Senate Standing Committee on Health and Human Services

Calling the one o'clock calendar for the Committee on Health and Human Services. First up we have SB3132 relating to syndromic surveillance. We have. First up, we have Department of Health in support. Are you present? Come on up.

Good afternoon, Chair, Vice Chair, and Committee. Yes, my name is Nathan Tan. I'm the Deputy State Epidemiologist and here to offer testimony with written testimony as well in support of the Bill.

Okay, so we have read your written testimony. If you'd like to add or just rest on it, we're happy with that. Yeah, go ahead.

Yeah, Just some very brief comments. It's really just to formalize the ability to establish a syndromic surveillance program. Currently there is one at the federal level that relies on voluntary participation and it's provided some really important data for the Health Department in terms of response.

I think most recently it's been able to provide some real time data related to the flu activity in the community. It's also provided information in response to the Maui fires.

We think it's important it will ensure the Department can continue to collect and analyze syndromic surveillance data even if the federal platform ceases to exist and no longer able to meet the department's needs.

Okay, thank you very much.

Thank you.

Next we have SHPDA in support. Dr. Lewin.

Vice chair. We will stand on our written testimony for this Bill in support.

Okay, thank you very much. Next up we have Paige Choi, Healthcare Association of Hawaii in support. Paige.

Thank you very much. Next, Hawaii Pacific Health. Michael Robinson in support.

We'll stand on our support. Thank you.

We stand in strong support.

Thank you. Next we have Devon Genua in support. Corinne Solomon providing comments. Maya Maxim in support. Deborah Umaka in opposition. Patricia De Los Santos in opposition.

Kirk Powell in opposition. Anybody else wishing to testify on SB3132 Members? Any questions? Okay, I think for Department of Health. Could I have a question? Come on up.

In the back of the room. You should start using drones and the drone will fly over to you.

Okay. So the people who are in opposition are super concerned that a centralized self data collection under 3132 is going to have privacy risk. And what is, what's your position regarding that?

Privacy is extremely important for the Department and the information that we receive is de identified. So we're not able to identify who, you know, identify the people that are related, you know that.

To the data you get? But there's not going to be any Social Security numbers, there's not going to be any date of birth. Okay. So that, that should satisfy the privacy issues. Okay, thank you. Anybody else wishing testify in 3132? Members, no more questions? Moving on. SB 3134 relating to emergency medical systems of care.

First up, Dr. Lewin, State Health Planning and Development Agency, in support.

Madam Chair, Vice Chair. I'm also sitting on EMSAC. I just want to make... But this is really going to modernize our whole EMS system. It's a very, very responsible and good bill. We strongly support it. Thank you.

Thank you very much. Department of Health in support.

Stand on our written testimony, Madam Chair.

Okay, I know who you are, but please identify yourself.

Garrett Hall, State Chief of Emergency Medical Services and Injury Prevention for the State of Hawaii Department of Health.

Thank you very much. Next, Major Stephen Logan, Department of Defense.

Neal Mitsuyoshi standing in for General Logan. The department stands on its written testimony in support.

Thank you very much. Okay, Department of Health, EMS Medical Director, Terrence Jones, MD, support. Ronald Kuroda, EMS Injury Prevention Systems Medical Director of Oahu Department of Health, in support. Eric Vaughan, EMS for Kauai, Medical Director for Kauai, in support. Karen Boyer, University of Hawaii, in support. Karen, are you present?

We stand on our testimony. We were in support with considerations.

Okay, thank you very much. Thinh Nguyen, Dr. Nguyen in support. Cecilia Wang in support. Marilyn Matsunaga in support. James Barros of EMS in support. Emergency HIEMA, Emergency Management Agency in support. Anybody else wishing to find SB 3134? Members, any questions? Okay, no. Moving on. Next one. SB 3136, relating to lead materials and water infrastructure. Department of Health in support.

Please proceed. Identify yourself.

Good afternoon, Chair, Vice Chair, Committee Members, my name is Joan Corrigan. I'm with the Department of Health, Safe Drinking Water Branch. And we stand by our testimony.

In support, thank you. Dr. Lewin of SHPDA in support.

Yes, we'll stand our written testimony Chair.

Okay, next we have Gabriel Agonot in support. Anybody else wishing to testify in SB 3136? Members, any questions?

Super Fast of SHPDA. Super fast.

Super fast.

If the Federal Government were to weaken the standards under the Clean Water Safe Water Drinking Act, would we have to follow suit under this Bill?

I believe we would act as Western States Alliance and change the standards to make to meet our own desired standards.

Okay, so we passed this. You'll still have the flexibility to do that?

We'll still have the flexibility to do that. We're doing that for vaccines. We're going to do it for other kind of protections.

And we have the Health Clean Water person right behind us.

Is he right?

I'm with John.

So, like, yes or no, what he just said.

I'm sorry, I didn't hear. Please.

Oh. If the Feds weaken the standards, would we have to follow suit under this Bill if it became law?

No, we would not have to. As long as we are as stringent or more we would be. We would still be fine. And I don't think that we would end up having to change it. The whole intent is to be protective.

Yep, exactly. I just want to make sure. Because we follow Federal standard, if Federal standard weakens, we don't want to follow or be pushed into a weaker standard.

Okay. And we are part of the Western alliance, so we'll see. Okay, thank you. Thank you very much. The only question I have. Okay, moving on. SB3138 relating to independent audits of deposit beverage distribution. First up, Department of Health in support Lauren Zirbel in support. Lauren, for Hawaii Food Industry Association. Are you present?

I see you move on. I mean, please proceed.

Thank you. We're here to testify in support with amendments. We prefer the language that does a full exemption for internal audit. The Department of Health has ample funds in their High 5 special fund, about $80 million with which to pay for audits. They have the authority to do that.

The language about auditing in the current statute is very confusing. Auditors don't really know how to do it. Our Members have been quoted 25k per location. It's a lot of money. It's actually more money than most of them give the state in high five tax dollars. So it really doesn't seem to make much sense to us.

So we would support with amendment. Thank you very much.

Thank you very much. John Mark Maggio of ABC Stores in support Garrett Marrero Maui Brewing Company providing comments. Garrett, please proceed.

Thank you. Good morning. I'll be quick. Thanks for the opportunity to testify. We would be in support with amendments as it currently stands. We would raise the threshold for the smallest producers from 2 to 5 million containers. And then we would ask for a modernized reporting system rather than paper stamp and mail each month.

It should align with the M18 GET and other common forms that we all file for business. As you know, I was part of the Info brief earlier this year. Sorry, late last year. And I'm happy to continue to work in service of the state to support this.

And it's mainly my concerns are all around how it impacts the small businesses. As Lauren mentioned, very expensive, very confusing auditing requirements. So with the edits that I and comments that I provided in my testimony, I'll stand there. Thank you.

Okay. Thank you very much. And thank you for participating on that Info Briefing, so.

Always, ma'am.

Thank you. Down to Earth, Organic and Natural in support, Allison Riggs, Tom Yamachika, Tax Foundation, providing comments that you don't look like Tom. Tom, are you present on Zoom?

Not President on Zoom. Chair.

Okay. Steve Haumschild of Lanikai Brewing Company providing comments that looks like you, Steve.

Hi, Chair. Vice Chair. Thanks for the opportunity. I'll also be brief. I mirror Mr. Marrero's testimony where, as a small brewer myself, it's very impactful on the cost. So getting the units up to 5 million and digital filing would make much more sense from the small business perspective. Here for any questions you might have. Thank you very much.

Thank you very much. Kenneth Hu, Hawaii Liquor Wholesalers Association in opposition. Rob Iverson, Reynolds Recycling in opposition, Reynolds Recycling. Bruce Iverson. Sorry. Okay, thank you very much for SB3138. Anybody else wishing to testify? Members?

Yes, Department of Health. I would like to provide a little bit of clarification, if must possible, on our testimony.

Okay. Identify yourself

Lene Ichinotsubo with the Department of Health Solid and Hazardous Waste Branch. The Department strongly supports this measure. We believe that this provides a balance between the auditor's comments and alleviating the financial burden of small businesses.

Using FY25 data, the proposed measure will only affect 24 distributors. Out of 3225 will be required to submit and independent audits every two years with 19 distributors every five years. Thank you for the opportunity.

Okay, thank you very much. Anybody else wishing to testify on SB3138?

Excuse me, Chair.

Yes, Tom Yamachika, please proceed.

Thank you, Chair. Members of the Committee, Tom Yamachika from Tax Foundation. We will stand our written testimony be available for questions.

Okay, thank you very much. With late testimony, we have for Meadow Gold Dairies in support. Anybody else wishing to testify on SB3138? Members, any questions? So I have one for Department of Health. So you've heard from Garrett Marrero of Maui Brewing and Lanikai Spirits.

What do you folks think about being able to modernize the submission of these audits by putting it in web based, like how Department of Taxation is doing now for GET Tax.

So we are currently working on an electronic system for distributors to submit information to us. And we've just released that contract and that's being done. We haven't thought about that for the audits themselves, but we can certainly consider that in that scope.

Okay, when you mean that you folks are working on when will it get done? Regarding the information.

So the work that's being done now is for the submissions for each, the monthly payments into the system. So that is being worked on now. We anticipate having it done. Was it the end of this fiscal year? We're working towards pushing it this summer.

Okay, so we're looking at 2026. Yes, mid-2026. And that's only for the submission of the payments, which is similar to tax, except the actual form of the audit. You don't have that capacity yet because you haven't sent that out for another feature or anything? Okay, sounds good. Any other questions?

Why not?

Okay, why not?

I mean it's everybody else is moving at the speed of technology, but yet you guys are thinking about it and you have a lot of money in this fund. Why not? Why not? Why haven't you like just gone for this already

For the audits? You know, that's something we need to consider. We. We haven't. We're in the process of also doing an RFP to hire an auditor to do the risk-based audits. But that's something we do need to consider. I agree.

Well, I hope you would move quicker on these things, but. Okay, thank you Chair.

Okay, thank you very much. Any other questions? Okay, seeing none. Moving on. Next we have SB 3139 relating to State Health Planning and Development Agency. First up we have, excuse me, Grassroots Institute of Hawaii in support. Okay, next we have Walden Au providing comments. For HMSA.

Chair, Vice Chair, Members of the Committee. Walden Au, on behalf of HMSA. We're just here to- or we're just here to provide comments that specifically provision two, found on page three currently should be under the purview of the Insurance Commissioner and DCCA. Otherwise support the intent of the measure. Thank you.

Okay. Okay. Dr. Lewin from SHPDA in support.

Chair, Vice Chair, Senator Favela, I'd love to comment on this. SHIPDA is a 50 year old agency this year and when it was originally created it had a very broad spectrum of responsibility. It was mostly federally funded. Back in those days the federal funding went away and we become, we have our regulatory function of Certificate of Need.

But the bigger picture wasn't funded or staffed really occurred. So today we're moving toward really being a kind of not a health authority with regulatory pressures over the health sector or other agencies. But I think it's important to say the second-

The function of SHPDA is defined as universal access to high quality, equitable and affordable healthcare for all the people of the state and to create a shared vision of Hawaii's healthcare future.

That means like sort of dealing with the silos that we create across all the agencies that have something to do with health, but also bringing our very excellent private sector into this mix and trying to envision together. With this physician Governor, where are we going? So that's basically what this is.

There are some housekeeping -- exempted and we think we support those as well.

Thank you, Dr. Lewin. Okay, anybody else wishing to testify on SB 3139? Members, any questions? Okay, I have one for Dr. Lewin. You heard HMSA, they think the health insurance coverage rates, benefits, affordability, etc. Should be remain with insurance commissioner and not under.

Yeah, we're not going to be regulating those, so that's fine. This Bill is really about persuasion and collaboration. There's no regulatory power beyond any of those factors.

Okay, sounds good. So you have no problem with removing that portion?

No problem at all.

Thank you. Okay, any other questions? Okay, seeing none. Moving on. Next up, SB3207 relating to background checks. First up, we have AG in opposition.

Good afternoon, Vice Chair Angela. Deputy General, we stand on our written testimony in support.

Thank you, Healthcare Association of Hawaii in support Paige Choi.

Thank you, Chair. Vice Chair, Members of the Committee, Paige Choi with the Healthcare Association of Hawaii. We do stand in strong support of this measure. Our testimony, I think, really details the issues our members have encountered in the past few years since the fingerprinting requirement has started to be enforced by the Department of Health.

There are major issues that we're experiencing with cost, accessibility of appointments and the compliance with other Hawaii state laws, in particular, employment, non-discrimination laws. We do think a Bill is needed. We really hope that you folks will pass this measure today. We understand the concerns raised by the AG and the Department of Health.

We think we can work through those as we go through this process. But we do think that this Bill is needed to address a lot of the burdens that our members have been experiencing. So thank you and we're available for questions.

Thank you very much. Next, Hawaii Pacific Health in support Michael Robinson.

Good afternoon. Chair and Vice Chair Mike Robinson, Hawaii Pacific Health. You have my written testimony. I just want to emphasize that this is not about us being opposed to background checks. This is us having concerns about the incremental value of fingerprinting. FBI fingerprinting, specifically.

All of our facilities have done background checks well before this Bill was made into statute in 2006. It hasn't been enforced for that long and we haven't had any issues. We perform background checks on all of our 7,700 employees. Half of our employees are licensed professionals.

Some of those licensed professionals are already getting fingerprinted through the licensing procedure. This would be an additional requirement. And it's also sole sourced to a vendor where we have to pay $70 per employee. And that is an unfunded mandate. It's a cost that we will have to bear.

This is also unfortunate when it's coming at a time when we are trying to attract people into the industry. And this Bill does not allow for. For it to be in compliance with Hawaii labor law, employment law. Thank you.

Next we have Jonathan Ching, Kaiser Permanente in support.

Chair Wilson, our testimony in support and request the amendments of the Healthcare Association.

Okay, thank you very much. Next we have Edward Chu, Hawaii Health Systems Corporation in support. Darlene Nakayama, Palolo Chinese Home in support. Rehabilitation Hospital the Pacific in support. Queen's Health Systems in support. Maya maxim providing comments. Dr. Fink, Director, Department of Health in opposition. Department of Health, come on up.

My name is Paula Cerio. I'm the Chief for the Office of Health Care Assurance. We stand on our testimony in opposition of this. The way that the Bill is currently written, it is an issue that it is saying that the entity, like the hospital or the third party provider or the operator would do their own background checks.

That is against federal law. So we have that in our testimony, as does the AG and the Department would prefer to work with stakeholders and with HAH to avoid any kind of statutory change and address the concerns that stakeholders have.

Okay, thank you very much. Next we have Brenda Ho, Hawaii Care Choices in support. Dr. Ignacio, Hawaii Medical association providing comments and Hannah lit in support. Anybody else wishing testify in SB 3207 Members? Any questions? Question? Yeah. Please proceed. Hospital guys? No, I saw

Robinson and we also have Jonathan Ching.

No, no, I don't want all you guys up here.

Well, you said hospital guys.

No, really

Only one we're missing here is.

Department of Health said what she said. You guys were shaking your head. So I want you to respond because I want to know more about the shaking of the head.

Sure you want to go first or?

Well, you know, I think what one of the concerns that we have is there's no federal requirement right now for fingerprinting of healthcare employees. We understand there might be some concerns around the vendors and who can use the vendors.

A major problem we're having right now is there is only one vendor and they are charging a huge amount for one of our nursing homes. We can say it cost almost $200,000. Again, totally unfunded. And then for our larger systems, closer to half a million. And that's the one time. Right.

To get everyone in compliance and then you'd have to continue that cost going forward. So again, you know, as my colleague said, we're not opposed at all to patient safety and doing these background checks, but we are concerned that we're implementing something above and beyond what's required federally and at such a high cost with such limited choice.

I'll add Vice Chair to that. I was shaking my head because I'm not aware of what federal law is that we were not in compliant with not doing FBI fingerprint checks. We're not talking about background checks.

So if there is a federal law out there, we have not been in compliance on it since the beginning and it has never been brought up.

That's what I figured. And then this to be the honest conversation it with this continues, these costs, they get passed on to the patients eventually. Right. So this is a drive we talk about trying to contain health care cost. So these are kind of some pragmatic things that we could look at. Correct.

I'll just add further thing about the federal law, I mean. Right. So for Kaiser, I mean, there is no other state that requires every employee that has, you know, patient access to require them to have fingerprints. There are some select. Right. And for purposes of licensing as a professional.

But, you know, we're unaware that there's any state that would require what is currently, you know, the Administration is currently requiring and as comprehensively. Right.

And there already is fingerprinting for many officials through their licensure. Right.

For nursing, there is. Physicians are not currently fingerprinted. So this would be another burden that they would have to go through. And this would be for both current physicians as well as prospective physicians. So for any new physician we want to recruit to Hawaii, we would be the one.

One amongst one of the probably a handful of states that are asking for this that they would have to be fingerprinted by the FBI. It's just. Yeah. Unusual.

Thank you very much.

Thank you, Chair.

So I have a question. AG Come on up. And my soil. Department of Health. Well, mostly AG, right? Well, whoever. Department of Health. Because you guys are in opposition and the reality is.

And I'm going to tell the health care guys and if we pass this and if the AG says this is wrong, you know the government is going to veto it. So it doesn't make sense for us to pass something that the AG is uncomfortable with. Right. So you heard their response. What is your response?

Is there a federal law that requires the fingerprinting be done? How Department of Health requires it?

Yes. I mean, I think, I think their comment is a little bit different as far as fingerprinting requirement. Federally, all we're commenting on is the proposed changes that the hospitals want to do is not federally authorized. The hospitals themselves cannot collect fingerprinting. So that's, that's the only thing that we're commenting on.

So whether or not they're required to do it, that's a separate question.

Oh, it's a collection.

Yes, we're commenting on. Yeah, the actual collection of the fingerprinting, which is, which is solely under the authority of the FBI.

Okay. And that's in the Bill?

Yes.

Okay. But you folks didn't propose any amendments. Your folks did just basically said say hold this Bill, which is to kill it. Okay. And the part of basically the same thing, it's the whole building of the collection.

This doesn't just apply to hospitals. This Bill applies to all licensed healthcare facilities in the state. So care homes, nursing homes, CCFFHs, everything, home health agencies. So to put this Bill in the way it is, it would impact absolutely everybody.

And a lot of those providers are already doing what is in statute, which is a fingerprint and all the background.

They're doing it, but they don't want to pay the expense because they're saying, I understand.

Yeah. And we recognize that it's an unfunded mandate and would be supportive of public funding for that. The other piece, I know. The other piece about this, just to point out is it is for long term care facilities and critical access hospitals.

It is required that they do a federal fingerprint and they're covered under OCA's licensing as well.

Okay, thank you very much. Any other questions? Okay, moving on. SB 2271. First up, relating to hospital licensing. First up, SHPDA, Dr. Lewin in support. Next we have Daintry Bartoldus of Hawaii State Council on Developmental Disabilities, in support. Hold on, you're standing on your written testimony, right? Yeah, because you didn't stand up.

Okay, next. Okay.

Daintry Bartodlus Executive Director for the Hawaii State Council on Developmental Disabilities. Yes, we are in support of SB 2271. Allowing hospitals to demonstrate compliance through any CMS recognized accreditation. Helps sustain hospitals capacity, particularly in rural and neighbor island communities, which is essential for assuring access to care for all of its residents, including folks with disabilities. Thank you. So much for this opportunity to testify.

Okay, thank you very much. Health Care Association of Hawaii, Paige Choy in support.

Thank you, Chair, Vice chair. We're in strong support of this measure. And we do also support the amendments suggested by OCA and the Department of Health for this particular measure. Just to change the word to approve CMS approved accrediting organization. Thank you.

Okay, thank you very much. Next, we have Kaiser Permanente in support. Dr. Fang, Department of Health in support.

Yes, we stand on our testimony.

Okay, anybody else wishing to testify on SB 2271? Members, any questions? Okay, moving on. We also have Senator Keohokalole and Senator Fevella present. Okay, next up, we have SB 2272, relating to home health licensing. First up, Hawaii State Council on Developmental Disabilities, Daintree. Oh, no, you're not Daintree. Okay, identify yourself.

Hi, Chair, Vice Chair, and Members of the Committee. I'm Megan Han, interning for the Hawaii State Council on Developmental Disabilities and we stand in support of SB 2272.

The Hawaii State Council on Developmental Disabilities supports this measure because individuals with developmental disabilities frequently rely on home health services to remain in their homes and communities so that they can avoid unnecessary hospitalization and institutional. Thank you for your time.

Okay, thank you very much. Next up, we have SHPTA in support. Healthcare Association Hawaii in support.

Thank you. We'll stand on our testimony in support, again, supporting the OKA amendments. I do want to note this is important to maintain high quality of care and high quality standards, but this is a measure that we can do to help reduce costs overall for the system by not duplicating surveys. So, thank you.

Thank you very much. Next, we have Department of Health in support. Anybody else wishing to testify in SB 2272? Members, any questions? Okay, moving on. SB 967, relating to health. First up, we have Director Yamane, Human Services, providing comments. Okay, Meredith.

Aloha, Chair, Vice Chairs, Members of the Committee. We stand on our written testimony.

Identify yourself. You're not... You're not Yamane.

I'm sorry. I'm Meredith Nichols, Department of Human Services.

Okay, you stand on your written testimony. Thank you. Next, State of Hawaii, Insurance Division providing comments.

Chair, Vice Chair, Members of the Committee. Justin Chu from the Insurance Division. DCCA stands on its written testimony.

Thank you. Dr. Lewin, SHPDA, providing comments.

Stand on our written testimony.

Okay, thank you very much. HMSA providing comments. Okay, Walden Au. Okay, next we have Shelby Pikachu Billionaire of Ohana Unity Party and Kingdom of Hawaiian Islands, in support. Shelby, are you present on Zoom?

Not present on Zoom, Chair.

Okay. Dawn Wakukawa in support. Courtney Kacir in support. L Elento in support. L Elento, are you present on Zoom?

She is, but her mic is off.

They are present.

Please proceed. Could you unmute yourself and put your video on, please, Ms. Alento? Okay, while we're waiting for, anybody else wishing to testify SB 967 regarding ketamine. Okay, we're gonna move on Ms. Alento. Next, we have SB 2285, relating to complex patient treatments. First up, we have Department of Health, Hawaii State Department of Health, providing comments.

Good afternoon, Chair. John Glare with the Alpha Drug Release Division, standing on our written testimony and thank you.

Thank you very much. Alan Johnson, Hawaii Substance Abuse Coalition, in support.

Chair, Vice Chair, distinguished members, I'm Alan Johnson, Hawaii Substance Abuse Coalition. The substance abuse agencies have evolved. We treat substance abuse and mental health, severely mental health, in one setting. We do not treat substance abuse and those with significant mental health issues, which is a huge population that often has physical illnesses too. This is unserved population.

The Federal Government has decided to move forward. Grants are coming forward only to those states who have a pilot project. Seven states got it this year, be 20 some next year. If we have a pilot project, we could do it.

Hina Mauka and Aloha House have already started this through grant and aids from you folks, and community grants. We've already started this project. We have doctors and nurses. We're working really well with it. We're ready to do this pilot project. 54,000 people need this. They're expensive, people.

This is the gap that we're not getting in substance abuse. We could use your support. Thank you.

Thank you very much. Brian Baker, Hina Mauka in support. Brian?

Aloha, Chair San Buenaventura, Vice Chair, and Members of the Committee. My name is Brian Baker, President and CEO of Hina Mauka, a mental health and substance abuse program on Oahu and Kauai. I strongly support Senate Bill 2285 because the current system fails people with complex needs.

Every day, we serve individuals living with substance abuse disorders, serious mental illness and chronic medical conditions all at the same time, yet our system treats them one diagnosis at a time through separate and disconnected systems. When care is fragmented, people struggle with recovery and end up recycling back to emergency rooms, hospitals, homelessness, and incarceration. SB 2285 recognizes the simple truth, people do not live in silos, and neither should treatment.

Integrated, complex patient models reduce crises, improve stability, lower public costs, and position Hawaii for new federal funding. SB 2285 is a commitment to coordinated, effective care. We would appreciate your support. Mahalo.

Thank you very much. Oh, you're right on time. Okay, thank you. Thank you for that. Okay, next up, we have Greg—I can't pronounce the last name—of Coalition for Drug Free Hawaii. I apologize for mispronouncing last name. In support. Dr. Nasha, Hawaii Medical Association, in support. Heather Lost, Kauai Health and Harm Reduction, in support.

Anybody else wishing to testify on SB 2285? Seeing none. Members, any questions? Okay, seeing none. Moving on, SB—Alento, are you still here? Okay, good. We're gonna go back to—which one is it that she's testifying?

Ms. Alento, if you are driving, please pull over before you give your testimony. Okay, thank you.

I'm a passenger. Yes, I appreciate that. No problem. My doctor, Dr. Robin Martin, has highly.

Okay, we lost you.

Oh, you did?

Okay, you'll get back. Please proceed. We got you back again.

Okay, thank you. I'm in support of this Bill because I believe people like myself would benefit from this particular drug therapy. And even just if there's one they're willing to pay for, like private insurance and it's not working, then we need to have the next one that is effective and it's very expensive so people like me can't get it, although I've been able to trial it and it's been very effective for me.

Thank you for the opportunity to present testimony and please highly consider passing this Bill. But as before, I know this bill's been out, what, at least three years, for private insurance as well.

Thank you very much.

Okay, moving on. SB 2289, relating to Certificates of Need. First up, SHPDA in support.

Aloha Chair, Vice Chair and Members. We support the intent of this Bill to streamline some Certificate of Need program exemptions. We did want to mention though, in our testimony that ambulatory healthcare facilities shouldn't be exempted.

We'd have all kinds of investors, folks popping in here with surprise facilities similar with the federally designated medically underserved areas. That's basically the whole state in all the rural areas. Again, that would just be an overreach for poor quality investment coming in to compete with our existing healthcare system.

We also would ask that we oppose the exemption for substance abuse treatment programs. A little bit more complicated there because we don't require CON for substance abuse treatment.

Sorry about that.

But unless they're residential and they're inpatients in the facilities. You know, there's a lot of consternation in communities about placement of these kinds of facilities in neighborhoods. And we understand, though, that CON does have a required notice, but that particular, the wording in the Bill doesn't really take the CON program. So we close those and we.

And the neonatal intensive care units, the others. So you've got our stuff?

Yeah, I got your written testimony. Thank you very much.

No, we're not opposing everything.

Okay. I understand that. Grassroots Institute of Hawaii in support, Ted Kefalas. Paige Choy Healthcare Association Hawaii, providing comments.

Thank you so much. I, you know, I do want to echo a lot of what the SHPDA administrator said, and I just want to comment that we met with our hospice leadership Committee meeting this morning. They're very concerned about some of the exemptions in the Bill.

I think they understand that, you know, we don't have to have a CON for everything, but for hospice in particular, there is a lot of fraud that we're seeing on the mainland in the program. I think the CON has been a very effective tool here to keep a lot of those fraudulent or opportunistic actors out.

And so we are concerned about the exemption for the hospice homes, but also, as noted, the federally designated medically underserved. That's a really large population, and that could be an opportunity for some bad actors to come in there. In some states, actually, Medicare is not allowing new hospices to open up or they're under strict scrutiny.

So we feel like we don't want to get to that point, and that's why we want to make sure we're protecting this particular framework here in Hawaii. So thank you. Okay.

Okay, thank you. Next we have Michael Robinson, Hawaii Pacific Health, providing comments.

Good afternoon, Chair, Vice Chair. We have comments. We are concerned, particularly in the area of the exemption of specialty services here, namely NICU services, pediatric service and Burn Center. One of the reasons is one of the mandates of SHPDA, one of the cornerstones of our state is that we do have a SHPDA and they do manage quality.

And one of the things that they run under the Certificate of Need Program program is to ensure that a new entrant that provides a service has the basic minimum quality standards. And we're also concerned with private equity doing, you know, entering into a marketplace. We have a nonprofit system.

So I think for our feeling is that for SHPDA to be not have oversight on the total management. We heard earlier that that is a desire of that Department to do exempting out specialized services, particularly in areas like Burn Center or NICU.

Where you really want to have kind of the best providing it and not somebody just off the street. The Certificate of Need provides safeguards against that. So we have concerns around that. Thank you.

Okay, next we have Navian Hawaii in providing comments.

Richmond Lazar, testifying on behalf of Navian Hawaii. We'll stand on our written testimony with comments. Thanks.

Thank you very much. US Renal Care providing comments. Melissa Pavlicek.

We stand on our comments.

Thank you very much. Knee Regulatory Research center providing comments. Queens Health Systems providing comments. Maui Health System in opposition. Liberty Dialysis, Venus Kidney Care in opposition. Lila Moore in support. Corinne Solomon in support. Hawaii Care Choices in opposition. Anybody else wishing testify in SB2289?

Okay, come on up. Identify yourself.

With apologies, we submitted some late testimony. My name is Melissa Pavlicek and on behalf of Bristol Hospice, our testimony is in opposition, but it really is only pertaining to the exemption for hospice and Pediatric.

You've already heard other testifiers express a desire to keep the certificate of need for those two types of services and just wanted to underscore our support for that.

Okay, anybody else wishing testify in SB2289? Members, any questions? Okay, moving on. Can we go on with decision making? Okay, so we're gonna do decision making on this calendar and last week's calendar. Okay, so first up, SB3132, Chair's recommendation is to, as soon as I find it, all of my crap here.

3132. Pass with technical non-substantive amendments for clarity and consistency. Any comments, questions, concerns? Seeing none. Pass with amendments. Vice Chair for the vote.

Okay, thank you very much. Recommendation 3132 is a Senate Draft 1. Noting the excused absence of Senator Kanuha. Of the Members present, any WRs or noes? Seeing none. Recommendation adopted.

Okay, next one. SB3134 Chair's recommendation is to pass this with Department of Health's proposed amendments and technical non substantive amendments for clarity and consistency. Any comments, questions concern seeing none. Vice Chair for the vote passed with amendments.

Okay, 3134. Recommendation Senate Draft 1 noting excuse of Senator Kanuha. Any WRS or Noes of the remaining present Members.

Seeing none recommendation is adopted

For SB3136, Chair's recommendation is to pass it as is. Any comments, questions, comments? Concerns seeing none. Vice Chair for the vote.

Okay, recommendation 3136 as is noting the excuse of Senator Kanuha Members present. No WRs or Noes? Seeing none, the recommendation is adopted.

For SB 3138, Chair's recommendation is to pass with amendments. We're going to accept Maui Brewing and Lonnie Kai's proposed amendments.

And so on page 2, lines 15 and 20, we're going to replace 2 million with 5 million and add a subsequent purpose for sub 4 to require Department of Health to develop a web based systems to allow for Internet submission by distributors of the reports required by this chapter.

Okay and we're going to put in a defective date okay to allow for further discussion of this of January 30, 2050. Any comments, questions, concerns? Seeing none Vice Chair for the vote.

Okay a recommendation is Senate Draft 1 noting excuse of Rep. So gosh, Senator Kanuha, any of the Members present wishing to vote no or WR? Seeing none recommendation has been adopted.

Okay. For SB 3139, we're gonna pass this with amendments. We're gonna remove section two on page three, pursuant to HMSA's concerns. And we're going to also adopt any technical non-substantive amendments for clarity and consistency. Any comments, questions, concerns? Oh, put a defective date also, January 3rd, 2050, to continue further discussion. Any comments, questions, concerns? Seeing none. Vice Chair for the vote, pass with amendments.

Okay. Recommendation 3139 is the Senate Draft 1. Noting excuse of Senator Kanuha. Of the Members present, any WRs or noes? Seeing none. Your recommendation is adopted.

So for SB2272 chair's recommendation is to pass it as is, any comments?

He said 22.

Aren't we in 2272?

3207. I thought yeah we're 3207.

3207 yes. Sorry.

Happens to the best of us.

Okay. That's right. Okay. Senior moments.

It's okay.

Okay. SB 3207 relating to background checks as noted in the discussion, AG's proposed concerns I mean AG's concerns need to be taken seriously by the Health Care Administration. I mean by HAH because it's even if we pass it, it's going to be subject to veto. But I want to continue discussion.

So we are going to pass this with amendments. We're going to accept HPHA proposed amendments. We're going to add in technical non substantive amendments for clarity and consistency. We're going to put in a defect date of 01-03-2050 to continue discussion.

We're going to request the Attorney General to propose amendments regarding the collection of fingerprints so that we don't kill off the entire Bill just because of one particular concern. Okay. Any other comments, questions, concern? Pass with amendments.

Okay, just a real quick comment. There have been bills that have gone to the governor's office before the AG has opposed that he has signed. So I wouldn't just totally take it out. That being said, recommendation 3207 is the Senate draft one noting the excused absence of Senator Kanuha. Are there any other Senators wishing to vote?

No reservations seeing none. Your recommendation has been adopted.

Okay. SB 2271 relating to hospital licensing. Chair's recommendation is to pass it as is.

There you go.

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

Okay. Recommendation on SB 2271 is as is. not in the excuse absence of Senator Kanuha. Any of the Senators present wish to vote? No. That we are seeing none. Your recommendations adopted.

Okay. Now SB 2272. Chair's recommendation is to pass this as is. Any comments, questions, concerns? Seeing none. Vice Chair for the vote.

Okay. 2272 as is recommendation. Noting the excused absence of Senator Kanuha. Any WRs or noes? Seeing none. Recommendation has been adopted.

Okay. For SB 967, Chair's recommendation is to defer this, pending the resolution of the sunrise analysis for which there is already a concurrent resolution that was filed on February 6th. So defer. Any comments, questions, concerns? Seeing none. Well, there's no votes, so we'll move on. SB 2285: Chair's recommendation is to pass this with amendments.

We are going to blank out the appropriation on page four, line 15. We were going to replace 2027 with 2028. We are going to note on the Committee in the Committee Report Department of health's request for $3 million. Any other comments, questions, concerns? Seeing none, Vice Chair for the vote.

Okay. Recommendation 2285 is a Senate Draft one, noting the excused absence of Senator Kanuha. Any WR or nos? Seeing none recommendation is adopted.

SB 2289. Okay. I'm going to pass this with amendments. I am, I understand, We're going to remove sections 18 and 19 per SHPDA concerns regarding hospital. Okay. We're also going to remove the hospice as part of this. But I am going to note that the only standalone hospice in East Hawaii got closed. Okay.

So I don't know about you folks's concerns, but I mean, I'll take your concerns to heart. But we do need hospice and so we're going to pass this with amendments. Remove sections 18 and 19 and we're going to remove hospice for now. But if we don't have enough, I'm going to revisit it again. Okay.

I'm just letting you know. Any other comments, questions, concerns? Seeing none Vice chair for the vote passed with amendments.

Okay. 2289, recommendation is a Senate Draft 1. Noting the excused absence of Senator Kanuha. Any WRs or noes? Seeing none. Recommendation has been adopted.

Okay, so we are going to adjourn that hearing and then we're going to recall the deferred calendar from February 6, 2026. For SB 2479, Chair's recommendation is to pass it with amendments. We're going to remove Section 1 of Section 1 and remove Section Sub C, Sub 1 from Section 8 of SB 2479. We need you folks to be quiet, please. Okay. Any other comments, questions, or concerns? Pass with amendments.

Okay. 2479: recommendation, Senate Draft 1, noting excused absence of Senator Kanuha. Any WRs or noes? Seeing none, recommendation has been adopted.

For SB 2589--

We're going to pass with amendments. We're going to insert the language from SB 2269, replace the language of 2589 with that of 2269, which is similarly titled and similar and a lot of similarities. And we are going to note in the committee report the request for $3 million.

The language that we are inserting into 2589 has blank appropriations and blank FTEs. So we're going to note the request of $3 million to cover all of these costs. Any comments, questions, concerns? Pass with amendments.

Okay. Recommendation is a Senate Draft 1. Noting excused absence of Senator Kanuha. Any WRs or noes? Seeing none. Recommendation has been adopted.

And with that, we are adjourned. And thank you.