Hawaii bills at first lateral

February 17th was “first lateral,” the legislative deadline for all bills to be assigned to their final committee in the originating chamber.  Any bills with multiple committee referrals that haven’t yet been heard are no longer in play.

Moving on are bills that address some of Hawaii’s most troubling health care needs, including mental health:

  • Prescriptive authority for clinical psychologists who also have completed extensive psychopharmacology training (SB384/HB767).
  • Licensing school-based psychologists to ensure standards and be able to bill third-party payers (SB224)
  • Requiring insurers to pay for mental health case management services for victims of sexual abuse (SB503/HB665)
  • Specifying Medicaid coverage for tele-psychiatric team-based care (SB1155/HB1272)

Contentious bills calling for water fluoridation didn’t get an outing but several bills would improve dental care and access.  SB27/HB843 restore funding for adult dental benefits in the MedQUEST program.  Other bills address availability and quality through licensing regulations:

  • Increase options for dental licensing exams (SB343)
  • Dental hygienist and dental assistant scope, supervision, and training (SB344/HB374, SB371, SB380/HB563, and SB381)

Several bills encourage clinical pharmacists to provide more patient care.  One authorizes pharmacists to prescribe and dispense contraceptives (SB513) while (SB514/HB676) allows provision of the human papillomavirus vaccine to people as young as 11 years of age.  HB1406, recognizing the potential for new treatment roles, would update the scope of practice for pharmacists.

Other workforce-related bills include creating a certification program for midwives (SB1312) and expanding prescribing scope for naturopaths (SB223).  Health professions loan repayment program funding (SB1078/HB916) and the creation of a Hawaii Health Corps (SB735) are moving forward as is a measure that would combine resources and sustainability for the primary care residency programs in Hilo and Oahu (SB730).

Supporting hospitals and nursing homes are HB93, a Medicaid add-on payment to long-term care facilities for more complex patients, and the hospital and nursing home Medicaid sustainability programs (SB397/HB89 and SB285/HB90, respectively).

A couple of innovative approaches to supporting health promotion and addressing social determinants were SB2, which called for insurance benefits to include housing and services related to homelessness, and SB1315, which would have insurers pay for Native Hawaiian cultural practices that improve health, such as hula, paddling, or lua.  The language in SB2 now calls for an auditor’s study of Medicaid-funded services for people who are homeless.  SB1315 was deferred but Senators plan to introduce a resolution asking insurers to support such practices in their community-benefit programs.

Other benefit expansions would make in vitro fertilization more readily available, including coverage for surrogates (SB502/HB664), and paying for at least 20 years’ worth of community reintegration services for people with brain injuries (SB225).

In other insurance legislation, both versions of the bill to adapt ACA requirements to Hawaii law are moving forward (SB403/HB552).  Other insurance-related bills address minimum net worth (SB1077/HB917), prior authorization processes (SB287/HB248), and network adequacy (SB387/HB914).  Bills are moving that would allow health savings accounts in conjunction with a Prepaid-compliant plan (SB384/HB407).