Honolulu, Hawaii



RE:    H.B. No. 541

       H.D. 1

       S.D. 2




Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2021

State of Hawaii




     Your Committee on Ways and Means, to which was referred H.B. No. 541, H.D. 1, S.D. 1, entitled:




begs leave to report as follows:


     The purpose and intent of this measure is to improve the delivery, funding, and evaluation of health care in the State.


     More specifically, the measure, as received by your Committee:


     (1)  Establishes a working group within the Department of Health to identify gaps in services, coordinate funding sources, and establish and identify outcome measures for behavioral health, substance abuse, and homelessness; and


     (2)  Requires the working group to submit a report to the 2022 Legislature.


     For the purposes of a public hearing, your Committee circulated a proposed S.D. 2 (Proposed Draft) of the measure, and notified the public that your Committee would be accepting testimony on the Proposed Draft, which includes all of the provisions of the S.D. 1 and contains the following additional provisions:


     (1)  Appropriates $4,780,880 on an emergency basis for payroll and other expenses to address the budget shortfall affecting the state comprehensive emergency medical services system; and


     (2)  Requires the Department of Commerce and Consumer Affairs to create an additional licensure category for emergency medical technicians certified by the National Registry of Emergency Medical Technicians at a higher level of practice than emergency medical responders but who do not provide emergency ambulance services.


     Your Committee received testimony in support of the Proposed Draft from the Department of Health, State Fire Council, Honolulu Fire Department, Maui Fire Department, Maui County Paramedics Association, AMR, Hawaii Substance Abuse Coalition, The Salvation Army, American Medical Response Kauai, and numerous individuals.


Your Committee received testimony in opposition to the Proposed Draft from two individuals.


     Your Committee received comments on the Proposed Draft from the Department of Human Services, Office of Hawaiian Affairs, Department of the Attorney General, Hawaii Medical Board,

Catholic Charities Hawaii, PHOCUSED, and two individuals.


Your Committee finds that the additional licensure category addressed in Part III of the measure recognizes that emergency personnel such as firefighters are not tasked with providing emergency transportation but are qualified to assist patients at the site of the emergency as well as in the ambulance during the transport of critical patients to medical facilities.


Your Committee notes that there were discussions regarding the additional licensure category, and the Hawaii Medical Board suggested that instead of being required to establish a new license, the Department of Commerce and Consumer Affairs should be required to examine the possibility of creating a new licensure category, including issues relating to scope of practice, qualifications for licensure, and necessary personnel and funding.  However, your Committee believes that establishing an additional licensure category will better align the actual scope of practice of the State's emergency responders with national standards as set by the National Registry of Emergency Medical Technicians, which is the main certifying organization for emergency responders in most states.


Your Committee has amended this measure by adopting the Proposed Draft with the following further amendments:


     (1)  Clarifying that the services referenced in Part I of the measure are services to persons experiencing behavioral health or substance abuse conditions, and resultant consequences, including homelessness;


     (2)  Clarifying that the additional category for emergency medical technicians in Part III of the measure refers to a "certification" instead of a "license," to more accurately reflect the language of Title 16, Chapter 85, Subchapter 7, Hawaii Administrative Rules;


     (3)  Making a technical amendment to the description of the membership of the working group to more accurately reflect the organizational structure of the Office of Hawaiian Affairs;


     (4)  Changing the effective date to July 1, 2050, to facilitate further discussion on the measure; and


     (5)  Making technical nonsubstantive amendments for purposes of clarity, consistency, and style.


     As affirmed by the record of votes of the members of your Committee on Ways and Means that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 541, H.D. 1, S.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as H.B. No. 541, H.D. 1, S.D. 2.


Respectfully submitted on behalf of the members of the Committee on Ways and Means,