SB2505 SD1

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 two-year phased pilot program, limited initially to paramedics in one county with a population of one hundred thousand or less.

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 beginning in one county with a population of one hundred thousand or less; 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~~] the State and all law enforcement officers, firefighters, and lifeguards shall be authorized to administer an opioid antagonist as clinically indicated.

(b) Beginning July 1, 2026, in a county with a population of one hundred thousand or less, paramedics licensed in the State may administer buprenorphine, under protocols established by the department of health and approved by the chief of the emergency medical services and injury prevention branch of the department of health, after administering an opioid antagonist to a patient experiencing an opioid-related overdose; provided that:

(1) The paramedic has completed training in opioid withdrawal assessment and buprenorphine administration approved by the department of health;

(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 of health 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 two-year phased pilot program to implement section 329E-3(b) and (c), Hawaii Revised Statutes, beginning in a county with a population of one hundred thousand or less 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. 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 2026-2027 for the department of health to implement the pilot program pursuant to this Act.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 6. This Act shall take effect on July 1, 2026; provided that on June 30, 2028, sections 2 and 3 of this Act shall be repealed and section 329E-3, Hawaii Revised Statutes, shall be reenacted in the form in which it read on the day prior to the effective date of this Act.

Report Title:

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

Description:

Authorizes licensed paramedics in a county with a population of 100,000 or less 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 two-year phased pilot program beginning in one county with a population of 100,000 or less and authorizes expansion of the program statewide as additional treatment resources become available. Requires a report to the Legislature evaluating program outcomes. Appropriates funds. Sunsets 6/30/2028. (SD1)

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		S.D. 1
STATE OF HAWAII