Aging. This is a very large scale undertaking initiative and a new project.

Currently within the Executive Office on Aging, we have the Hawaii Dementia Initiative. We just successfully finished our public awareness campaign. We're supporting bills that are going to provide training to first responders and raise awareness for dementia friendly businesses. We're also working on implementing Act 286 from last year, and we're currently working at capacity.

So it's going to be difficult for us internally to stand this project up. Also with the current economic uncertainty, we think that this isn't the right time for this bill. But if this does pass or goes forward, we do have a technical amendment we'd like to add. On page two, section B around...

It says as part of the program, the Executive Office on Aging may contract with health care providers to expand access to Alzheimer's disease treatment and diagnosis services pursuant to Chapter 103f. We'd like to also add in chapter 103D so we have flexibility.

Okay, thank you. Okay, thank you very much. Next we have Louis Erteschik, Hawaii Disability Rights Center, in support. Glen Higa, Hawaii Parkinson Association, in support. Audrey Suga-Nakagawa. I see you here. AARP in support. Thank you very much. Chris Lutz, Alzheimer's Association of Hawaii, in support. You don't look like Chris Lutz. You look better.

I'm Coby. Chris is okay. Thank you, Senator, for hearing this bill and introducing a version of it. This bill is...

Identify yourself.

Oh, sorry. Coby Chock with the Alzheimer's Association. This bill is so critical. As we all know, more and more people are going to be diagnosed with Alzheimer's and many more undiagnosed, but still get Alzheimer's disease.

And we want to make sure that regardless of where you live, especially on the neighbor islands where access to care is so, so limited, that you get the highest quality of care and you can get to these new treatments that can really change everything.

We envision a world that we change this disease, hopefully ending it, but at the very least, changing this from a fetal disease to a chronic disease that we can manage. And with these new treatments coming out and so much more in the pipeline, this will be a chronic disease very soon.

And we want to make sure our infrastructure is set up to handle this. So our testimony does have some suggested amendments that has some outline of what the program would look like.

We also have an amendment that I didn't put in the testimony, but I think it would help EOA if we had a project manager to help with that capacity issue. So, four FTEs for the dementia care specialist, one per county, and one project manager for the program. Thank you, Senator.

Okay, thank you very much. Next we have Kira Miyatake in support. Jen Alto in support. Natalie Graham-Wood in support. 1, 2, 3, 4, 5. Jerry Perone in support. Jerry, are you present? Is that you, Jerry? No. Okay, next we have... Well, we have Coby Chock already. Barbara Black, is that you on Zoom? Please proceed.

Yes, it is, yes. Chair, Vice Chair, Members of the Committee. My name is Barbara Black. I live on the Big Island. I strongly support this bill. My husband has Alzheimer's, and we had an early diagnosis for him because we were able to go to Oahu and to San Francisco. PCPs are overwhelmed on the neighbor islands, and no memory care facilities are available.

Early diagnosis is a gift because people can plan how they're going to manage and what to do and time to learn. Access to early detection, treatment, and coordinated support should be easily available and accessible to all those dealing with this disease throughout the state. The HANAI Memory Network would provide a statewide solution to its growing dementia crisis.

Thank you very much. Okay, we have 15 other individuals in support. I see somebody. Is that Jerry Perone? Are you on Zoom? Or identify yourself, whoever is on Zoom. Are you to testify on 2589? Okay, Peter Black, please proceed.

Yes. All right, so I'm the husband and I'm the guy with Alzheimer's, and we're fortunate to have gotten an early diagnosis. And I strongly support this bill and thank you for your time.

Thank you very much. Anybody else wishing to testify on SB 2589? Come on up. Identify yourself.

Hi, my name is Hayden Cobb. Good afternoon, Chair, Vice Chair, Members of the Committee. I strongly support this bill because my own personal connection with the disease. My dad passed away from Alzheimer's, and a few months later my mom passed away as a caregiver.

And I'd also like to highlight some statistics about this disease as well in the Hawaii population. So there's approximately 31,200 people that are 65 and older that are living with the disease currently in the Hawaii islands. And these numbers are looking to increase as the years go on.

And I just wanted to say that these statistics are a reflection of how detrimental this disease is on a micro, meso, and macro level, which is something I urge you to take into consideration during the process of passing this bill. Thank you.

Thank you very much. Anybody else wishing to testify on SB 2589? Members, any questions? So I have one, Caroline. So I know it's a whole new program. How long do you think you'll need to implement?

I think realistically setting up the partnerships, getting the different navigation on every island, developing the job descriptions. A year and a half, possibly.

Okay. So like potentially a two year runway maybe for you folks to stand it up. Okay. Even though it was Alzheimer's Association's bill, apparently they have proposed amendments to this. They proposed 3 million. Is that enough? Anyway, that was the mark was on the bill. Right. I don't know how they came up with that.

I'd have to look. If we're talking physical locations, that's going to be a cost. Obviously it depends on how we decide we're going to structure all of that in each county.

Or just have like programs using the current county's office of aging. Yeah. That way you don't need to have physical structures. Right? All you need is probably some kind of coordinating personnel, like Coby Chock was talking about. And to, it sounds mostly educational. Right. Because regarding the actual medications, that's going to be prescribed by the doctors. It is basically educating the public that these are...

The screening ability is there, that it is not a fatal disease, that they don't need to just accept it, that we are right there on the potential cure, if not a cure, when you're already... Right. So it's a huge educational. Because the advancement that has occurred in the past couple of years has been astronomical really. Right. So knowing that, 3 million, I think. And then if you folks need more, you guys can ask for more.

We'd come back to the Legislature if we needed more. Yes.

Okay. Okay. Thank you. And then I will have Coby Chock. Coby, this was your bill and the new amendments.

Yes, Senator, we actually like the version that you introduced of this better.

Oh, okay. I like that. Okay, so what we can do is we will insert... Do you know what that bill number is?

That bill number... Is it 1853?

1853. Okay. SB 1853. Okay, sounds good. Yeah. That was your bill. Yeah. I thought this was your bill too.

This one's similar. We trimmed down the other one so that the appropriation could be smaller. Of course, that would just be a pilot on one island. The four dementia care specialists would be one per island or per county. And that's preferred, obviously. But if the budget is tight, then one is a good start.

Okay. One county is enough. Okay. So okay, thank you very much.

Thank you.

Okay, any other questions, folks? We're going to move on SB 2564 relating to adoptions. First up, we have Judiciary and support. Oh, new person.

Good afternoon. Chair, vice chair. Honorable Members of the Committee. My. My name is Andrew Park. I'm a Family Court judge out in Kapolei. My apologies for not checking in properly with the Committee Clerk. It was busy in here. I serve under Diana Daris, Deputy Chief, under whose name this is has been submitted.

We stand in strong support of this bill. This is a part of the Judiciary package. And The House Companion 2088, I believe, is being heard presently by Chair Tarnas Committee, and it has received the same testimony and support as this Committee has received from the Department of Human Services. I'll stick around if you have any questions.

Yeah, there's no opposition here. Thank you very much. Thank you very much. Okay, Director Yamane in support. Anybody else wishing testifying? . Yes. Okay, Thank you very much.

Okay, anybody else switching testifying? 2564 Members. Any questions? Moving on. SB 2569, also Judiciary package. This time it's Judge Castaneti in support. Anybody else wishing to touch? Are you for the Judiciary? Yes. Okay. Are you gonna stand your written testimony? Thank you. Okay, anybody else wishing testify? 2569, seeing none Members. Any questions? Okay, moving on.

SB 2572, Judiciary package. Okay, Judge Medeiros. No, you're not Judge Medeiros, but identify yourself. Come on up. You're in support.

Andrew Park for Senior Judge Dyan Medeiros. I'm a Family Court Judge in Kapolei. This is a part of the Judiciary package. Good afternoon again, Chair, Vice Chair, Honorable Members. We stand in strong support of this bill, which has also received supportive testimony from others.

Yeah, thank you very much. And I see... Elodie, are you testifying for Director Yamane, providing comments? Oh, in support. I had comments. Yeah. Thank you.

You're welcome. Okay, moving on. Terri Lum, Hawaii State Chapter of Children's Justice Center, in support. Anybody else wishing testifying 2572? Members, any questions? Seeing none. Moving on. SB 2557 relating to homelessness. First up we have Dawson Chang in support. And next up we have Jun Yang providing comments. Anybody else wishing to testify in SB 2557? Seeing none.

Members, any questions? Okay, moving on. SB 2545, relating to veterans. First up, the Hawaii Office of Veteran Services in support. Major General Logan, Department of Defense, in support.

Vice Chair, Chair, Vice Chair, Members of the Committee. Brigadier General Retired Neal Mitsuyoshi here representing General Logan, Department of Defense. We stand on our testimony in support and prepare to answer any questions you may have.

Thank you. And I see Sean Sanada, are you present on Zoom for Oahu HHSC, providing comments?

Hi, Chair, Vice Chair, Committee Members. Sean Sanada on behalf of the Oahu region. We stand on our comments related to this request. Happy to answer any questions.

Thank you very much. Thomas Driskill in support.

Chair. Thomas Driskill, individual testimony, strong support. Stand on my testimony. Thank you.

Thank you very much. Hawaii Military Affairs in support. Anybody else wishing testify on SB 2545? Members, any questions? I do for... Yes. Why don't you come out, DOD. And Mr. Driskill, if you are able to. Okay. Because I believe I worked with you last year on this. Okay. Biggest concern is that you folks don't have enough bed space to be able to be self supporting. You folks will be able to... Yes, I heard you folks only have a building with a capacity for 40 beds. Okay. Whoever wants to answer.

This facility will have 60 beds, Chair.

Okay, so that's like borderline there.

Chair, the important point here is State Veterans Home Program within the VA allocates to each state a specific number of beds.

Oh, yeah, that's right. I remember this.

Yes, ma'am. You take our facility in Hilo, 95. You take the 120. We have 53 beds left over. The VA will pay us the per diem. So what we did last year. Thank you so much to the legislature. Is we discussed and the leg approved seven full paid beds by the state. So seven state beds plus the 53. 60 is the cut line. We can make it work. It will be a profitable facility. It's tight.

It just needs to break even. We just don't want you guys coming back to the state every day.

It'll make a profit. It'll make a profit, Chair. And it will not return for further appropriation.

Thank you, folks, very much.

Thank you, ma'am.

Thank you for all your work in this.

Thank you all for putting this bill in.

Thank you. Thank you. Yeah. Thank you for reminding me what happened. Okay. And yeah. Anybody else wishing testify on SB 2545? Members, are we ready... Oh, we have quorum. Are we ready for decision making?

We can go.

Yeah, we did. Yeah. Nobody was here to testify after you prepared for it. Thank you. Okay. Yes, we did. Okay, so SB2479. I was going to defer this, but I'm going to defer the decision making to next week. But I mean, not next week, next hearing. This Friday at 1:00pm@ 1:00pm okay.

Are you in. Directly in decision making now or.

Yes, we are decision making now.

Make sure you.

Sorry. Sorry. Decision making for SB2479. We are going to defer the decision making for SB2479 to the next hearing, which is this Friday at 1pm for at this room 225. Okay. Next one for SB2505 relating to opioid disorder order treatment. You know, this is a work in progress.

We're still going to pass it with amendments, but we're only going to apply it to the smallest county available who is not here because we just, we need to know whether or not it's going to work. Okay, so make it only a two year program, blank appropriation amount for Department of Health to implement.

And at the on the Committee report, we're going to ask them to use for Department of Health to use opioid settlement funds, if any, to implement this. And that's basically the only reason I'm doing this is because there may be monies for it. Okay. But otherwise. Any comments, questions, concerns?

I have some concerns. I. I think you can vote no. Well, I don't want to kill the Bill, but the fact. No, the thing is I just think that the county should possibly choose a location for the pilot. I agree. Instead of us choosing it, we're choosing it.

Okay, go ahead. Because they want us to choose it and that's why I'm choosing. They do want you to us to choose it. That's, that's why it's It's HSX package. No, no, no.

If they didn't that's why I asked a question of her whether they wanted us they had a process.

Okay, so SB2505 pass with amendments applying it only to one county two year program blank appropriation. Committee report is going to request Department of Health to use opioid settlement funds for this. Any other comments, questions and concerns and the start date is going to be. We're going to have a well no because of the opioid settlement monies.

We're going to make it effective. As of when do I said Norman? July 202726. July 2026 and end date is two years thereafter. Any other comments, questions, concerns seeing none pass with amendments.

Okay. 2505: recommendations pass with amendments, noting all members here. Any WRS or noes? Seeing none. Recommendation has been adopted.

Okay. SB 2679 relating to youth mental health. We're going to pass this with blank appropriation amended with state procurement officers proposed amendments. In the committee report, we are going to accept accept the request of CAMHD to administer the pilot program to ensure needs of the LGBTQIA plus.

Any comments, questions, concerns? Seeing none. Vice Chair for the vote.

Okay. 2679: recommendation senate draft one, noting all presence of all members. Any WRS or noes? Seeing none. Recommendation is adopted.

For SB 2668, Chair's recommendation is pass it as is. Any comments, questions, concerns? Seeing none. Vice Chair for the vote.

Okay. Noting the presence of all members. Any WRS or noes? Seeing none. Recommendation has been adopted.

For SB 2589.

We're going to insert the language in SB 2113. You know what? We're going to defer this one for decision making.

For Friday at 1pm discount. Okay. Defer and get the language of the other Bill. Okay. Next up we have SB 2564 as is recommendation is to pass as is any comments, questions, concerns seeing none Disregarding to adoption.

All right. Seeing none noting presence of all Members. Any wisdom are no seeing none recommendation has been adopted.

Okay. SB2569 pass another Judiciary package bill recommendation is to pass as is. Any comments questions concerning none Vice chair for the vote.

Okay. Noting the presence of all Members. Any WRS or No seeing none recommendation has been adopted.

SB 2572 another judiciary package Bill recommendations to pass as is. Any comments, questions, concerns seeing non vice chair for the vote.

Yeah, please not all Members presence and WRS are No seeing none recommendation has been adopted.

Okay. SB 2557 recommendation is to pass as is. Any comments, questions, concerns, seeing none Vice Chair for the vote.

No to the presence of all Members. Any WRS or no seeing none recommendation has been adopted.

Okay. 2545 recommendation is passed with amendments. We're going to accept Department of Defense proposed amendment and any technical and sub non substantive amendments needed for clarity and consistency. Any comments, question?

Chair I totally support this Bill, but for reasons that are outside of it, I'm going with reservations.

Okay, sounds good. Our only Maui Senator is with reservations. Well, and he'll discuss it later on, I'm sure. Any other comments, questions, concerns? Seeing none Vice Chair for the vote.

Okay, noting my WRS. Any other WRS or No seeing no none recommendations been adopted and with that we are adjourned.