STAND. COM. REP. NO. 1406
Honolulu, Hawaii
RE: H.B. No. 1156
H.D. 2
S.D. 1
Honorable Ronald D. Kouchi
President of the Senate
Thirty-Second State Legislature
Regular Session of 2023
State of Hawaii
Sir:
Your Committee on Health and Human Services, to which was referred H.B. No. 1156, H.D. 2, entitled:
"A BILL FOR AN ACT RELATING TO HEALTH,"
begs leave to report as follows:
The purpose and intent of this measure is to:
(1) Authorize the provision of long-acting psychotropic medication to patients who are subject to emergency examination or hospitalization;
(2) Authorize certain health care facilities to request the Director of Health to file a petition for an order for treatment over a patient's objection;
(3) For requests that satisfy the requirements for administration of treatment over a patient's objection, require the Director of Health to pursue a petition to request an order for treatment over the patient's objection or convene an administrative panel, under certain conditions;
(4) Expand which individuals may be ordered to receive treatment over an individual's objection;
(5) Require the Family Court or an administrative panel
to file a final order on a petition to request an order for treatment over the
patient's objection within thirty days of the date the petition is filed;
(6) Authorize psychiatrists, advanced practice
registered nurses, and interested parties to request the Director of Health to
file an assisted community treatment petition;
(7) For requests that satisfy the criteria for assisted
community treatment, require the Director of Health to file a petition
for assisted community treatment within a certain number of days;
(9) Authorize the Family
Court to use online hearings for assisted community treatment petitions;
(11) Require the Department of Health to report to the Legislature on the number of requests for petitions for assisted community treatment submitted to the Director of Health after a certain date.
Your Committee
received testimony in support of this measure from the State Council on Mental Health; The Institute for Human
Services, Inc.; and two individuals. Your Committee received testimony in
opposition to this measure from the Department of Health, Hawaii Disability Rights Center,
American Civil Liberties Union of Hawai‘i, and one individual. Your Committee received comments on
this measure from the Judiciary and
The Queen's Health System.
Your Committee finds that certain
individuals presented to hospitals in emergency situations may be living with a
chronic mental illness or experiencing a psychiatric crisis that requires stabilization. In these situations, due to the importance of
timely treatment, it may be necessary to administer certain appropriate
medications over a patient's objection.
This measure would expedite the process for obtaining authorization to
treat over objection, including for assisted community treatment, to ensure
individuals living with behavioral health issues receive the care they need at
the appropriate time.
However, your Committee notes the concerns
raised in testimony that part I of this measure, as currently written, violates
individuals' constitutional protections, particularly for individuals living
with disabilities and mental health conditions.
In addition, this measure, as currently written, does not adhere to the
judicial procedure for the involuntary treatment of an individual established
in state case law, is infeasible to implement, and would lead to greater
inefficiencies and costs.
Your Committee further notes the concerns
raised by the Judiciary regarding part II of this measure. Specifically, the Judiciary notes concerns
that the proposed requirement for the Family Court to file a final order on a
petition for assisted community treatment within thirty days of the date the
petition is filed unless exigent circumstances exist is not clearly defined and
may result in unintended consequences.
Additionally, the Judiciary notes that the statutory definition of an
individual who qualifies for assisted community treatment may preclude the
individual from knowingly and voluntarily stipulating to a proposed order for
treatment. Amendments to this measure
are therefore necessary to address these concerns.
Accordingly, your
Committee has amended this measure by:
(1) Deleting language that would have:
(A) Authorized the provision of long-acting psychotropic medication to patients who are subject to emergency examination or hospitalization;
(B) Authorized certain health care facilities to request the Director of Health to file a petition for an order for treatment over a patient's objection;
(C) For requests that satisfy the requirements for administration of treatment over a patient's objection, required the Director of Health to pursue a petition to request an order for treatment over the patient's objection or convene an administrative panel, under certain conditions;
(D) Expanded which individuals may be ordered to receive treatment over an individual's objection; and
(E) Required the Family Court or an administrative panel
to file a final order on a petition to request an order for treatment over the
patient's objection within thirty days of the date the petition is filed;
(2) Deleting
language that would have required the Family Court to endeavor to file a final
order on a petition for assisted community treatment within thirty days of the
date the petition is filed unless exigent circumstances exist;
(3) Deleting
language that would have authorized the subject of a petition for assisted
community treatment to stipulate to the petition, including the proposed
treatment plan, and the Family Court to enter the stipulated order without an
evidentiary hearing, under certain circumstances;
(4) Inserting
an appropriation of an unspecified amount for the Judiciary to obtain
applicable resources to effectuate this measure;
(5) Inserting an effective date of June 30,
2050, to encourage further
discussion; and
(6) Making
technical, nonsubstantive amendments for the purposes of clarity and
consistency.
As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1156, H.D. 2, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 1156, H.D. 2, S.D. 1, and be referred to your Committee on Judiciary.
Respectfully submitted on behalf of the members of the Committee on Health and Human Services,
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________________________________ JOY A. SAN BUENAVENTURA, Chair |
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