Senate Standing Committee on Agriculture and Environment

Good afternoon. Mahalo for joining us today for the joint HHS and housing, joint committee on Monday, March 30, 2026 at 1PM. We're convening Room 225 with my co Chair, Senator Chang.

Following this, there is also another joint hearing with Energy and Intergovernmental Affairs. And following that, we have a agriculture and environment joint hearing.

And following that, we just have a health and human services, hearing. This meeting is being streamed live, and all the subsequent meetings are gonna be streamed live on YouTube.

The likely unlikely event that we must abruptly end this hearing due to technical difficulties, the committee will reconvene to discuss any outstanding business later at 1PM, Wednesday, April 1, 2026, in Room 225, and a public notice will be posted on the legislator's website.

To facilitate this hearing in a timely manner, as you know that we have four hearings, we will be enforcing a one minute limit on testimony. I will be reading, and Senator Chang will be reading a list of individuals who submitted written testimony for each measure.

We apologize if the closed captioning does not accurately transcribe the names. If you're interested in reviewing the written testimony, please go to the legislator's website. You will find a link on the status page for the measure.

We appreciate your understanding and remind you that the committee does have your testimony, that we have all reviewed them. So I encourage you to use your time to either add additional comments or you can stand on your written testimony.

And with that, I am allowing Senator Chang to proceed with his hearing.

Thank you so much, Senator San Buenaventura. We have one item or one pair of resolutions on the 1PM agenda for the joint committees on Housing and Health and Human Services, SCR 160 SR 151 urging HPHA, DHS's homeless programs office, statewide

office on homelessness and housing solutions, and HHFDC to create a housing ladder program to help individuals and families graduate into unsubsidized housing. Will be taking testimony on both simultaneously. Our first testifier is HHFDC in support.

Good afternoon. HHFDC stand by.

Thank you. HPHA in support. Thank you. Statewide Office and Homelessness and Housing Solutions in support. Thank you.

Lila Mower in support. Is there anyone else wishing to testify on SCR 160 and SR 151? Okay. If not

I have a question. Is anybody here from the, Housing and Homelessness Solution? I don't see anybody. Oh, you are? Okay.

Yeah. I

see with any any, follow-up answers.

Okay. Because, yeah, you're not Jun Yang. But So I have a question. So could you come on up here?

That's the reason I asked whether or not you were here. So you're supposed to be, not you, Jun Yang, but go ahead since you're representing Jun Yang, conducts those interagency meetings for for the homeless coordinators, and I used to attend them before.

And is that something that could be used as a because it's already there, the interagency to create this homeless ladder plan?

Yes. I believe that would be one of our strategies and tools, to work on this initiative with the other collaborating agencies.

Okay. Thank you. Ben Park, come on up. Since you're you're one of the people I mean, your agency is one of the people who are supposed to be listed to create this housing ladder program. It doesn't sound like it's just urging you folks to work together,

but it doesn't sound like that there is a requirement that you folks actually come up with a housing ladder plan. Is there any movement towards that?

Afternoon, Ben Park with the Hawaii Public Housing Authority. I think we're gonna take this resolution back to our directors. And I know we we still collaborate now on how we transition from homelessness to public housing to section eight and then to getting

to unsubsidized housing is is not gonna be able to fit everybody, but we will get back to the directors and and work on that for the resolution.

Okay. And and, frankly, Housing and Homelessness Solutions, there is a bill moving, Senate bill that basically will fund you folks for another couple of years. But as part of that bill, you folks are required to come up with a plan to reduce statewide homelessness by 25%.

I think I started off with one year, but has since changed to two years. Is that something that you could integrate with this, housing ladder?

Reducing homelessness is, is our top priority, particularly unsheltered homelessness. So we would, we would work with, our department and director to incorporate that into any plan developed under this housing ladder.

Okay. So it's it sounds like because basically that that's part of the housing ladder. Right? From the homelessness to transition on up. K.

That's basically it. I don't have any other questions.

I have questions for them.

Okay. Sandro, go ahead.

I know we're talking about the percentage. And we know you guys are supposed to be collaborating together, but why is the collaboration with all the agencies that is on the out there all the time? We're trying to get this data and information.

I know Senator Moriwaki talked about making sure that we get the data shared data.

Not sure if that's your guys' department, but, you know, when we have nonprofits dedicating themselves for houselessness or people that don't have homes, you know, I've been doing this for a long time, and the bill before I was Senator.

And, you know, our homeless crisis got worse. We're still giving a lot of money out there, and there's no accountability. So I don't know how you guys gonna collaborate with the rest of the people. But you know what my idea would be?

Every single person getting money for homeless, they all their money back. Unless they can show us statistics on how they're reducing it. We can give you guys the 25%, but you guys don't even know the percentage of why we had help anyway in the beginning.

So even we make a resolution, which is a resolution, we're asking you guys to do this. Our urgency, not just you guys, and not just you guys. You guys are here. But, again, going forward, how are these urgencies?

We're gonna tell these guys who we're giving them money, millions and millions of dollars, and half of that go to their, paperwork. The other half, I don't know where it go. Very small goes to the community.

Reason why I say that is because with with me, when I was serving on the neighborhood board at the Everbeast Lions Club, every dime that the Lions Club get because we don't do it for profit.

We do it for service. Those guys forgot that who's doing this. So you guys can collaborate or you guys like with the percentage that we're because I like I like this bill. It's great. But, again, how we will get results?

The results is lessening the amount, not growing. No. He's blaming other things that's happening. But, again, not only the cost of living, just not holding these guys accountable. Because I get a few shelters.

He got you talk offline that they're just a revolving door. A revolving door. Kick them out, two years later, they're back, revolving door. A lot of us get the statistics. Put in the statistics, get the grant, get the money.

That's all they're worried about. Those guys are still yet on the streets. I still get the same homeless guys that went into the shelter, came back out, went to another shelter, came back out. There is no collaboration.

So if this is right there to looking at these guys who are finding out more homes and we're gonna do the 25%, I support that. But again, you guys gotta figure out how we can do this.

All these guys who take in the money from the state and our grants, owe them accountable. If cannot, then we gotta come up with a bill to cancel all the funds because they're top heavy. They have a lot of administration, a lot of money going through the administration.

You know how you guys do it? Not you guys again. You know how you do this? You actually get out of your office and you go down there and you talk with them. Encourage them. Do not give them one handout while a handout.

Sit. Because I I wanna see how this is gonna work. And if it doesn't work, we need to collaborate as senators and representatives to see how we will cut everybody's budget and as they can show us results. That's how they get paid. Thank you.

Thank you, Senator.

And I just have one more comment, co chair. As you can tell, and as you could hear from any listening to any city council hearing regarding their budget for homelessness, We've reached a point of compassion fatigue. And I know on Hawaii County,

they're already starting to cut their homeless budget. And that's also the reason I required it on on when you folks when the office of housing and homeless solution was asking for another 25,000,000 or so with no plan on actually reducing.

That that's the reason we require we're requiring these plans.

Okay? And for Senator Favella's edification, the 25% requirement and health required them to start with a starting point based upon pointed time counts of this year, since they're starting it up again. Okay. Basically, that's it. We're, you know, this is just a resolution.

The other one is a bill, however. And if we don't end the bill, also require that further funding of the Office of Housing and Homelessness solution is gonna require basically a reference to that plan as to what we're doing about it. Yeah?

Just putting up kohalas willy nilly without any plan. Again, we've reached a point of compassion fatigue. Okay? Thank you.

Thank you.

Thank you. Thanks. Okay. Alright. Are you into decision making?

Yes. Do you have accept quorum?

I don't have quorum, but but because I have the other ones, we will defer decision making until we reach quorum.

Okay. Great. Well, we have quorum for housing. So alright. So Chairs have been conferred. Chair's recommendation for SCR 160 and SR 151 will be to pass this measure unamended. And I think there was some good discussion earlier,

so maybe we can incorporate the concerns of senators Fevella and co Chair San Buenaventura into the committee report as well. Questions or discussion?

K. Again, for SCR 160 and SR 151 for the committee on housing, chair's recommendation is to pass unamended. Chair votes Aye.

K. Chair's recommendation is to pass SCR 160 and SR 151, both unamended. [Roll Call] Mister Chair, your recommendation's adopted. Thank you.

And for health and homeless health and human services, we are deferring decisions. No. We're not. No. We're not. We have our quorum.

Any of your r's or no's?

Thank you very much. And with that, the we are adjourning Housing and Humans, Health and Human Services. Calling the Health and Human Services, I believe 1:07 calendar until the other co Chairs of the other joint committees appear.

First up, SCR 30, requesting the auditor to assess the social and financial effects of mandating health insurance coverage for brief cognitive assessments for individuals 50 years of age and older. First up, we have excuse me.

Auditor's office providing co request in opposition, I guess. Next, we have Hawaii Disability Rights Center in support. Alzheimer's Association in support. Lila Moore in support. Mansa Debaki in support.

Barber Service in support. Jerry Peron in support. Department of Health providing comments. And Johnny May Perry in support. Anybody else wishing to testify in SCR 30 requesting the auditor to assess the social and financial effects of mandating health

insurance coverage for brief cognitive assessments for individuals 50 years of age or older?

Excuse me, Chair? Done. Oh, we do have Koby Chalk, and Barbara in this call.

So, yes, Alzheimer's. Please proceed.

Sure. Thank you for hearing this bill. And Koby Chalk, on behalf of the Alzheimer's Association. We'll stand on our written, testimony and support.

You very much. And I see, Mr Black. Are you here for SCR 30? Yes. Yes.

Okay. Please proceed. You have one minute.

Alright. Alright. Yeah. I'm gonna find out who I am, Mr. Black. And my wife and care caregiver Barbara and I are living on in the Nolle on the Big Island.

And Members of the committee, I really wish I had received a brief cognitive assessment when I was 50 years old. 23 years later, I did get a brief assessment. And at that time, I was retired and covered by Medicare,

which was very fortunate because that's what I learned that I had I was cognitively impaired and had been for some time. And that's when I became a Alzheimer's patient.

Learning that my disease was in a relatively early stage of development allowed us to adjust to this new and frightening reality while I was still relatively functional.

Our path has been much more positive than it might have been, and we were we are very grateful for this. For this reason, I strongly support support this bill.

Thank you, Mr. Black.

Thank you for the opportunity to testify.

Okay. Now we have Barbara Black, your wife. Please proceed. You need to unmute yourself.

Okay.

Go ahead.

Yes. My name is Barbara Black. I'm Peter's caregiver, and I'm strongly in support of SCR 30 because while we were stunned when we found out that Peter had Alzheimer's, That early diagnosis was a blessing for us.

It let us plan for the future and for Peter, give him access to one of the new Alzheimer drugs. And I had a chance to learn what I could learn about Alzheimer's and caregiving.

And it's sort of a matter of equity when I think about this, that, people who aren't eligible for Medicare but are already experiencing cognitive decline should have the opportunity to easily get early screening leads to earlier diagnosis, care planning, and access to treatment.

So I respectfully urge you to support SCR 30 so all Hawaii residents have a better chance at early detection.

Thank you very much, Mrs. Black. Members, any questions? Anybody else wishing to testify on SCR 30? Okay.

I have a short question of Koby Chalk. Koby , are you present? Alzheimer's Association.

I'm here, Chair.

Okay. Did you see the auditor's opposition?

I did.

Okay. The the big problem we have is that the House Bill refers to a cognitive assessment and use the phrase including, but not limited to, which then becomes super general instead of just saying a brief cognitive assessment.

You can share. So, the reason for that is like, Dr. Lewin's comments in the testimony, he mentions that anybody who might be, getting Alzheimer's disease or have cognitive impairment should be able to get a cognitive assessment.

So ideally, it'd be for those 50 and older. But if someone is, say, 49, and their doctor feels that, given their family history or whatnot, they should be getting cognitive assessments maybe even sooner, we wanted to leave that opportunity for them as well, although it would be less common.

Okay. So here's the problem. The problem is we are super specific because the prepaid health care plan that we need to protect that is really unique to Hawaii and I think Massachusetts is something similar, we cannot just mandate services unless we know whether or

not it's gonna affect that prepaid healthcare plan. So having something, a a bill that refers to something very general and requiring mandating coverage, it's gonna screw up our prepaid healthcare plan.

So I would strongly recommend that next year, you folks tighten the request.

K. Saying a brief cognitive assessment for those who are 50 year old or over. K? Because otherwise, you know, the state is not gonna throw away our prepaid health care plan just to to satisfy you folks.

That makes sense.

Thank you very much.

Thank you, Chair.

Any other questions? Okay. Right now, we're gonna do a brief recess and get back to the 1:02 calendar. So the 1:07 calendar is recess until Calling the 1:02 calendar and joint hearing of Health, Human Services and Energy and Intergovernmental Affairs.

Present with me is my co Chair, Senator Wakai, and his committee Members, senators Richard, Senator Rhodes, Senator Chang.

And the rest of my committee is my co Chair, my Vice Chair, Senator McKelvey and Senator Fevella. First up, we have SCR 24, SR 21 supporting the governor's decision to join the West Coast Health Alliance to guide public health decisions.

First up, we have Department of Health in support.

Good afternoon, Chairs, Vice Chairs, and Member of committee. My name is Nathan Chen. I'm with the Department of Development.

Thank you very much. Next, we have Hawaii Public Health Institute in support.

Hello, Chairs, Vice Chairs, committee Members. I'm Chris Caulfield from the Hawaii Public Health Institute. We're in support of this bill this resolution as well. Like, we think it comes at a great time. Hawaii's participation in the West Coast Health Alliance comes at a

time when there's many public health professionals and medical organizations expressed grave concern about some of the rollbacks coming out of the federal administration in regard to vaccines, reproductive care, chronic disease.

The WHCA was formed specifically to ensure that public health guidance remains rooted in scientific evidence and that public communication is grounded in evidence based research that protects the public health.

So public health doesn't stop at state borders. Infectious disease crosses, state borders, social health determinants, supply chain disruptions, impact multiple states simultaneously, and we think this is a great resolution, and we hope you'll move it forward.

Thank you very much. Next, we have Theresa Armbruster in opposition. Theresa, are you present? I will I will name those who have registered first. Come on up, Theresa.

Aloha, Chair and committee Members. I'm Terry Armbruster, and I oppose SCR 24 and SR 21. I do not support the governor's decision to join this alliance, because, just because you're joining this alliance does not mean we're going to increase public confidence in vaccines.

And this, it seems like this alliance is mainly going to be pushing vaccines and no other kind of health alternatives to build up immune system, healthy immune systems. There's more naturopathic ways too.

And also, many are aware of what happened during Covid. The Covid vaccine alone had a lot of adverse reactions, serious injuries, and death. So, even though you keep saying everything's science based and evidence based, well, one of the, so called experts,

medical experts, is the American Academy of Pediatrics, which it seems like this, alliance is going to rely on some of their guidance. And right now, there's a RICO lawsuit against them for fraudulent, vaccine safety claims. And, in that lawsuit, there's also.

Thank you. And I do oppose it. Thank you. And I was saying our written testimony. Thank you.

Thank you, Theresa. Okay.

Thank you. And I I did see what you said about the American Association Pediatrics. K. Linda Miata in opposition. Linda, are you present on Zoom?

Yes. Please proceed. Okay. Please proceed.

Aloha. I'm Linda Miata. I am opposed to SCR 24 and SR 21. Vaccines are not the most effective health tool to prevent illnesses. There are many safe natural remedies to prevent illness without damage and side effects.

I personally know of people who have been injured by vaccines who struggle today due to side effects and one even died. Have you noticed the increase in autism, myocarditis, blood clots, and cancer? These are all damaging effects from vaccines.

I had seven teacher friends come down with cancer amongst only 50 Us teachers. They all took the vaccine. This is not normal. Have you noticed more young people dying before their time? Do you know the ingredients in each vaccine?

Ingredients have changed since we were kids. Military bio defense experts have confirmed in peer review that the measles virus and the measles vaccine is the product of gain of function.

Have you studied the VAERS report to see how many people have been injured? It's heartbreaking. What other consequences will arise if we join this Alliance? Will we lose federal aid and funding in other areas?

Thank you so much, Linda.

Thank you so much, Linda. Next, we have Kim Cordery, also in opposition. Kim, are you present? Yes. Come on up.

Aloha, Chair and committee. Thank you for letting me this, have this opportunity to oppose. I'm opposed to SCR 24, and I'm opposed primarily because I do not believe that this is in the interest of the general public.

I believe that it's the interest of the way they that our governor is taking us. And as Linda said, I don't believe that it it actually includes any of the healthy aspects of building a healthy immune system naturally.

Our God given immune systems are built on natural it's a natural health, not alone by vaccines. By vaccines, there are, as she said, many, injuries and adverse reactions. So I'm opposed to this, and primarily also because I believe this goes against our constitutional

rights, that to have a board decide or have the government decide on our own health, I believe that is just not right. So I oppose. Thank you.

Thank you very much. Next, we have, Cheryl Toyofuku in opposition. Cheryl, come on up.

Aloha Chair and committee Members. My name is Cheryl Toyofuku. I'm a mother. I'm a grandmother. I'm a retired registered nurse and a health advocate.

I strongly oppose, this resolution, SCR 24 and SR 21. This West Coast Health Alliance was in response to the lowering of the childhood vaccine schedule. And, we all have heard many testimonies over the years about the adverse reactions from

vaccines, many during the Covid time where there were a lot of deaths, many of our family and friends. I think our legislators, our lawmakers should do a little bit more research on the vaccinations and that it does not really build up our natural immunity.

It's artificial immunity being injected into us versus natural.

So it's like similar to SB 3133 which is forming an advisory committee that's promoting vaccines or the American Association of Pediatrics that also promotes vaccines. But why are we focusing so much on vaccines for preventive health measures?

There's so many other natural, nontoxic ways to build our Ohana's health. So I strongly oppose this resolution. Thank you.

Thank you very much, Cheryl. Reyna Laughlin in opposition. Reyna, come on up.

Aloha Chair, Vice Chair, and Members of the committee. I am in strong opposition of SCR 24 and companion SR 21. The governor's decision to join the West Coast Health Alliance is not fairly representing the will of the people of Hawaii.

A concern is how it will impose on our medical freedom as it did during Covid 19 where public health decisions and mandates were made for us.

A grave concern is the recommendations of vaccinations, which are terrible ingredients many of us don't want in our bodies or our children's bodies, such as aluminum, mercury, aborted fetal cells, and more.

There's a lot of people concerned about vaccinations and the recommendations by the CDC or other health organizations that this alliance would align with so people would have, should have the choice to choose their own, medical decisions.

This alliance would also give the governor to give standing orders, and that I have a problem with. Standing orders is not allowing us, our own medical freedom. For these reasons, I oppose.

Thank you very much. K. Judith Clark in support. Brett Brett Colbis in opposition. Terry Yoshinaga in opposition.

Rita Kamakimura in opposition. Anybody else wishing to testify? Oh, come on up. Sorry.

This is my first time. Sorry.

Okay. Sorry about that. Identify yourself.

Good afternoon, Senator, Chair, Vice committee. Thank you so much. I oppose this resolution.

Please identify yourself.

My name is Yeva Bambridge.

And I oppose this resolution. I'm here because I believe I have a right to make decisions about my own body, and that's not negotiable for me. I don't want to be mandated to take something. I would like to choose. I am in excellent health.

Okay.

I take no medication. I'm asking you to protect that choice.

Thank you very much.

Have a great afternoon.

K. Come on up. K. Identify yourself.

I'm Loretta Dubin, and I say thank you, Chair and co Chairs and committee, for allowing me to speak. I am in opposite very strong opposition to this West Coast Health Alliance. I myself have had family members that have passed away after getting the Covid shots.

And so that's very recent in in all of our memory banks here. Our body is the most important infrastructure we have and that we have to steward. Okay? So we have to know what we're putting in our body. It is it is not effective, and it is not safe.

I've been a nurse for fifty years. And during the Covid years when they were injecting people, the hip hippie jibbies, they were they threw out the rules about how they even gave injections, and people were passing out at these little clinic sites.

This is not a debatable issue. But thank you very much for hearing me out, and I hope you vote in the Thank

you very much. K. Nobody else having registered to, testify in SCR 24, SR 21. Anybody else wishing to testify? Come on up.

Aloha, Chair San Buenaventura, Chair Wakai, and Members of the Senate Health and Human Services and Emergency and Intergovernmental Committees. My name is Margaret Mejia.

First of all, we don't need the government to guide us in any of our individual health decisions.

I'm, representing Hawaii Christian Coalition. Hawaii Christian Coalition is opposed to SCR 24 and SR 21 relating to the governor's decision to join the West Coast Health Alliance to guide public health decisions.

We believe in bodily autonomy and medical freedom. Second, we at Hawaii Christian Coalition would like to point out that the so called science that Governor Josh Green is promoting is not real science.

The last legislative session, over 2,000 people testified against the HB 1118 because they wanna make choices regarding, vaccines for their children in schools. Governor Green said that vaccines are safe and effective. He said masks work and we should social distance.

None of these things can be proven scientifically to work. As a matter of fact, the opposite is true science.

Thank you very much. Anybody else wishing to testify on SCR 39 and excuse me. I just forgot which one we're talking about. SCR 24 and SR 21. Come on up.

Please identify yourself.

Chair Chairs, Vice Chairs. Jack Lewin, administrator of SHIPDA, and I just really support the governor's decision to join the Western Alliance. I think it's a very good thing for the people of Hawaii, and, SHIPDA strongly supports it. Thank you.

K. Thank you very much. Anybody else wishing to testify on sCr 24 r 21? Members, any questions? K.

Moving on, I now give it to, my co Chair for the for the remainder of resolutions.

I'd like to walk us through the next pair of resolutions. They are SCR 8SR 10. This is regarding building permitted for health and safety for older adults wanting to, refurbish or renovate their homes. I have is any there anyone in the audience or online wishing to testify on SCR 8or SR 10? Members I oh, yes.

Dr. Lewin.

Thank you, Chairs, Vice Chairs, and Members. SHPDA supports this this effort, on behalf of for persons with disabilities. We think it just speeds up the process. We think that would be very helpful for fall prevention and for other kinds of issues if the resources are available. Thank you.

Thank you, Dr. Lewin. Is there anyone else wishing to testify on these two measures? If not, members, any questions?

K. We're gonna move on to the last pair of resolutions. They are SCR 90 and SR 85. It's regarding commuter friendly parking accessibility. Is there anyone wishing to testify on these two measures? Not members.

We have written testimonies submitted by two individuals, both of whom are in support of this measure. If, give us a few seconds and we're going to take a brief recess prior to the vote.

Okay. Recalling the joint committee on energy, intergovernmental, and government. Energy and intergovernmental affairs and health and human services. So for SCR 24, SR 21, chairs have confirmed and we do not have, sufficient votes. So HHS is gonna defer SCR 24, SR 21.

Any comments, questions, concerns? Seeing none.

Same recommendation for EIG. Any thoughts, comments? If not, we're gonna move on to the next pair of resolutions, SR 8, SR 10. The two chairs have conferred. We'd like to move these two resolutions along.

We'd really help those who are in need of renovation to their home, who are on the senior side of our community to get the renovations they need done more expeditiously. So the chair's recommendation is to pass this measure, these two measures as they are. Any discussions? If not, Senator Chang, I vote yes.

First recommendation for SCR 8 and SR 10 is to pass unamended. Chair, Aye. Vice Chair votes aye. Senator DeCoite is excused. Senator Richards?

[Roll call]

So for HHS, same recommendation, Vice Chair for the vote.

Okay. Same recommendation, Senate Draft 4 1. Oh, sorry. As is. As is.

Noting the, presence of myself and Chair San Buenaventura and Member Fevella, all those excusing. WLs and no. Seeing none, recommendation is adopted.

Sorry. Well, the final two pairs of resolutions, SCR 90 and SR 85, we'd like to pass this measure out as they are. We'd like to help our seniors who need to get parking accessibility in various businesses around around the state. So the chair's recommendation is to pass as is. Any discussion?

If not, Senator Chang, I vote yes.

Chair's recommendation for SCR 90 and SR 85 is to pass unamended. Of the members present, are there any objections or reservations?

Seeing none, the recommendation is adopted.

Thank you.

For Health and Human Services, same recommendation. Vice chair for the vote, chair votes aye.

Okay. Recommendation, is to pass unamended. Opening the excused members, any of the others, no. Seeing none, recommendation is adopted.

Okay. And with that, we are adjourned for the joint committee on energy, intergovernmental affairs, and health and human services. Continuing the health and human services 01:07 calendar, next up is SCR 35 SR 34 requesting the auditor to assess both social and financial effects of proposed mandated health insurance coverage for the diagnosis and treatment of autism and for applied behavioral analysis services. First up, for SCR 35, we have Department of Education in support. Louis Erteschik, Hawaii Disability Rights Center in support.

Yes. Thank you, Senator. I was really involved when when the insurance mandate was passed. I'm trying to remember what year it was. I think rep I I think representative McKelvey was in the Senator McKelvey now who was a represent I I don't know if you were in the legislature or not.

Senator Baker was a big champion. It it was the result of years of struggled advocacy. So at the time, the compromise that was reached certainly seemed reasonable. I mean, it's mostly for kids, and so the idea of the age cap and the dollar cap is you can appreciate that's how legislation gets made. But I think time has shown that it really does benefit over people, and it's also shown that this stuff isn't cheap.

And so and so the dollar cap is kind of is is is becoming a limitation. So so I think it makes sense for the auditor to look into this issue and do an analysis and then give you some information to make a decision next year. Thank you.

Thank you very much. Next, we have Bayada Kristin Koba-Burdt in support. Kristin, please proceed.

Thank you, chair, vice chair, members of the committee. Kristin Koba-Burdt on behalf of BAYADA. I'll echo what Lou said for AD HDRC at the time we passed this with representative at the time that Kelby support with an age and dollar cap. The important part being, those are not enforced. Those are considered a violation under the federal mental health parity law.

So currently, the entire population under private health insurance is able to access regardless of age or dollar cap. Currently, Bayada serves adult clients for ABA services. And so making sure that that's noted for the auditor's report that that coverage already exists. It's really a matter of cleaning up the state law in the event that the federal protections were to go away.

Okay. Thank you very much. Anybody else wishing to testify on SCR 35 SR 34? K. Members, any questions?

So my question is for Bayada. Are you still present? Yes. Okay. I think it was in your testimony that basically says that federal law already requires such coverage.

Correct.

Okay.

So the federal mental health parity law prohibits quantitative treatment limits such as age and dollar caps, And so they have not been enforced by the local health plans. The big thing that we wanna make sure we're getting right in the state law is to remove those age and dollar caps. If the federal law were to change, those protections would go away.

Okay. Thank you very much. Louis Erteschik, I have a question. Sure. According to Baiada, his testimony died.

Did you have a chance to review it?

I was just glancing at it this morning on the a little bit.

Okay. Because, basically, they say that it's it's not necessary, except, apparently, they want to remove the caps on coverage. If we're gonna remove the caps on coverage, then we're gonna have the same problem as the prepaid health care plan limitation. Right? Which means we cannot pass this bill.

I mean, this resolution unless we have those limits. Otherwise, our prepaid health care plan is in jeopardy.

I honestly am not certain. I I mean, I'd be happy. I, you know, I know Kristen well. I mean, I'd be happy to talk with her and and and try to get back to you if if that helps.

Okay. That's an that's an insurance commissioner requirement. If if you look at the other ones, we actually that's the reason why we need an auditor to let us know we're not a. Yeah.

Right. That's why I thought the auditor's idea I mean I mean Okay. You sort of can't lose by having the auditor do an analysis of that. Right? You're not actually passing any law this year.

No. But we have to put limits on what the auditor can can actually examine.

I see. In terms of the impact, you mean, if it's open ended, then the auditor doesn't know how far to look. Whereas if you say we're going from 25 to 50 or something like that. Yeah. Okay.

So we have we have a pop we have a problem with with an unending cap of of insurance coverage.

Could you amend the resolution to put in a cap?

The bill has to match the resolution. The bill needs to be changed.

I see.

The underlying bill.

Because because because the result was based on the bill.

Right. The bill is not in front of me. So okay. You you hear hear hear the problem, Bayada?

Yeah. Is it possible for the auditor to essentially look at our caps currently enforced and that answer is no, and then therefore,

Well

it would not be the impacts if they were removed in state law?

So if it's if it's a question of enforcement, it's not for the auditor.

It's basically for, Office of Consumer Protection. Right? And, the insurance commissioner, but not for the auditor. The auditor only determines whether or not there is insurance coverage, whether or not we should have insurance.

Yeah.

Correct.

Right. Mandated insurance coverage.

Okay. And that Okay. Thank you very much. Any other questions? Okay.

Right.

At this time, we are gonna recess the 107 since I have my co chair here now for AEN. So we're recessing the 107 calendar. Recalling the HHS AEN I mean, recalling. Calling the HHS AEN 104 calendar. First up, we have excuse me. Is it me or you?

Okay. Me. Okay. First up, we have SCR 39, establishing the joint legislative mattress stewardship program design working group to study, evaluate, and make recommendations on the structure and implementation of a statewide mattress stewardship program. And I I apologize.

I should call my members. And I have co chair here, Senator Gabbard and his committee, Senator Rhodes and Senator Richards. Okay. So first up for SCR 39, we have Department of Health.

Hawaii Department of Health stands on our written testimony in support. Thank you.

Thank you. Next, we have Ted Bolen in support. Johnny May Perry in support. Anybody else wishing to testify on SCR 39 SR 29? Seeing none.

Okay. Can we members, any questions? Okay. Moving on. Next up, we have Waimanalo Gulch.

SCR 142, Department of Health providing comments. K. So this is SSCR 142 and SR 134. And next, we have Johnny May Perry in support. Anybody else wishing to testify on SCR 142 SR 134?

Yes. I do. Okay.

Pikachu. Please identify yourself and proceed with your partner.

I I am the one and only Pikachu Shelby Billionaire. They tried to scare me with a bomb, but they could not scare me. We still march for freedom, and we're fighting for Waimanalo, SCR 142 as well. So I had my written testimonial. It was late last minute.

So let me just bring it up real quick. And so I'll just be real quick, real brief for everyone because we live in Wainai. We know all the garbage dump from all those tons of trash we've seen on Instagram. It's gonna come to Wainai. Even the call of Waimanalo Gulch, we got issues.

We got problems. So shout out to Senator Kurt Fevella. I talked to his staff and team to keep me at birth to support everything we got going on. We still wanna support everything you guys doing in the building. So we do have to stop establish the proper gear for the dust monitoring.

This mess is not good enough to go. Obviously, this will fail because you got PM 2.5 PM temps inside. So you got all that scientific data. I would need those hazmat suits like you're going on full gas mask gear if you could put me in there. But there is a free tour.

I just signed up from the city and waste management. The city tour the trash. If anybody wants to join Pikachu, the city is gonna, pick up up in pick us up in a bus and take us to all the tour sites for free to go see where they're gonna put all this waste. So I invite you all to come out and join us, and please support this bill because Pikachu loves you all. Hearts gotta catch them up.

Chee Hoo. Yeah you. Westside, Bestside. Minute or less. I love you all.

Thank you very much. Anybody else wishing to testify on SR 134 SCR 142? Members, any questions? So, I'm going to ask Senator Fevella's question since this is his resolution. To Department of Health, could you come on up?

Bam.

So it looks like from your from your testimony, you folks have dust monitoring dust monitoring stations already, but not to the extent I'm gonna have Senator Pobela because they're saying that they're doing enough, and you're saying not

to the So so ask them the question. So the last meeting we had with their expansion of the Waimanalo Lodge, the guys' dust monitors is not in the areas that is gonna be affecting the community. So, again, how much dust monitors do you guys have over there on the property?

There are none on the property. Alright. Sorry. I'm Barry Chang. I'm with the cleaner branch as well.

There's none on the property.

Three miles away.

How much?

There's one Three miles away. Monitor 53 miles away in

And what they're monitoring?

Yes. They're monitoring. Particulate matter, which dust.

Oh, understandable, but that's three miles away. We, like, know when it's leaving the the dump, what is being collected. I understand three miles away, but how we know is that is that all coming from the couch?

We don't know if it's coming

from the couch. That's what I'm saying. So when we when we did dust monitoring when I was working construction, it was we was doing Kapolei. We never do them. We never beach.

We did it right in the area of Kapolei so that they know how much red dirt was going on the houses, what they was ingesting. And the and the Hawaii University of Hawaii had done the research. Yes. The Hawaiian things was in there like strychnine or whatever. There's nothing around the the gouge for decades.

People have been getting sick around PBT and that gulch. And, again, we get them three miles away. So the recommendation was to have it in a in an area that you guys can actually monitor it so we can know what's happening and what's going on over there. Our families are sick and dying. And our area over there, you're you're you're expecting life expectancy is ten years less than anywhere else.

So if anybody, like, volunteer raise you guys' hand, we can put one top site in your community. Because our community is suffering. My family is dying. So we're asking this and you guys just come over and say, oh, we get 13 miles away. Is that designated for Waimanalo Gauch?

Is that three miles away?

To Waimanalo Gauch. It's a regulatory model.

That's what I'm saying. So this resolution, if you guys understand it, is for Waimanalo Gulch. Because, again, we need to protect Department of Health need to to protect the people on the Waianae Coast, people that are driving there, people that are visiting there. It's it's not happening. So, again, when when when we're gonna stop when we don't have any more of our people living there?

Right? They're gonna expand this gauge whether we like it or not. So the provisions from the Department of Health should say, hey. You guys wanna make this? You guys need to put this in.

Recommendations should come from you guys, telling the city that you guys need to put these provisions or you guys cannot you guys cannot extend it. I I don't know really know why. Again, we we we've been going this along. A lot of mayors change, but then I talked to the mayor. He said he was gonna look into it.

By looking into it and doing it is two different things. You know? We get we people dying over there. So, I mean, if you can go look at the statistics, it talks about ten years. Like and and and most of the most of the landfills let's give you guys a brief.

Most of the landfills in rural poor areas. Why do you think? We get planted property on the other side of the island. We get Coco Head Crater. We get Diamond Head.

You know? How come we don't put those in there? We got a little landfill over there so they can take their own up out of. But they're not because you guys gonna have attorneys and all these other people to get money, take you guys to court and the city. But it's okay.

Keep keep going to town. It's okay if the Hawaiians and the locals on that side die. See? So this is something that you guys should make the recommendation to the city and county of Honolulu from the Department of Health saying that we have too many people getting sick. Go to YNA comprehensive.

Put the data. They have it. PBT, respiratory, eczema, heart disease, kidney disease. Oh, no. No.

Because of what what they eat. That's what they're gonna say, what they eat. Well, that's not you guys, but the city said that. Oh, we already help what they eat. No.

Federal guidelines says 10 less of, you know, life expectancy if you live around or near a landfill. Because we don't have a county of what actually is going into the air or what people are breathing. That's the reason why this resolution because we went to the meeting at Waimanalo, and the guys at Provo Waimanalo, the the disposal guys that do Waimanalo, they have no answers. They have no answers for the community.

So, again, we want something from you guys, even though you guys, I guess, not, saying you guys have, what, three miles away.

We don't want three miles away. We want something that's gonna be dedicated to that area that's causing contamination to the people. And that's the reason why this resolution was made. That was what the community was asking at that meeting, and nobody from the city or anybody want to say anything. So I told the mayor, and I I tell you guys that that's where this resolution was built.

The people is getting sick and dying in that area. So that's my thing. So again, are you guys gonna be able to work with the community and the mayor to bring something closer or you guys just gonna keep with you guys generic treatment hours away and hopefully that he monitor something in the air that's causing people to die on the website.

The Waimanala Gulf, Landfill, they would be responsible for fence line Right.

What is your guidelines? K. You guys talking about We What is the Department of Health guidelines?

Yes. You

guys do it for PBT. PBT gets some monitors and some dust water particle things that barely works. What is the guidelines that the Department of Health is giving to the city at The Gulch to prevent people from getting sick and dying. Do you guys know what contamination is coming out of The Gulch? When was the last time you guys tested up there?

Okay. You you heard our concerns.

Yeah. That's Yeah. So that's what happened. Our regulations. I want you guys to to bring something up because if they continue the double ups, we gotta have some guidelines with somebody, and you guys are in Department of Health.

Okay. Thank you very much. Yeah. Any other questions?

Yeah. Before they before they go, so you were saying that the roads. That the the operator of the of the landfill is supposed to monitor at the at the perimeter of the Gulf or the perimeter perimeter. What what were you saying?

Yeah. We wouldn't do a fence line monitoring. The the You you would? Landfill.

Operator would. Are they? Yeah. Are they doing fence line monitoring?

Well, they have

Please. It's not in their permit right now. But

Okay. So fence line. Monitoring. If they don't monitor, then does the Department of Health are you supposed to step in and monitor? Or what's supposed to happen?

Fugitive dust emission limits in their in our in their permit. It's not supposed to go beyond the lot line of the property boundary, and we enforce that.

Okay. So

So there's been minimal complaints.

Mike stating that the permit conditions which we feel are sufficient, it's two permits with with our branch and the solid houses waste branch. There are conditions that require them to control dust. Okay.

Covering it, suppressing the cost of the house.

But you're saying that you're saying the portion of

the The regulations are that the dust cannot cross the property line.

Okay. So you

It's not about fence line monitoring. Sorry. I think we got off on that. It's we're talking about fence line monitoring. It's the regulations that there are conditions and requirements that they cannot

So how do you know that there's no dust getting past their fence?

And that's the difficult part, Senator, is that we rely on the community to be our eyes and ears and report when they see things. And I we understand, Senator, that it seems like we're just reactive. Right? We cannot have a person there all the time.

Oh, no. We're not we're not on a station.

Well, I I don't know if we can, but you're I we understand that you're asking for stations and all that. But I think we're part of the permit. We tip yes. There you go. So you can't just

don't say change the

Yeah. You guys give enough permits, like I told the mayor Yes. People. You guys give them all the candies. Yeah.

You guys don't really qualify?

I'm sorry.

Can Okay. Sorry. Sorry. Can I

finish my

Senator Rose

Sorry? Sorry. Sorry. Sorry. Is the

so the permit says they're not supposed to let dust over the the line. Yes. So that part of it's already permitted. There's already a condition in the permit about that. But then how do you know that there that's being enforced?

You're saying that it's just complaint driven?

Yes. That's unfortunately, that's the we had so we understand the frustration. I think there are other play there are places that are like this.

And does it have to be does state law require that it be complaint driven or is this something that you can go monitor on your

I, I don't know the answer to that.

I don't know think the law tells us that we can't, but I think

It's in our rules. Our white administrative rules.

That you can go and monitor it yourself.

Do you go It's just by visual.

I'd say. Okay.

Alright. But you're right. It's more or less complaint driven.

I think that's what you're saying.

Well, but that's the way it is with everything.

Yes. Yes.

I mean, same thing with with litter and and traffic. Yes. Usually, we don't have a monitor.

But here you have a permit hook.

Yep. That's the thing.

It's a permit requirement.

Yeah. I mean, so that's the route I think. Hopefully you

guys Then then the question is who who enforces the permit? It would be well.

Yeah. It would be violation of the permit would fall upon you guys.

Right. Yes. Inspector goes out there.

An actual inspector.

And give a field citation.

And then again, that's complaint driven, right? Because they normally

But they also do your due diligence that we

need to

the air station, right?

So let's go back to the resolution. The resolution does require them to work with the county regarding that, which is the way he drafted it. K. Any other questions?

Sounds like a plan.

Okay. Okay. Moving on. Okay. That's it.

So are we, are we ready to proceed with decision making? So for SCR 39, SR 29, Chair's recommendation is to pass with amendments per Department of Health's testimony. We're gonna remove all references to the word joint.

We're gonna just make them the chair and responsible for this stewardship program. Is that okay with the introducer? Okay. And technical non-substantive amendments needed for clarity and consistency. So pass with amendments. Chair votes aye. Vice Chair for the vote.

Okay. SCR 39, SR 29, recommendation is Senate Draft 1. Noting the presence of myself and you and Senator Fevella. Any WRs or noes of the present Members? And all others are excused. Seeing none. Your recommendation is adopted.

Same recommendation for AEN. Any discussion? Chair votes aye. Vice Chair.

For SCR 39 and SR 29, passing unamended.

No. With amendments.

With amendments. Chair votes aye. Vice Chair votes aye. [Roll Call] Chair, you have four in favor. Your motion is adopted.

Thank you, Members.

Okay. For SCR 142 SR 134 we've had robust discussion. Chair's recommendation is to pass with amendments. Since there is no appropriation, we're going to amend the resolution on line 36, page two. Instead of requiring department of health to establish, we are going to require them to recommend.

So replace the word establish with recommend. Thus monitoring stations. Okay. Otherwise, no other amendment. Any comments, questions, concerns?

Seeing none, vice chair for the vote passed with amendments.

Okay. Recommendations on the resolution before us are to pass with amendments. None of the appreciated excused members. Any WRs or no? Seeing none.

Recommendation adopted.

Same recommendation for AEN. Any discussion? Chair votes aye, vice chair.

On SCR 142 and SR 134 of the four members in attendance. Anyway, voting with reservations. Any no votes? Chair, we have four in favor. Motion adopted.

Thank you. Motion's adopted.

And with that, the joint committee on AEN and Health Human Services is adjourned.

Recalling the 107 calendar on health and human services. Next up, we have SCR 18 requesting the auditor to assess the social and financial effects of proposed mandated health ketamine, health insurance coverage for intravenous ketamine therapy to treat depression. First up, we have SCR 18. Office of the Auditor providing comments.

Anybody else wishing nobody else having registered or provided testimony to testify. Anybody else wishing to testify in SCR 18? Okay. Seeing none, moving on. Next we have SCR 76, requesting the auditor to assess the social and financial effects of mandatory health insurance coverage for biomarker testing.

So first up, we have Alzheimer's Association of Hawaii in support. Coby Chock. Please proceed.

Vice chair McKelvie. I'm Coby Chock on behalf of the Alzheimer's Association, and we'll stand on our written testimony in support. Thank you.

K. Thank you very much. Next slide, Cynthia Au, American Cancer Society Cancer Action Network in support. Cynthia?

Cynthia Au, ACS is in support. For SCR 76. We stand on our written testimony.

Okay. Thank you very much. Next, we have, Primo Castro, Biotechnical Innovation Organization in support.

Not present, chair.

Nope. Not present. Next, we have Pedro Haro, American Lung Association in Hawaii in support. Pedro, Eric Abe, Hawaii Primary Care Association in support. Hawaii Women Lawyers in support.

Elton Fukumoto, American Cancer Society Center Action Network in support. Maui Cancer Resources in support. 4, 5, 6, 7, 8 and ten other individuals or so in support. Anybody else wishing to testify in SCR 76? Come on up, doctor Lewin.

Chair San Buenaventura, vice chair Kelby, members. We we've been seeing this legislation for the last four session legislative sessions, and there probably some common sense to it. I mean, FDA does have testing and drug indications for various medical conditions. The idea is is around mandating the coverage. But certainly, the coverage is needed for for heart disease, cancer, neurodegenerative disease, and other other diseases.

We might wanna ask the auditor to look at where how routinely this is being covered elsewhere and whether there are impediments like prior authorization that get in the way of making this coverage here. Certainly, this is standard of care for those diseases. Thank you.

Thank you very much. K. Anybody else wishing to testify on SCR 76? K. Members, any questions for biomarker testing?

Next up is SCR 51, requesting the Author to assess the social and financial effects of requiring health insurance to provide coverage for medically necessary proton beam therapy for cancer treatment. First up, we have Office of the Auditor providing comments. Okay. Anybody else? Nobody else having registered to testify. Anybody else? Come on up, Dr. Lewin.

Chair and Members. All of our testimony didn't get uploaded to this...

Okay. So SR 51, proton beam therapy.

Just wanna just say that, you know, that for the Pacific, maybe we could use a proton beam machine here. Typically, they're only available when there's a population of about 3 million people or more. There are newer... The Auditor might wanna look at the fact that there are newer proton beam technologies that might become available here if we collaborated together.

Because they're so important for pediatric cancer, but for other special, a number of other cancers. But it's we're not quite ready, but I think the time may come soon. Thank you.

Thank you very much. Anybody else wishing to testify on SCR 51? Members, any questions? Okay. Moving on.

SCR 150 requesting the governor to obtain a controlled substance exemption from the Drug Enforcement Administration for registered medical cannabis patients and registration web waivers for state licensed dispensaries. First up, Akamai Consulting in support. Please proceed, doctor Otto.

Aloha, chair, vice chair, members of the committee. Thank you for the opportunity to testify in this resolution. You have my written testimony in strong support. I just wanted to add that I don't believe the department or the AG submitted written written testimony to your committee on this measure. So at least they didn't object, which, is a good sign and perhaps an indication of a policy shift towards protecting the interstate medical use of cannabis.

In any case, I'm happy to answer any questions you may have about why this is such an important measure for our medical cannabis patients to dispensaries and the future of medical cannabis in Hawaii.

K. Thank you very much. Next, we have Courtney Cassier in support. Manolo Morales in support. Helen Higa in support. Wendy Gibson Deboni in support.

Anybody else wishing to testify in SCR 150? Members, any questions? Okay. Moving on. Next, we have SR well, that's SCR 150 and SR 141.

Next, we have SCR 119 requesting Hawaii State Center for Nursing to conduct a study compiling recommended safe patient staffing ratios. First up, we have Hawaii State Center for Nursing providing comments. Laura Reichardt.

Aloha, chair. This is Laura Reichardt. I am director of the Hawaii State Center for Nursing. I ask for guidance from the committee. First, we welcome the opportunity to do this report.

Our mission is collaborating on fostering workplace conditions that, to support nurses to remain in a fulfilling profession. So I think we're well positioned. The first clarification I seek is, is this only for hospital nurses or is this just nurses across all different settings? The second is I have a concern with a request for a dashboard. Of the organizations I provided in my testimony that Ifound 13 that go beyond what was in the resolution, nine recommend both strategies and ratios.

And then an additional four only recommend strategies. So that's going to be hard to put in a dashboard. I'd prefer to provide a repository so that this is, this is accessible. But not use the dashboard because it will not include the strategies that are very important. And then finally, I ask for clarification.

In the resolution, it talks about nursing professional organizations, state regulation, and international regulation. Those are all very different methodologies. So if we could focus on one, that would be preferred. I just want to recommend the legislative reference bureau study that already did the state regs.

Yep. Yeah. I read your very lengthy written testimony. K. Next up.

Thank you.

Thank you. Rosalie Agassu, Hawaii Nurses Association, Local 50 in support. Rosalie, are you present on Zoom?

Not present, chair.

Okay. Terilyn Luke, Hawaii nurses and health care professionals in support. Terilyn.

Hi, chair. Right here.

Okay. Terilyn.

Terilyn Luke from Hawaii Nurses and Healthcare. I stand on the testimony that we submitted, and there are several other of our members that also strongly supported this bill. It is a way for retention definitely for our members that continually leave the workforce at an earlier age, based on the working conditions currently in our community.

Thank you very much. Next, we have Linda Beechanor, Hawaii American Nurses Association in support.

Thank you so much. Yes. I am Linda Beechanor from Hawaii American Nurses Association. Now I'm speaking for the

Why don't you come on up? If you're gonna say something other than stand.

I will I will stand on my testimony.

Okay. Thank you very much. Okay. Randy Pereira, HGA, in support. Octavia Price, Kaiser Permanente, in support.

Marissa Jacobs, HNHP in support. Charles Kimball in support. Paul Hine in support. Kaylee Berg in support. 3, 4, 5, 6, 7 individuals also are all in support.

Penny Ann Ida, in opposition. Anybody else, wishing to testify on SCR 119 SR 112? Members, any questions? So

Aloha, Senator San Buenaventura and, Vice I did submit written testimony and I stand by it.

Thank you very much. Thank you very much. Okay. Members, any other questions? Anybody else wishing to testify in SCR 119, SR 112?

Ok. Real fast question for the nurses. Did you read Laura Reichardt's written testimony? Do you have any problems if we adopt HCR 105 or HR 97 instead? It just clarifies what they are required to do.

Same thing except it clarifies.

Yes. Yes.

You have no problems.

No problem.

Thank you very much. Okay. Moving on. SCR 149, SR 63, requesting the department to establish an informal working group to assess the services and funding necessary to address the needs of complex patients who at least have two or more diagnoses that include substance use disorders, mental health disorders, or chronic physical illness. First up, we have Department of Health. Okay. Next we have Hawaii... I see Alan Johnson. Come on up. In support. I believe this is your reso.

I retired, but you can't get rid of me.

There you go.

Well, thank you, Chair, Senators. I'm Alan Johnson with Hawaii Substance Abuse Coalition. We really appreciate the opportunity for this transformational grant because this is a major problem in Hawaii. We treat substance abuse over here. We treat mental health here.

We don't treat them together. 54,000 people are not getting that treatment for many years because what substance abuse does, we only treat the severely mentally ill. So substance abuse has the capability to treat this, but we're not treating people with bipolar, PTSD, with diabetes and cancer and substance abuse.

And now and so now the federal government is saying if the states that develop a pilot grant, they'll fund a transformational grant for 3-4 years. That funding will set the rates and structure so Medicaid can take over and pay for this.

It's a huge opportunity for us to be proactive. And this is your homelessness. This is your EMR. This is, this has been the solution for years. Thank you for this opportunity.

Thank you very much. Next, we have Hawaii Disability Rights Center in support. Okay. Thank you. Brian Baker, Hina Mauka in support. Leelynn Brady, Aloha Independent Living Hawaii, in support. Anybody else wishing to testify on SCR 149, SR... I mean, SR 63. Come on. Thank you very much. Anybody else wishing to testify on SCR 149? Come on up. Identify yourself. This is relating to complex patient model. Yeah.

Yes. Laretta Dubin, RN. What I've noticed, and this is from working here since the 80s, is they got rid of having... It's like, these managers, like, case managers back in the, oh, when was it? Late 90s, early 2000s. And that has caused innumerable amounts of problems. So I'm in favor of this bill.

But I do wanna see some managed care happening, which is follow-up for these patients. Because you have the substance abuse on one hand, you have the mental health here, and nobody overseeing this. And it's caused a lot of problems. We won't go into all that, but thank you for giving me the opportunity to voice that.

Thank you very much. And I think Alan Johnson agrees with you because it's his resolution to create this informal working group. Okay. Anybody else wishing to testify on SCR 149 and SR SCR 149? Members, any questions?

Seeing none. Next we have SCR 63 requesting DCAB to study the healthcare communications needs of the and develop guidelines for individuals who are deaf, hard of hearing, or deaf blind. First up, Louis Erteschik in support.

Support.

Thank you very much.

Neil and Brady, a law independent living Hawaii in support. Lila Moore in support. Anybody else wishing to testify on SCR 63? Members, any questions? Moving

has late testimony in support.

Okay. And this also includes SR 57. Thank you very much. K. Members, any questions?

SCR 63, SR 57. K. Seeing none, moving on. SCR 75 requesting department of health to lead the statewide coordination of services and supports for fetal alcohol spectrum disorder. First up, we have Hawaii department of health providing comments.

Okay. Judiciary providing comments. Fasting group, Amanda Luning in support. Come on up.

Aloha. Amanda Luning, Hawaii FASD Action Group.

I'd just like to add in response to the Department of Health's comment that we, it was act 192, not 193, and that we are running that project, and that we did submit our reports to them for the first year that include state based coordination as a recommendation because the assumptions that were made under that, and the assumptions that were made under that and some of the assumptions that were made under that initial pilot, were not the way that the project was submitted because we knew we didn't really have capacity for that.

So if you look at the reports that are attached to our testimony with a little QR code, they have been published and they're on our website. They were provided to the Department of Health, in October and then again in December and also to the folks that, supported the Act 192 in the first place.

So those are reports that they can use already for what is being asked in this resolution in relationship to the coordination and then the planning.

Thank you very much. Okay. Next, we have Louis Erteschik in support.

Now I know you were in the legislature when act 192 was passed because you were you were the major champion, and that was a huge accomplishment and victory for for the FASD advocates. So since that time, they've done a great job, but what's happened is that it took like like over a year to release the funds. The Department of Health kind of dragged their feet, so it threw them behind.

And and what's happened also since since that time is they can tell you better than I've been. My understanding is that that there was a federal legislation passed that provides funds if the if the state would have an official coordinator.

And that and when I when we talk to the Department of Health, they don't really know much about that. So I think I see the thrust of this resolution as asking the Department of Health to step up and do what they should be doing because this should be a priority. It was to you and and it is to us. And there's a lot of frustration that the state is not making the progress that it should in terms of actually getting services.

So that's why the resolution was introduced.

Thank you very much. Next, we have Alan Johnson, Hawaii Substance Abuse Coalition in support. Mila, Brian Baker Hinamauka in support. Jared Ellis in support. Anybody else wishing to testify in SCR 75 / SR 69?

Thank you.

Shipto.

Chairman, members. Shipto. Late testimony, we'll get to you at some point. But we we just think that this is an underdiagnosed issue, and and if and so we like to I would defer to the Department of Health in terms of the resources they have. We think we need to apply resources to this, particularly to increase the the rate of diagnosis in the prenatal space so that we could start early treatment later when it's needed.

And we think it's a need. Thank you.

Okay. Come on up. Hey. Identify yourself.

Hello, chair and vice chair. My name is Ivan Lui Kwan. I urge adoption of the the resolution. Many years ago, I served on the board of the March of Dimes, and we believe that the March of Dimes, that there was a real nexus between birth defects and the consumption of alcohol. What I what I thought was missing in our interactions back then.

What is the are the efforts that it's called for in in this resolution? More specifically participation by organizations that have capacity such as the Department of Health, Human Services, Education, Judiciary, and also coordination among these agencies. And third, training of skilled professionals, increased awareness of education. I have a hard time believing that pregnant women would continue to consume alcohol if they understood that drinking would cause damage to to their babies for life. And so that's why I believe this resolution is so important.

Thank you very much. Thank you. Anybody else wishing to testify? SCR 75. Come on now.

You need to identify yourself too.

Aloha. Good afternoon, chair, vice chair, and members of the committee. My name is Darlene Chen Scoville, and I'm a volunteer advocate for FASD for almost ten years, diligently working and tirelessly advocating for this population. I recently have done interviews, Taoyuan doctors, pediatricians, and PCPs, and none of them diagnosed. Also, the according to the report of the Department of Health, we have an FASD unit that that doesn't exist.

And and with act 192 very critical this portion, we need to coordinate because they do not know where to send these children and what to do. So thank you for the opportunity to testify.

Thank you very much. K. Anybody else wishing to testify on SCR 75 / SR 69? Members, any questions? No.

Department of Health isn't here. Well, no. But there there are different parts of Department of Health. I'm just about yeah. Okay.

Thank you very much. Okay. Moving on. Yeah. They're they're they're the elephant in the room that didn't show up.

Okay. SCR 21. Requesting Hawaii Health Systems Corporation's East Hawaii Regional Healthcare Systems to conduct a feasibility study on establishing a rural health clinic or comparable rural health access point to serve the volcano community. First up, Lanikai Du and Company in support, Volcano Community Association in support. James Morgan, Volcano Community Association in Cathy English.

Cooper Center Council in support. Marsha He, are you present on Zoom?

Not present, Chair.

Okay. And we have 3, 4, 5. Okay. Like the entire volcano community. I didn't testify.

Okay. Melissa Kuntz, are you present on Zoom?

Not present, Chair.

Okay. So over 20 other individuals, all in support. Anybody else wishing to testify on SCR 21 and SR

18.

18. And SR 18. Okay. Members, any questions? Nobody to ask questions of, so we're going to move on.

Next, we have SCR 7. This is IMALTA. Affirming and supporting requirement that hospitals provide life saving emergency care to pregnant people, including reproductive and abortion services. When such care is medically necessary to stabilize a patient under the emergency medical treatment and active labor act? First up, Hawaii State Commission on Status of Women in support.

Okay. Hawaii Public Health Institute in support. Kris Coffield, come on up.

Aloha. Kris Coffield from the Hawaii Public Health Institute. We're in support of this resolution. The Emergency Medical Treatment and Active Labor Act, EMTALA, was established by Congress in 1986. And as stated in the resolution, it applies to all emergency medical conditions, including pregnant pregnancy related emergencies.

It requires hospitals to provide stabilizing treatment using standard care and defers to a physician's clinical judgment in determining what treatment is necessary to stabilize a patient. We would note here that reproductive care is health care, and this resolution helps to address legal confusion.

There was a study that came out in 2025 examining EMTALA and obstetric emergencies, and it found that state abortion laws, may undermine federally protected emergency care or conflict with federally protected emergency care and create this unnecessary uncertainty, uncertain climate for clinicians who are attempting to comply with EMTALA stabilization requirements when it comes to reproductive care. This state has a long legacy of protecting reproductive rights. This is a resolution just another step in that legacy, and we hope that you will move it forward.

Thank you very much. K. Next, Young E Overly, AAUW, in support. Mandy Fernandez, ACLU of Hawaii in support. And we have Hawaii Women Lawyers in support.

Theresa Arbister in opposition. Come on up.

Aloha, Chair and Committee members. I'm Theresa Armbruster and I oppose SCR 7, SR 7. And I understand my written testimony, but I do want to highlight a few things. It was a Supreme Court case, Texas v. Becerra, and they specifically looked at the definition, the EMTALA's definition of emergency medical condition for a pregnant woman.

And it stated that a condition that threatens the health of the, of the, pregnant woman or the health of the unborn child. And they, noticed that it, that creates an obligation to stabilize both the mother and the unborn child. And also, it stated that, EMTALA does not explicitly state that a hospital must provide abortion care as a necessary stabilizing treatment for every emergency medical condition. And also, EMTALA does not specifically state that religious exemptions are not allowed.

This would violate a person's constitutional right of free exercise of religion or their Religious Freedom Act.

And, also, it's very concerning that you're requiring all hospitals compliance, especially, regardless of their religious affiliation.

K. Thank you.

And abortion is not, standard of care for a religious hospital.

Thank you. Theresa. K. Anybody else? No one else having registered to testify.

Okay. I understand. Okay. So come on up. Come Yeah.

Come on up. You haven't registered, but you need to, say who your what your name is. This is for SCR 7 SR 7.

Okay. Please testify.

Yes.

My name is Reina Laughlin. So good afternoon, chair, vice chair and members.

I strongly oppose this. If this passes, there will be an increase in unnecessary deaths of unborn babies and danger to the mother and other medical decisions that may not be necessary for patients. Physicians' determination of life saving emergencies, we need to understand, is not always accurate, which is the case in my personal experience and those of my three friends. Physicians are quick to call a situation life threatening and to recommend abortion.

In my situation, when I was five months pregnant, they told me that my unborn baby was going to most likely, probably not survive.

So they actually didn't just encourage and recommend. They were pushing me to get an abortion as they did with my two other friends or three other friends. In which case, my baby did not survive, but I have the choice to continue full term and take that chance. And my three others, they all had healthy babies.

Thank you very much.

For this reason I oppose.