HB36

SECTION 1. The legislature finds that homelessness continues to be one of the State's most significant and challenging social problems. According to the 2018 Hawaii statewide homeless point-in-time count conducted in January 2018, there are 6,530 homeless individuals in the State, an overall decrease of 9.6 per cent from 2017. However, the costs of caring for this population have continued to grow. Homeless persons face a wide range of issues, including general health issues, mental illness, and substance abuse. These issues affecting homeless persons also impact the general population through the costs of social and health care services. In 2016, homeless persons in the State made more than twenty thousand hospital visits. Medical visits by the homeless cost state hospitals $214,000,000 in 2016, up drastically from $70,500,000 in 2010. Treating these homeless individuals is sometimes uncompensated; one hospital alone incurred $10,500,000 in uncompensated costs in 2015.

The legislature also finds that mobile clinics are increasing in popularity across the nation as governments try to find ways to address the health care needs of the homeless population. In places such as Dallas, Texas; Denver, Colorado; San Jose, California; and Seattle, Washington, mobile clinics offer a variety of free health care services for local homeless populations, resulting in significant cost savings when compared to emergency room visits. One estimate from 2016 found that each dollar spent on mobile clinics saved twelve dollars in other costs.

The purpose of this Act is to appropriate funds for purchasing, staffing, and operating two mobile clinics to serve persons residing in ohana zones.

SECTION 2. For purposes of this Act, "ohana zone" means a place:

(1) That has a program to address basic needs of individuals experiencing homelessness; and

(2) Where wrap-around services, social and health care services, transportation, and other services may be offered with the goals of alleviating poverty and transitioning individuals experiencing homelessness into affordable housing.

SECTION 3. (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 to purchase, staff, and operate two mobile clinics to serve persons residing in ohana zones; provided that:

(1) No funds appropriated pursuant to this section shall be made available unless the entities identified in subparagraphs (a) to (c) each separately provide matching funds on a dollar-for-dollar basis to the amount appropriated by the State:

(A) City and county of Honolulu;

(B) The Queen's Medical Center; and

(2) The staff may include one primary care provider, one nurse, one pharmacist, one psychiatrist, and other staff as needed, including a social worker, an outreach worker, and students pursuing a degree in medicine or nursing; and

(3) The mobile clinics may provide, at minimum, the following services:

(A) Non-emergency medical services for chronic, acute, and episodic conditions;

(B) Testing for sexually transmitted disease, human immunodeficiency virus, and hepatitis;

(D) Child and family services;

(E) Behavioral health and substance abuse services;

(F) Mental health services;

(G) Dental care;

(H) Referral services;

(I) Shower and laundry services;

(J) Clean clothing;

(K) Health insurance enrollment;

(L) Pharmacy services;

(M) Street medicine; provided that for the purposes of this subparagraph, "street medicine" means the practice of directly delivering health care and related services to persons found on the streets, in parks, along river banks, on beaches, and in abandoned buildings; and

(N) Other assistance services;

provided further that the department of human services may procure the mobile clinic services pursuant to chapter 103F, Hawaii Revised Statutes.

(b) Subject to the availability of funds, the director of human services may designate other political subdivisions or private organizations in addition to those listed in subsection (a)(1) to participate in the program established pursuant to this Act; provided that the matching funds requirement established in subsection (a)(1) shall also apply to the designated political subdivision or private organization.

SECTION 4. This Act shall take effect on July 1, 2019.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	36
THIRTIETH LEGISLATURE, 2019
STATE OF HAWAII