SB2505

SECTION 1. The legislature finds that Hawaii continues to face a growing opioid crisis, with rising rates of overdose and opioid-related emergency department visits. Paramedics are often the first health care providers to encounter these patients, providing a critical opportunity to connect them to evidence‑based treatment.

The legislature further finds that national data, including a 2023 study published in the Annals of Emergency Medicine, demonstrate that the administration of buprenorphine by trained emergency medical services personnel following naloxone can significantly reduce withdrawal symptoms and increase the likelihood of patients engaging in opioid use disorder treatment within thirty days.

The legislature recognizes the department of health's concern that it is essential to ensure that patients who receive buprenorphine in the field have access to follow-up treatment within twenty-four to forty-eight hours. The legislature therefore intends to establish a phased pilot program, limited initially to paramedics and counties with identified treatment linkage capacity.

The purpose of this Act is to:

(1) Authorize paramedics, under department of health‑approved protocols, to administer buprenorphine following naloxone in cases of suspected opioid overdose;

(2) Require the department of health to verify and designate treatment centers that can accept patients within twenty-four to forty-eight hours of an emergency medical services encounter;

(3) Implement the program as a phased pilot program in one or more counties; and

(4) Require the department to evaluate the program and report outcomes to the legislature.

SECTION 2. Section 329E-3, Hawaii Revised Statutes, is amended to read as follows:

"[[]§329E-3[]] Opioid antagonist administration; emergency personnel and first responders. (a) Beginning on January 1, 2017, every emergency medical technician licensed and registered in Hawaii and all law enforcement officers, firefighters, and lifeguards shall be authorized to administer an opioid antagonist as clinically indicated.

(b) Beginning July 1, 2026, paramedics licensed in the State may administer buprenorphine, under protocols established by the department of health and approved by the state emergency medical services medical director, after administering an opioid antagonist to a patient experiencing an opioid‑related overdose; provided that:

(1) The paramedic has completed department‑approved training in opioid withdrawal assessment and buprenorphine administration;

(2) The patient is alert, has regained decision‑making capacity, and meets the clinical criteria for buprenorphine field initiation, as defined by the protocol;

(3) A same‑day or next‑day referral is made to a designated treatment provider authorized by the department of health; and

(4) Documentation of the administration, withdrawal assessment, and referral is submitted to the department for program evaluation.

(1) Establish clinical and operational protocols for administration of buprenorphine in the field by paramedics;

(2) Designate and maintain a list of treatment centers and providers capable of accepting referred patients within twenty‑four to forty‑eight hours; and

(3) Ensure coordination between emergency medical services, emergency departments, and substance use disorder treatment programs."

SECTION 3. The department of health shall:

(1) Implement a phased pilot program to implement section 329E-3(b) and (c), Hawaii Revised Statutes, beginning in at least one county having verified linkage‑to‑care capacity and may expand statewide as additional treatment resources become available;

(2) Provide or contract for the training of paramedics in the assessment, administration, and documentation of buprenorphine field initiation; and

(3) Submit a report to the legislature no later than twenty months after the pilot program's start date, which shall contain an evaluation of:

(A) The number of patients treated under the pilot program;

(B) Withdrawal symptom outcomes;

(D) Any operational challenges or recommendations for statewide expansion; and

(E) Any proposed legislation.

SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 5. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________
	By Request

Report Title:

Hawaii State Association of Counties Package; DOH; Paramedics; Buprenorphine; Opioid Overdose; Pilot Program; Report

Description:

Authorizes licensed paramedics to administer buprenorphine after administration of an opioid antagonist in cases of opioid overdoses, under certain conditions. Requires the Department of Health to implement a phased pilot program in at least 1 county with verified linkage-to-care capacity and authorizes expansion of the program statewide as additional treatment resources become available. Requires a report to the Legislature evaluating program outcomes.

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

THE SENATE	S.B. NO.	2505
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII