STAND.
COM. REP. NO. 367-26
Honolulu, Hawaii
, 2026
RE: H.B. No. 2372
H.D. 1
Honorable Nadine K. Nakamura
Speaker, House of Representatives
Thirty-Third State Legislature
Regular Session of 2026
State of Hawaii
Madame:
Your Committee on Health, to which was referred H.B. No. 2372 entitled:
"A BILL FOR AN ACT RELATING TO ASSISTED COMMUNITY TREATMENT,"
begs leave to report as follows:
The purpose of this measure is to authorize registered nurses and licensed paramedics who are operating as part of a county program to administer prescription medication prescribed as part of an assisted community treatment order treatment plan in settings other than a hospital, psychiatric facility, or other designated facility.
Your Committee finds
that subjects of assisted community treatment orders must be taken to an
emergency room or admitted to a hospital and be attended by a psychiatrist or
advanced practice registered nurse to receive court-ordered treatment. However, mentally ill individuals who are
subject to these orders and refuse to be moved, and whose actions do not to
rise to the level of necessitating the initiation of emergency transportation to
a psychiatric or other designated facility, cannot access the treatment they
desperately need. Your Committee further
finds that state licensed registered nurses and other state licensed health
care professionals who are participating in a community paramedicine program
that has been approved by the Department of Health are able to develop ongoing
relationships with the clients they serve and can carry out assisted community
treatment orders by administering treatment ordered by a qualified psychiatric
examiner.
Your Committee notes
the concerns raised in testimony by the Department of the Attorney General and Department
of Health that this measure may unintentionally be interpreted to authorize the
administration of treatment without the consent of the subject of an assisted
community treatment order. Your
Committee recognizes that the current process of requiring that the
administration of treatment over the objection of the subject occur in a
hospital setting is necessary to protect the safety of the subject and the
health care provider administering the medication. Your Committee further notes the Department
of Health's concerns that while paramedics are authorized to administer
medication, this authorization is limited to medication that is included in the
Emergency Medical Services Department of Health Standing Orders and that
administration of medication not included in those orders could result in a
paramedic operating outside of the scope of their practice.
Your Committee notes the testimony of the Emergency Services Department and Department of Community Services of the City and County of Honolulu that the current method of administering medication to subjects of an assisted community treatment order often requires significant law enforcement and hospital resources as these individuals may need to be detained by police officers, transported to an appropriate hospital facility, held for evaluation of the subject by a qualified psychiatric examiner, or monitored until medication has been administered. Your Committee recognizes that limiting administration of medication to the subject of an order in a non-hospital setting to situations where the subject consents to the administration may not address the concerns raised by the City and County of Honolulu. Accordingly, your Committee respectfully requests that your Committee on Judiciary & Hawaiian Affairs, should it deliberate on this measure, to consider the necessity of limiting the types of situations in which medication may be administered.
Accordingly,
your Committee has amended this measure by:
(1) Authorizing qualified state-licensed health
care professionals who are participating in a community paramedicine program
that has been approved by the Department of Health, rather than licensed
paramedics, to administer medication pursuant to an assisted community
treatment order;
(2) Requiring the subject of an assisted community
treatment order to consent to the administration of medicine before a
registered nurse or state-licensed health care professional may administer the
medication;
(3) Clarifying that a registered nurse or state-licensed
health care professional may administer treatment if the treatment is provided
through a community paramedicine program in addition to a county community
outreach program;
(4) Clarifying that the location where medication
may be administered must be designed specifically to administer community
paramedicine care in addition to prehospital care;
(5) Changing the effective date to July 1, 3000,
to encourage further discussion; and
(6) 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 Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 2372, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 2372, H.D. 1, and be referred to your Committee on Judiciary & Hawaiian Affairs.
Respectfully submitted on behalf of the members of the Committee on Health,
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____________________________ GREGG TAKAYAMA, Chair |
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