Honolulu, Hawaii
                                                   , 1999

                                 RE: S.B. No. 860
                                     H.D. 1

Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii


     Your Committee on Health, to which was referred S.B. No. 860


begs leave to report as follows:

     The purpose of this bill is to include marriage and family
therapists (MFTs) as providers of the mental health, alcohol, and
drug abuse services coverage mandated under chapter 431M, Hawaii
Revised Statutes.

     Your Committee received testimony in support of this measure
from the Department of Health, the Hawai'i Chapter of the
American Psychiatric Nurses Association, and many concerned
individuals.  The Hawaii Psychological Association (HPA) and
Hawaii Biodyne provided testimony in opposition to the bill,
questioning the ability of MFTs to provide competent mental
health and substance abuse treatment services.

     Your Committee heard testimony that many couples and
families suffering from drug and alcohol abuse, marital,
parenting, domestic violence, workplace, and other problems, are
unable to afford the necessary services of MFTs because these
services are not covered by health insurance.  Your Committee
also heard testimony that including MFTs as providers of mandated
mental health, alcohol, and drug abuse services would reduce
costs by providing the option of MFT services where more
expensive psychiatric or other specialty treatment is not
necessary.  In addition, this bill would allow the Department of

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                                 Page 2

Education the option of using insurance reimbursable services of
MFTs to satisfy the requirements of the Felix Consent Decree.

     In partial response to the concerns of the HPA and Hawaii
Biodyne, your Committee notes that chapter 431M makes provision
for peer review of mandated benefits, and requires that covered
benefits be limited to services certified as medically or
psychologically necessary at the least restrictive appropriate
level of care.

     Your Committee believes that further discussion of this
measure would be beneficial, and has replaced its contents with
that of H.B. No. 327, a bill with similar provisions that passed
out of your Committee earlier in this session.  Your Committee
has also made technical, nonsubstantive amendments to the
definition of "partial hospitalization services" for purposes of
clarity and style.

     As affirmed by the record of votes of the members of your
Committee on Health that is attached to this report, your
Committee is in accord with the intent and purpose of S.B. No.
860, as amended herein, and recommends that it pass Second
Reading in the form attached hereto as S.B. No. 860, H.D. 1, and
be referred to the Committee on Consumer Protection and Commerce.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health,

                                   ALEXANDER C. SANTIAGO, Chair