H.B. NO.



H.D. 1











Relating to health.





     SECTION 1.  The legislature finds that effective treatment of patients with complex substance abuse or other mental health conditions requires heightened coordination of medical and psychosocial care, development of accompanying quality metrics, increased involvement of the public health system, strengthened public-private partnerships, and an increase in qualified staff.

     The legislature finds that historically, substance use disorder treatment programs in Hawaii have operated independently of each other, offering limited or little coordination of services and without ensuring that client care shifts freely between levels of care and the various contracted SUD programs as clinically appropriate.  The legislature also finds that the State has need for a synchronized system of care rather than an assortment of independent programs and treatment modalities, which is best achieved through a re-designed, coordinated, and responsive system of care that provides clinically appropriate substance abuse treatment and recovery support services statewide.  Further, a continuum of care structured to deliver substance use disorder treatment should include levels of patient care modeled after the American Society of Addiction Medicine patient placement criteria for substance use disorder services.  In addition, movement among those levels of care should be based on individual needs and transition should be as barrier free as possible.  Finally, services need to be readily available to those who need it, when they need it, how they need it, and where they need it.

     The legislature further finds that coordinated entry systems and an integrated continuum of care for substance abuse and related behavioral health treatment systems provides a mechanism to achieving the goal of a more effective and responsive behavioral health system.  Additionally, the legislature finds that the department of health’s alcohol and drug abuse division has initiated implementation of a coordinated entry continuum of care through a request for proposal for its contracted treatment services to begin October 2019.  This new approach to implementing a coordinated entry continuum of care will be called Hawaii Coordinated Addiction Resource Entry System (Hawaii CARES).  This re-designed system, that implements the CARES component as the anchor, will:

     (1)  Provide a centralized referral and treatment process that includes helping a patient access specialized treatment, select facilities, and navigate barriers such as cost and transportation, and following up with a patient as needed;

     (2)  Expand case management and outreach for persons struggling with substance abuse, mental illness, and homelessness;

     (3)  Provide for the development and expansion of certified peer recovery mentors to more effectively support long term recovery, model recovery-oriented behaviors, and promote a sense of community;

     (4)  Reduce administrative barriers to care coordination, support for the patient, and continuous quality improvement;

     (5)  Provide flexibility in directing general and federal funds to components of the system that most need it, and assure that resources are utilized at maximum efficiency and that duplication of effort is minimized;

     (6)  Develop a centralized inventory and tracking system of available treatment beds and outpatient slots to assure expeditious access;

     (7)  Assure ongoing capacity development by better identification of actual versus perceived need and strategic targeting of identified systemic barriers; and

     (8)  Leverage community partnerships and resources of stakeholders such as the department of public safety, law enforcement, the judiciary, department of human services, county organizations, health plans, and the community to improve health and wellness while reducing societal and individual risk factors and other negative determinants of health.

     The purpose of this Act is to appropriate funds to establish and maintain comprehensive and coordinated continuum of care treatment services for those individuals who suffer from substance use and related disorders through the Hawaii CARES program.

     SECTION 2.  (a)  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 2019-2020 and the same sum or so much thereof as may be necessary for fiscal year 2020-2021 for the treatment of patients with substance abuse disorders and related behavioral health conditions through the Hawaii CARES program.

     (b)  Subject to the availability of funds, the director of health may designate additional political subdivisions, or request additional private entities, to participate in the program established pursuant to this Act.

     (c)  The sums appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 3.  This Act shall take effect on July 1, 2050.

Report Title:

DOH; Substance Use; Appropriations



Appropriates funds to the Department of Health to establish and maintain comprehensive and coordinated continuum of care treatment services for sufferers of substance use and related disorders.  (HB38 HD1)




The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.