House Standing Committee on Health

Good morning, and welcome to the Committee on Health. Today is Friday, 04/17/2026, and the time now is just about 10:30AM. We are here in Conference Room 329. With me, I have Chair Greg Takayama and member of the easy heart field, and I'm sure other members will be joining us shortly.

If we don't mind, we'll go ahead and start off the agenda. We have SCR 21 SD 1, requesting the Hawaii Health Systems, Operation East Hawaii Regional Healthcare System to conduct a feasibility study on establishing a rural health clinic or comparable rural health access point to serve the volcano community. It's like on Zoom. Dan Brinkman in support. Aloha, Dan.

Go ahead. Please proceed.

Well, good morning, Chair Takayama, Vice Chair Lee Loy. Appreciate the opportunity to testify and strong support for SCR 21. We did submit written testimony, but I thought it'd be good to voice our agreement and testify over video conference about the matter. So in general, our region, our board has tried to implement the philosophy where we have we actually help build out and provide local services within the community, basic services such as primary care and urgent care.

So the request of the resolution, is very much in alignment with the strategic plans for the region.

We've been able to make some significant progress over the last few years in doing so, with clinics in Pahoa and in Keaau and hopefully a larger and hopefully a larger health center that's being worked on in Keaau. We have looked at the volcano area in the past, and, unfortunately, you know, there aren't any buildings or even buildings we could convert temporarily. And so we felt that, to really address that would require a longer term fix.

We've had some experiences with doing some mobile health care and others, but she doesn't it's not all that conducive, and our providers don't necessarily enjoy that. I think we're best suited to get a definitive solution to get some local services within the volcano area and have done some initial, I guess, investigation of that.

So much of what's in the resolution is, very much in alignment with what we would seek to offer. One of the reasons I did wanna speak in person is that, if we are able to get some support for the design, site preparation, etcetera, Even this session, we could certainly accelerate the process. It is something, though, that will require a substantial bit of capital investment to make, make this, I think, this wish into a reality. So I'll stop there.

Glad to answer any questions from the from the members or anyone else who is interested.

Thank you, Dan. Also on Zoom, I have Kathleen. Present? Great. Kathleen, please proceed.

Hi. Can you hear me? Yes. We can.

Hi. Good morning, Chair Takayama and Vice Chair Keohokapu-Lee Loy. I'm happy to be here. I am the resident of Volcano Village and also a retired public health nurse. I'm also a member of the Volcano Health Collaborative.

I'm on the board. I stand on my testimony as submitted, and I'm here to answer any questions that the committee members may have.

Thank you, Kathleen, for being here. Also on Zoom, Melissa. Perfect. Melissa, please proceed.

Aloha. Mahalo. Chair Takayama, Vice Chair, Lee Loy. I submitted written testimony and stand on that. I'd also like to note that this resolution for a feasibility study is an important first step towards improving health care access to volcano, the millions of visitors that pass through here, the workers who are employed here, the elders who enjoy and take care of this community, and younger families like mine with children.

Thank you so much.

Okay. Thanks, Melissa, for being here. Members, I also have, in support, Hawaii Volcano Health Collaborative, Rotary Club of Volcano, Hawaii Health Systems Corporation, and about 25 other individuals. Anyone else wishing to testify on Zoom or in Yep. I see doctor Jack Lewin.

Good morning, Chair, Vice Chair, Members. Shipton didn't testify on this, but we we certainly see the need. Our advisory council on Big Island very much understands the need for for reaching out primary care into the into this community. And, obviously, the money is not here right now, but I think getting getting the process going would be good for future years because it is a gap area. Thank you very much.

Thanks, doctor Nguyen. Anybody else here in the room on Zoom? Okay. Members, any questions? Okay.

Moving on. Our members will move on to SCR 50 SD1, establishing the Hawaii Health plan working group to design and recommend a basic affordable Hawaii health plan available to every resident of the state. First up, we have Doctor Lewin.

Chair, vice, chair, members. Jack Lewin, SHPDA. This is something that's very important to us at SHPDA.

We understand with the HR1 impacts coming that we're gonna have a rising number of uninsured people. We already have something like about 3.4% of the population. That's 50,000 people though who can't afford to buy insurance but make too much to be MedicAid eligible. And they're they're going at risk, and it's kind of a dangerous situation. It's gonna add another group at least that big of new uninsured people.

What we did with the state health insurance plans back in 1990 when we faced a similar challenge, we got the Prepaid Health Care Act, MediCare, and MedicAid in place. There were still a bunch of people who were in this uninsured gap group, if you will.

We created the state health insurance plan, which provided very low cost insurance. We made a deal with the hospitals to cover some of their cost needs, because they would be uninsured people anyway. They would exceed the cost in most cases.

So we helped we worked some arrangements out with hospitals for emergency and for that kind of coverage. But basically, these people back in those days paid most of them paid their premiums. We had subsidies for them, but they got very low cost insurance.

Today, I mean, for the uninsured out there, Medicaid folks and and MedQuest folks and Chip, we'd love to see everybody get full coverage. That's $5,000 minimum per person.

So when you add up how many people we're talking about here, it's a huge amount of money. So for a thousand dollars, however, we could get comprehensive preventive services, comprehensive primary care, and pay for it at commercial rates so that people so that the providers wanna take care of it. We'll cover that and at much lower cost and many of the the beneficiaries will pay for that service.

We work out some arrangements for labor and delivery and some other things for hospital coverage, but we gotta do something in the short term. This is not a big this is not the fix for the future.

This is a short term fix until we really fix our health care future together. Thank you.

Thanks, Dr. Lewin. Also, Department of Labor and Relations, Jade Butay. Please share your name and your

Chair, vice chair member is Joanne Biddenhar. The department stands on their testimony offering comments and available for any questions. Thank you.

Thank you. Also comments from Legislative Reference Bureau, Office of Hawaiian Affairs, Hawaii Medical Association, and Hawaii Primary Care Association. Is there anyone on Zoom wishing to testify?

Anyone else in the room?

Members, any question?

Question.

Go ahead.

I'll go first. Okay. SHPDA. Hi, Doctor Lewin. Thanks for being present.

I noted in your testimony that the recommendation was to include MedQuest, which they are included in the resolution. My question is, there's also testimony to include the Hawaii Medical Association as part of the working group?

I'd love to see the Primary Care Association, Hawaii Medical Association. Yeah. This can be an inclusive group.

We should, we should really be working together. We didn't wanna assign everybody a responsibility if they didn't wanna do it. But, look, we'd love to have them. Support.

Thank you.

Alright. Thanks for answering my question without me having to ask that. Alright.

Thank you, vice chair. For Doctor Lewin as well, thank you for testifying.

You mentioned when the Hawaii passed the prepaid health care program back in the nineties or in the eighties.

Yeah.

And there was that group of people who barely made it the threshold or did not make the threshold, so they weren't covered.

Yeah.

Is that still happening today? I mean so you folks worked out a deal then to get them covered. Is that coverage still in effect today?

You know what's amazing is that the law that we created the state health insurance plan, it was never canceled or eliminated. It's still there. The statute's there. It just has no money or staff attached to it. It was part of the Department of Health.

So my team in back then when I was Director of Health, built this program, and it turned into insurance program that that covered 50,000 people in the state eventually at its at tight. It was folded by Governor Cayetano into the MedQuest program, and I think his intention was really good.

But the premiums went from about $350 for a family a month. To about, you know, 1,500 or 2,000. So that didn't work because because the Federal Government acquired every benefit in the universe.

Because this wouldn't be MedQuest families. These are those. Who wouldn't qualify for MedQuest, but there is not

This is really gonna be a separate program. It's not one that we see as the future, but it's a place right now to get people the essential care they need. What happened back then was we got, we made some deals with the hospitals, and they were they took people with no billing or charges for most admissions. And then we worked with them in terms of where they had really big bosses to try to cover those to the legislature.

But so that wasn't a lot of money though because it's a younger, healthier population of people. And typically, you're gonna have labor and delivery appendicitis, you know, broken arm or somewhat for pediatric injury. And most of these submissions are less than three days. So we can work something out, but the real money needs to go to the primary care prevention upfront.

So just to clarify, that program that was enacted back then is still there. It's just not funded by the legislature.

It's still there. We could pick the the statute up again and put money in it. The group may wanna do it a little differently because the statute is a little more generous back then as affordable cost than it would be now. So we might wanna pull back a little bit on what we can afford for drug coverage and hospital coverage in order to keep the budget within what the state can afford to fund.

So is this program or in, is this resolution really called for if that program still exists, which could be funded?

We'll get to work group together and then, you know, we'll decide what we think is best because we get all the best thinkers together to talk about it. But we have a wheel vehicle if we wanna use it.

Got it. Okay. Thank you.

If I could ask, for doctor Lewin while you're still up there. I think what you just said perhaps addresses the concerns expressed by the Department of Labor, which is that if we enact a new program, it potentially could interfere with the ERC exemption that we currently

Which we cannot possibly endanger.

No. But if this program already exists and operated at some point, then clearly, it did not jeopardize.

It did not.

Anyway,

Exemption.

That's what I want.

We simply don't wanna let people slip into this program who have coverage elsewhere. That is not who eligibility for coverage had to be very careful not to have people that would be covered under ERISA in the workforce. Pop in here because it's a lower cost program for them. Maybe they're out of pocket cost or gonna be higher than this program cost. So, you know, we just can't allow that to happen and we won't.

Understood. Thank you, Doctor.

Thank you. Thank you, members. Alright. Any other questions?

Alright.

Members, if we could now move on to SCR 75 SD1. Purdeing the Department of Health to need a coordinated interdepartmental effort to reduce the impact of fetal alcohol syndrome disorder and mistake, including development of a plan for interagency collaboration to ensure coordination of support. Of course, doctor Luen, you're up first.

Okay. Yeah. Our advisory councils have recently started hearing concerns about more women who get pregnant, who have a alcohol use issue. It can be a very, very serious expensive problem for the for the newborn child who's affect who's affected by the alcohol problem during pregnancy. So and and one of the things that we're we're learning is that we just don't see the problem.

We see it in the aftermath of the kids who are affected. And part of the fact is women get pregnant. They don't they're not they're not doing prenatal care, and they're still drinking. Nobody's talked to them about it. In some cases, it's a very sensitive issue to bring up.

So I I I mentioned it in the testimony that there are some very inexpensive laboratory tests that could be used as part of prenatal screening. It would just give us an indication of a risk that could then be discussed with and and we could try to intervene if we can. So we're learning that this problem a lot of education and prevention orientation, it just sort of dropped off the radar screen.

It needs to pop back up there because just one kid affected can be, you know, hundreds of thousands or millions of dollars. We just wanna do the prevention piece.

We have the money this year to talk about it. We didn't have the numbers, but we hope that in the future that we really will address this and And this this resolution could start that process. Thank you.

Thanks, doctor Duen. Also, on Zoom, I have Amanda from Hawaii FASD Action Group. Aloha, Amanda.

Thanks, folks. Mahalo for having us. Just quick, I we submitted reference, testimony and raised down on that testimony. I just wanted to add that we are the primary entity that's doing work back January.

And so when you look at what we know from that first a year and a half or so, like Jack mentioned, we don't quite have the landscape to implement that in a realistic way in that we don't have a specialist, we don't have a FASD informed systems, we don't have a public order messaging that currently exists.

And so so much of this is about getting folks together. And our reports and our our work is essentially what we would love to be able to use as a starter point for us to figure out some costs associated with state based coordination's disposition, but then also really getting everybody on the same page.

And so just want to add the as the folks that are doing that work from act one ninety two, which is the three year project that folks are referring to, we're not implementing it the way it was written. The RP that went out did change. And so we are doing primarily, like, what Jack said, the landscape analysis.

We're looking at our diagnostic capacity in this state. We're realizing that we don't we don't have what perhaps we thought when the language in that bill was passed. So we need to come back to the table so that next year, we can put together some legislation that makes more sense based on Hawaii's capacity. Mahalo.

K. Thank you, Amanda. Also on Zoom, Luis from Hawaii Disability Rights Center. Not present. Not present.

Also, I have Darla on Zoom. Yes. K. Aloha. Please state your name and proceed.

Yes. Thank you. Good morning, chair, vice chair, and members of the committee. My name is Darlyn Anne Chen Scoville. I am a doctoral researcher studying fetal alcohol spectrum disorder in Hawaii's pediatric and primary care settings.

And I'm also a lifelong advocate for children and almost ten years fighting for FASB children in our state. With this, I'm here in strong support of this Senate Concurrent Resolution. I I I also respectfully request two amendments. First, the judiciary being explicitly reinstated as a partner agency only because we have been training people who work in the juvenile prison system, and we are actually asked to start screening at the the our prison system for for adult prison system.

And fetal alcohol spectrum disorders are lifelong brain based disabilities caused by prenatal alcohol exposure.

With that said, thinking statistically, one in seven pregnancies are alcohol exposed, and one in twenty have FAST. That's national and international statistical data, and our state do not have that. In my research, Hawaii pediatricians and primary care providers spread FASD as a hidden disability. They see children whose profile clearly fit for negative alcohol exposure, but there are few practical tools or clear pathways or coordinated services. When I did my interviews, I interviewed 31 doctors in our state pediatricians and primary care providers.

The question has always been, if we diagnose them, where do they go? What shall we do? Because we do not have an infrastructure as, you know, currently going with us. When FISD goes unrecognized, problems show up everywhere to failure, disrupt displacement, mental health crisis, justice system involvement, and reviews suggest a high proportion of justice involved really above meeting the criteria for affairs. This side, there's no logical impairment and not willful defiance, and that is why specifically including judiciary in this resolution is so important.

Judges of training conservation officers need training and free referral options so we are not unintentionally criminalizing disability related behavior. In fact, we are currently in Amanda and I are currently in Seattle attending the SISB International Conference and hoping to partner with everyone to take care of this problem. Can you imagine one in twenty children in our school system have FASB that are undiagnosed? Thank you.

K. Thank you for your testimony. Also, members in support, Hawaii Department of Health with comments, Hawaii Substance Abuse Coalition in support. In a matter of course.

The department.

I see that our testimony was included, so I don't know if it's the correct version.

Okay. Great.

Sorry about that. So I'll talk about it. Well, I can't figure out how I was here because I didn't see that our testimony I can say I may have missed it. We we appreciate I I'll say hi. So I I appreciate the intent of the the measure. I I turn this when we focus on a single diagnosis. I'm circling the specific diagnosis.

The systems approach, right, based on the impact that conditions have on children, take a more holistic approach. So there's conditions that could be arranged either of autism spectrum disorder, FASD, ADHD, neurofibromatosis, Asperger's, on and on. So what they all have in common, right, is that there may be some interaction between the environment and genetics and it has a range of how it can manifest. But all of these can have conditions that can have health conditions, behavioral mental health conditions, learning challenges.

We need a system to identify a child's needs.

Right? Not based on particularly what their diagnosis may or may not be, but how do we assess their needs in a holistic consistent fashion. Right? There's a concept of a multi tiered system of supports which is actually applied to schools so that's where a lot of this can first get identified. So the grades, absence, behavioral problems, to then see web supports dig deeper, do deeper assessments and find out what may be needed to best support the whole kid.

From a Department of Health perspective, you know, we really look upstream. So as we've heard on some of these other measures, invest investing in primary care rather than, you know, more hospital beds. So how do we prevent this? And it's not just alcohol. We're seeing increasingly cannabis, used during pregnancy and the harms to that that can have similar presentations and conditions.

So if we look at more of how do we improve prenatal care, prevention of exposure to toxins during pregnancy, not limited to alcohol, but a broader approach that we're doing to education for things to avoid and, earlier receipt of prenatal care, like, that's a good thing, and we think that's the best investment, to really get upstream ahead of this.

And, you know, as we look at them more from a a school based approach, how we, systematically consistently assess how students are doing, what their needs may be, and then find ways to support their needs. So, again, I appreciate the intent, but I I think we need a slightly different approach in how we go forward with this. So thanks for your time.

Thanks, doctor. Also in support, Hina Malka, and two other individuals. Anybody else wishing to testify? Anybody on Zoom?

Disability rights center.

Yes. Oh, Gary. Yes. Good morning. Good morning.

This is Lou Urgeshek from the Disability Rights Center trying to testify on SCR 75. Thank you. We're a strong support. We have been working on a fetal alcohol issue for a long time and and the has done a great job,

but we really more state involvement. So we're hoping that this resolution and and as as I indicated in our testimony, we think an earlier reporting date would be appropriate. So thank you.

K. Thank you. Anyone else on Zoom? Great. Thanks.

Any mem question. Let's try that again. Members. Any questions? I I have one for doctor Fink.

Doctor Fink, thank you for showing up. So it's an interagency collaboration along with findings. But what I hear you saying is findings and recommendations to improve prenatal or upstream or I identify upstream care is what I hear you say.

I I think we would there's multiple needs, and I don't wanna say that this is a need, right, at the exclusion of other needs. As a as a matter of public health, we support prevention, and we think increasing in education and prevention, if if we can mitigate, you know, the exposure, right, That that's a that is the best return, on limited state funds.

Okay. Thanks, doctor. Anyone else? Okay. Members, we're gonna move on.

Just for note, SCR 109 was withdrawn from our agenda. And so, members, we're gonna move on to SCR 149 SD one, requesting the Department of Health to establish an informal working group to assess the services and funding necessary to address the needs of complex patients who have two or more diagnoses that include substance abuse, substance use disorder, mental health disorder, or chronic physical illness. First, department of health in support. Mister Allen Johnson, Hawaii Substance Abuse Coalition in support.

Alan, thanks for being here. Please proceed.

Thank you. Good morning, chair, vice chair, distinguished members. Alan Johnson with the Hawaii Substance Abuse Coalition. We, in our field, are the most excited. It's the best news we've ever heard in fifteen years.

I mean, this is evolution. I mean, the the Federal Government says, let's end the silo. We've got mental health care. We've got substance abuse here. We don't work together.

And those people who are the most chronic, they have PTSD. They have substance abuse. They have diabetes. They have that where do you go for help? You don't.

And we see them all over the place. And all these wonderful evidence based practices are not being applied to this population. And substance abuse has the skill set. Right now, we have developed our skills so that we provide all the mental health and substance use support to all the Hawaii state hospitals. We have doctors and nurses.

We have great expertise. Over here, nothing. 54,000 people aren't getting that kind of services. And we, of course, the most chronic would need our services, the residential services. So the Federal Government is saying to help us end that, they will offer grants to those states who start a pilot project because they're saying that the state is not interested, we're not gonna fund this transition.

And so what this the funding will do is it will set the staffing, the rates, and the structure with the intention that Medicaid will take it over. So that's this is a a total evolution of processes. And I I want to just say one thing about what substance abuse brings to the table. We are recovery point. We provide those coping skills, relapse skills.

We are about building purpose, and we're about building independence. We help people with community support find their own like, we offer state services and find something that's meaningful to them and provide the support to that so we're not continuously on state services. So that's our goal here, and we really appreciate the opportunity to share the good news. Thank you.

Thank you for being here. Hina Mauka, Brian Baker.

Aloha, chair tech. I'm a vice chair and members of the committee. My name is Brian Baker. I'm the president and CEO of Hina Mauka. I want you to picture someone in our community, your auntie or your uncle.

Someone struggling with addiction, but also living with depression or perhaps PTSD, and managing something also like diabetes or heart disease. Now imagine what happens when they try to go get help. They're sent to one place for medical care, another for mental health, and some are totally different for substance use treatment. And when they are referred to most substance use facilities, they find out that their mental health and that that facility finds out about their mental health or medical condition, they're frequently turned away.

No one is coordinating.

No one is seeing the whole person. We see this over and over again. People in this type of system do not get better. They fall through the cracks, they disengage, and too often, they come back to us only in crisis, either through the emergency room or the justice system. And at that point, the care is less effective and it's far more expensive.

The simple reality is these conditions do not exist in isolation. Mental health affects substance abuse, substance use affects physical health, and physical health affects everything. So when we treat them separately, we really should not be surprised that it doesn't work. But now imagine something different. A place where the same person can receive all their care together under one roof, where medical providers, mental health Clinicians, and addiction specialists are all working as one team with one care plan focused on one patient.

That is what integrated residential care can make possible. When we do this right, we don't just help individuals stabilize and recover. We reduce the the consistent cycling through emergency rooms, hospitals, jails, and prisons, and we begin to address the broader impacts that we're seeing every day here in Hawaii, whether it's on the news or on your drive to work, the homelessness, the incarceration, the community instability. Other states are already moving in this direction, and federal resources and funding are following.

Thanks for being here. Also on Zoom, Nicole from Aloha House Inc.

Aloha, Kakanyakakako. My name is Nicole Hokowana, and I'm the CEO of Maui Behavioral Health Resources overseeing Aloha House, Malama Family Recovery Center, and Maui Youth and Family Services.

Our organizations provide substance use treatment, disorder treatment, mental health, and residential services across Maui County, and I'm here to what Alan Johnson and Brian have already said and also expressed my strong support for SCR 149 and the request for the Department of Health to convene an informal working group to assess services and funding needed to serve individuals with complex co occurring conditions. Many individuals served in Hawaii's behavioral health system experienced multiple overlapping conditions, including substance use disorders, serious mental illness, and chronic physical health conditions.

Our current funding and service structure often require providers to treat these conditions separately resulting in what we see every day, which is fragmented care, poor coordination, and limited effectiveness for individuals with the highest acuity and service utilization.

Integrated care models are nationally recognized best practice for adjusting complex patient needs. I believe we can all see that it's it's a common sense approach to treat the multiple conditions at once and reduce barriers.

Often what we see at our own residential treatment center here on Maui or our spaces here on Maui is that we need to either discharge individuals to get their medical needs met or we're not able to provide for some of their mental health needs in a timely enough manner in order to stabilize these individuals who also are struggling with addiction. And so what we see are repeated cycles and entries into our systems of care and kind of lack of effectiveness.

So, anyway, I heard the beep, and I just hear the and offer my my and thank you very much.

Thanks, Nicole. Thanks for being here. We also have doctor Lewin, department of health in support. Anyone else wishing to testify on Zoom or in the room? Members, any questions?

Alright. To play with you guys. Members will head back to the top of the agenda. Members on SCR 21 SD one. The recommendation is to move forward as is.

Members, any questions? Seeing none, chair Takayama for the vote.

Okay.

Voting on SCR 21 SD one. Chair and vice chair vote aye. Representative Amado excused and shall be so noted for the remainder of the agenda. Representative Hartsfield? Aye.

Representative Martin? Aye. Representative Holtz? Aye. Representative Takenamucci?

Aye. Representative Alfose? Aye. Representative Garcia? Aye.

Your recommendation's adopted.

Thank you, chair. Thank you, members. Moving on to SCR 50 SD one, establishing up away health plan working group. Members, this one, we're gonna make some amendments, and we'll start with such a compelling testimony from doctor Lewin. We're gonna have Shipta be the chair for this working group.

And then members on page two lines 27 through 29. We're gonna add in members, chairs of the Standing Committee of the Senate and the house, representatives from commerce and consumer protection, who will also be part of this primary part of the working group. So it would be them or their designee.

On page three, about nine's twenty two thirty, we're gonna add in one representative from MedQuest administration or their designee, and that's based on testimony from doctor lewin along with one representative from Hawaii Medical Association or its designee as provided in testimony from the medical association. And then we'll go ahead and renumber the working group to be consistent with the additions.

Members, any questions?

Comment. Vice chair.

Go ahead.

I'm not opposed to the resolution. I think it's a good thing to have discussion moving forward. I would like to see the previous program that that doctor Lewin had mentioned from the nineties resurrected, And maybe this committee next session can take a look at that and see if if the legislature could adequately fund that. But I some of the language in there, I do have some concerns on. So I'm gonna move with reservations, but in support overall of the mission.

Thank you. I'll go ahead and note that in our committee report that maybe this working group can go ahead and explore that in addition to the work that we've identified for them. Anyone else with comments, concerns? Chair Takayama for the vote.

Okay. Voting on SCR 50, SD one with amendments, noting the excused absence of representative Mato and reservations of representative Garcia. Any other members with reservations or no?

Seeing none,

your recommendations are done.

Thank you, chair. Members, now we're on to SCR 75 SD one urging the Department of Health to be the coordinated interdepartmental effort to reduce the impact of fetal alcohol syndrome. Members, I'm gonna make another edit to this particular resolution hearing from the Department of Health.

We're gonna add in at the very bottom, be it further resolved that the Department of Health is requested to provide information to improve provide information and education to improve prenatal health care and other upstream mitigated measures, along with submit a plan for interagency collaboration, and provide recommendations and findings, all to be done at least twenty days prior to the regular session of 2027. Members, any questions?

I have a question. Would you consider adding cannabis in there as well instead of having a big basis to alcohol? So information to improve prenatal education and mitigate upstream, including cannabis use.

Figure it's the same target population. Thanks. Members, any other comments, questions? Thank you, members, chair, for the vote.

Okay. Voting on SCR 75 SD one with amendments. Any members voting with reservations or no? Seeing them, your recommendations.

Thank you, members. And of course, finally, we're on to SCR 149 SD one requesting the Department of Health to establish an informal working group to assess the services and funding necessary to address the need of complex patients who have two or more diagnoses that include substance use disorders, mental health, or chronic physical. Members, we're gonna move this for this one. We just have to make some technical amendments needed for clarity, consistency, and style other than that. Any comments, questions, concerns?

Chair for the vote, please.

All members being present with the exception of representative Amado. Anyone voting with reservations or no? Seeing none, the recommendation is adopted.

Thank you, chair.

You know, before we gabble up, I just wanted to let everyone know that this will be the last hearing of the health committee this session. And I wanted to let everyone know what what an honor it's been to be your chair.

And I I think we've made improvements and will make improvements in our health system last year in this and just thank you very much.

Thank you, chair.

Great job. Thank you.