STAND. COM. REP. NO. 2117-26

Honolulu, Hawaii

, 2026

RE: S.B. No. 847

S.D. 2

H.D. 2

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

Your Committee on Consumer Protection & Commerce, to which was referred S.B. No. 847, S.D. 2, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO PSYCHOLOGISTS,"

begs leave to report as follows:

The purpose of this measure is to establish a three-year pilot program to allow qualified psychologists under the supervision of a supervising psychiatrist to prescribe psychotropic medications for the treatment of mental illness to certain patients under the psychologist's care at a federally qualified health center located in the County of Kauai.

Your Committee received testimony in support of this measure from the State Health Planning and Development Agency; Board of Psychology; Office of the Mayor of the County of Kauaʻi; Office of the Mayor of the County of Hawaiʻi; Legislative and Social Action Committee of the American Psychological Association's Division 55, the Society for Prescribing Psychology; DepressionEducation.org; Resilience Therapy and Assessment Services, PLLC; Family Solutions Counseling Center; Hawaiʻi Mental Health Coalition; National Association of Social Workers, Hawaii Chapter; Mental Health America of Hawaiʻi; Hawaiʻi Psychological Association; a petition with numerous individuals in support; and numerous individuals.

Your Committee received testimony in opposition to this measure from the Hawaiʻi Association of Professional Nurses; Hawaii Medical Association; Hawaiʻi Psychiatric Medical Association; Hawaiʻi Chapter of the American Academy of Pediatrics; a petition with numerous individuals in opposition; and numerous individuals.

Your Committee received comments on this measure from the Department of Health and Hawaiʻi Primary Care Association.

Your Committee finds that expanding prescriptive authority to qualified and specially trained psychologists has been implemented safely in other jurisdictions and care settings. Your Committee further finds that evidence from those jurisdictions demonstrates improved access to mental health care and positive patient outcomes, particularly for rural, underserved, and high-need populations. Your Committee notes that prescribing psychologists are subject to rigorous education and training requirements and practice within established standards of care. By allowing appropriately trained psychologists to provide prescriptive services, this measure supports improved access to behavioral health care while maintaining appropriate safeguards and oversight.

Your Committee has amended this measure by:

(1) Specifying that medications prescribed under the pilot program are eligible for Medicaid reimbursement to the extent such prescriptions would otherwise be eligible if prescribed by a psychiatrist;

(2) Expanding the pilot program to Wilcox Medical Center and Samuel Mahelona Memorial Hospital;

(3) Requiring employers to report adverse events, patient outcomes, and escalation protocols relating to services provided under the pilot program to the State Health Planning and Development Agency, which is required to annually report the results to the Board of Psychology;

(4) Amending the definition of "prescriptive authority" to limit that authority to patients with major depressive or generalized anxiety disorder;

(5) Limiting the psychotropic medications that may be prescribed under the pilot program to only selective serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI);

(6) Changing the effective date to July 1, 3000, to encourage further discussion; and

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

As affirmed by the record of votes of the members of your Committee on Consumer Protection & Commerce that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 847, S.D. 2, H.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 847, S.D. 2, H.D. 2.

Respectfully submitted on behalf of the members of the Committee on Consumer Protection & Commerce,

____________________________

SCOT Z. MATAYOSHI, Chair