STAND. COM. REP. NO. 1402-26

Honolulu, Hawaii

, 2026

RE: S.B. No. 2089

S.D. 1

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 Human Services & Homelessness, to which was referred S.B. No. 2089, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO MENTAL HEALTH,"

begs leave to report as follows:

The purpose of this measure is to expand the services eligible for Medicaid Prospective Payment System reimbursement to include certain services furnished by a federally qualified health center or rural health clinic and provided by mental health professionals under the clinical supervision of a licensed mental health professional.

Your Committee received testimony in support of this measure from the State Council on Mental Health; State Health Planning and Development Agency; Office of Hawaiian Affairs; Waianae Coast Comprehensive Health Center; and Akahai Emotional Wellness, LLC. Your Committee received comments on this measure from the Department of Human Services and Hawaii Medical Association.

Your Committee finds that the State faces a severe shortage of licensed mental health professionals, which has caused significant barriers to care for Medicaid beneficiaries. Your Committee further finds that enabling supervised pre-licensed mental health professionals to serve Medicaid recipients will increase the number of qualified providers available to low-income individuals and families, help reduce waitlists, and fill critical gaps in the State's behavioral health system.

However, your Committee understands that patient safety must remain central, and that certain areas of this measure should be fleshed out to ensure that any implementation includes well-defined, auditable parameters. After discussions with the State Health Planning and Development Agency, your Committee has suggested language for the following areas:

(1) Regarding permissible levels of training: Trainees must be enrolled in an accredited bachelors, masters, or doctoral degree behavioral health training program;

(2) Regarding minimum supervision standards: Supervision competence is a distinct professional competency that requires targeted education, training, and experience and an ongoing process of maintenance of competence in the competency domains being supervised. Quality supervision requires regular, documented, and competency-based supervision that prioritizes patient safety, ethical practice, and professional growth, which includes a minimum of mandatory weekly training meetings, frequent live observation of clinical work, review of charting and documentation, and adherence to state licensing and insurance regulations; and

(3) Regarding patient notification: Patient notification of provider qualifications and oversight relationships must be uniformly provided and a patient's request to be seen by a fully licensed professional or the supervising clinician must be honored.

Your Committee respectfully requests your Committee on Consumer Protection & Commerce, should it choose to deliberate on this measure, to consider incorporating the language suggested above.

Your Committee has amended this measure by:

(1) Clarifying that this measure is contingent upon and enforceable only to the extent approved by the federal Centers for Medicare and Medicaid Services;

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

(3) 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 Human Services & Homelessness that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 2089, S.D. 1, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 2089, S.D. 1, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.

Respectfully submitted on behalf of the members of the Committee on Human Services & Homelessness,

____________________________

LISA MARTEN, Chair