Report Title:

Psychiatric Health Services; Mental Health; UH



Establishes the psychiatric health services pilot project which enables psychiatrists to collaborate with primary care physicians at federally qualified health centers for psychiatric care to patients.  Makes appropriation.  Repealed 6/30/11.



H.B. NO.














relating to mental health.





     SECTION 1.  The legislature finds that mental health care is an essential component of the overall health and well-being of every resident of Hawaii.  Unfortunately, there is a severe shortage of mental health specialists available to provide these much-needed services, particularly in rural communities and neighbor islands.  This shortage has resulted in primary care physicians shouldering the responsibility of managing psychiatric patients in addition to their primary care patients.  This creates an extremely volatile situation.  Psychiatric patients have special needs that are more adequately addressed by professionals who specialize in psychiatry.  According to the University of Hawaii department of family medicine and community health, twenty-five to twenty-eight per cent of psychiatric patients who have received psychiatric care from primary care physicians stopped therapy within one month, and more than forty per cent stopped therapy within three months.  Primary care physicians often under-dose psychiatric patients and have difficulty with patients' adherence to therapy. 

     By encouraging a collaborative effort between primary care physicians and psychiatrists, the State can help psychiatric patients receive more effective treatment, and primary care physicians can receive guidance in proper dosing of psychotropic medications and therapy adherence.  In addition to periodic face-to-face consultations with primary care physicians, psychiatrists could effectively reach more patients by consulting with primary care physicians via teleconferences and group lectures on psychiatric disorders and treatment such as anxiety disorders and treatment for depression.

     The purpose of this Act is to establish a psychiatric health services pilot project to introduce an integrated behavioral model at the Bay Clinic, West Hawaii Community Health Center, and other federally qualified community health centers on the island of Hawaii to enable:

(1)  Psychiatrists to collaborate with primary care physicians; and

(2)  A mental health team to provide patients with necessary mental health care.

     SECTION 2.  Psychiatric health services; pilot project; expansion.  There is established within the department of health's rural health division for administrative purposes the psychiatric health services pilot project to enable psychiatrists to collaborate with primary care physicians and a mental health team at the Bay Clinic, West Hawaii Community Health Center, and any other federally qualified health centers on the island of Hawaii to provide patients with needed psychiatric health care.  The pilot program shall provide two psychiatrists and a licensed clinical social worker to work with existing mental health providers at participating health centers to treat any patient in need of psychiatric services.

     The department of health shall submit an annual report to the legislature on the pilot program no later than January 15, 2009, 2010, 2011, and 2012.  The initial report shall include funding proposals for the pilot program for the 2009-2011 fiscal biennium as well as any proposed legislation.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2008-2009 for the psychiatric health services pilot project pursuant to this Act.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 2008, and shall be repealed on June 30, 2011.