H.B. NO.



















SECTION 1. The legislature finds that telehealth adoption in Hawaii is increasing. The report of findings from the 2017 Hawaii Physician Workforce Assessment Project estimates that approximately 15 per cent of providers report a telehealth experience, which is an increase from 2014 of less than 5 per cent. This rate increase coincides with enactment Act 159, Session Laws of Hawaii (SLH) 2014, and Act 226, SLH 2016, both of which diminished several long-standing barriers to increased telehealth adoption such as reimbursement parity with face-to-face visits and malpractice coverage reform.

However, despite this favorable policy environment telehealth utilization remains frustratingly low. A continuum of issues across multiple sectors must be addressed such, as incentives for provider adoption, patient comfort with new technology, health care workforce training, technology and telecommunications infrastructure, and administrative simplification between health systems.

Therefore, the purpose of this Act is establish permanent resources to achieve Hawaiis goal of establishing telehealth as a community standard for health care access.

SECTION 2. Chapter 321 is amended by adding a new part to be appropriately designated and to read as follows:


"321- Definitions. As used in this part, unless the context requires otherwise:

"Telehealth" means the use of telecommunications as that term is defined in section 269-1, to encompass four modalities: store and forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non-interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purposes of: delivering enhanced health care services and information while a patient is at an originating site and the physician is at a distant site; establishing a physician-patient relationship; evaluating a patient; or treating a patient.

321- State telehealth policy, roles and responsibilities. (a) It shall be the policy of the State, through its programs, authorities, and resources to promote telehealth to deliver health care from a distance as an effective way of overcoming certain barriers to accessing care, particularly for communities located in rural and remote areas.

(b) The department of health is authorized to lead statewide efforts to assure consumer choice, reduce disparities in access to care, enhance health care provider availability, and improve quality of care through telehealth.

321- Telehealth advisory council. (a) There is established within the department of health for administrative purposes the state strategic telehealth advisory council. The advisory council shall advise the governor in the development and implementation of a comprehensive plan to establish telehealth as high quality, cost-effective, and reliable means of health care access.

(b) The advisory board shall consist of at least nine members who shall be appointed by the governor without regard to section 26-35. The governor shall designate a member to be the chairperson of the advisory board. The director of health or a designee shall serve as an ex officio nonvoting member of the advisory board.

(c) In establishing the advisory board, the governor shall appoint at least:

(1) Two members of organizations that represent health care facilities, one of whom shall be a representative of a hospital;

(2) Two members of organizations that represent health insurers; one of whom shall primarily serve medicaid beneficiaries;

(3) One member of organizations that represent broadband infrastructure or telecommunications services;

(4) One member from the office of the governor or a designee;

(5) Two members of long-term care services, one of whom shall be a representative of a nursing home and one of whom shall be a representative of a home health agency or community-based health services program;

(6) Two health care practitioners, each of whom practices primarily in a rural county; and

(7) One member of organizations that represents mental health providers;

provided that there shall be at least one state strategic telehealth advisory council member from each county in the State.

The members shall serve without compensation but shall be reimbursed for actual expenses, including travel expenses, that are necessary for the performance of their duties.

(d) The state strategic telehealth advisory council shall be exempt from chapter 92, Hawaii Revised Statutes.

321- State telehealth coordinator. (a) There is established the full-time Hawaii state telehealth coordinator to support the state strategic telehealth advisory council. The state telehealth coordinator shall facilitate the establishment of infrastructure and policies across all agencies of the State and private sector to promote the expansion of telehealth in Hawaii, including:

(1) Promoting administrative support to the state strategic telehealth council;

(2) Coordinating with the department of commerce and consumer affairs on issues relating to professional and vocational licensing, and insurance regulation as they relate to telehealth;

(3) Coordinating with the department of commerce and consumer affairs and department of business, economic development, and tourism on broadband connectivity;

(4) Coordinating with the department of education, the department of public safety, department of human services, the employer union trust fund, and other state agencies that finance or provide health care services to promote the use of telehealth;

(5) Coordinating with the University of Hawaii and other agencies on telehealth research to assure quality, cost effectiveness, and efficacy;

(6) Coordinating with the department of labor and industrial relations, the University of Hawaii, the department of education, and other agencies to assure a telehealth-capable workforce;

(7) Coordinating with the office of the state chief information officer on matters related to cybersecurity; and

(8) Coordinating with the private sector to assure alignment and consistency with state goals.

(b) The coordinator shall be selected by the director of health.″

SECTION 2. (a) The department of health shall establish and convene a working group to research and make recommendations to reduce barriers related to health care system credentialing, privileging, and related administrative processes that may contribute to delays and inefficiencies for health care providers delivering care to patients. The working group shall be exempt from chapter 92, Hawaii Revised Statutes.

The working group shall submit a final report, including recommendations for further action, to the legislature no later than twenty days before the convening of the regular session of 2020.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $110,000 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 establishment of one permanent full-time equivalent (1.0 FTE) state telehealth coordinator position within the department of health.

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

SECTION 4. This Act shall take effect upon its approval, and shall be repealed on January 1, 2022.









Report Title:




Establishes goals for the adoption and proliferation of telehealth to increase health care access. Establishes the Strategic Telehealth Advisory Council and permanent full-time State Telehealth Coordinator position.




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