Hawaii Legislative Report: Health Bills Decked

Hawaii’s legislative cross-over deadline is March 9th so all bills, except the budget, need to have been decked by March 3rd in order to move from their originating body to the opposite side.

Of general interest, both bills that preserve ACA insurance mandates (SB403/HB552), and one that would enable medical aid in dying (SB1129) are alive.

Hawaii’s high-profile homelessness dilemma resulted in a number of bills that address housing and assistance for people who are homeless.  Some of them are:

  • Funding outreach services through the Dept. of Human Services (HB1195)
  • Creating permanent positions at the Hawaii Public Housing Authority (SB968)
  • Supporting the MedQUEST Hawaii Pathways program (SB7)
  • Appropriating funds for mobile clinics (SB347/HB527)
  • Authorizing general obligation bonds to build affordable rental and public housing (HB488)
  • Appropriating funds to DHS to support and coordinate services for the homeless (HB1240)
  • Directing that $2 million in Tourist Accommodation Taxes be used to address homelessness in tourist areas (HB317)

A variety of bills would address two of the most notable weaknesses in Hawaii’s health care system – behavioral health and oral health:

  • Providing prescriptive authority for psychologists (SB384)
  • Requiring Medicaid coverage for tele-psychiatry services involving a coordinated care manager (HB1272)
  • Licensing school psychologists (SB224)
  • Authorizing APRNs to provide the same assisted community treatment services as physicians (HB912)
  • Requiring informed consent related to opioid prescribing (SB505)
  • Ensuring that mental health benefits are available for victims of sexual assault (SB503)
  • Restoring Medicaid-covered dental benefits for adults (SB27)
  • Increasing flexibility for dental licensing exams (SB343)
  • Allowing dental hygienists to practice under general supervision (SB380/HB563)
  • Addressing scope and licensing for hygienists and assistants (SB344 and HB374)

Also of significant importance is access to care.  Related bills are:

  • Hospital and nursing home Medicaid sustainability programs (SB397/HB89 and SB285/HB90, respectively)
  • Allowing pharmacists to prescribe and dispense contraceptives (SB513) and administer vaccines (SB514)
  • Licensing midwives (SB1312)
  • Appropriating funds for a state loan repayment program for providers (HB916)

Health insurers are watching:

  • Expansion of in vitro fertilization benefits (SB502)
  • Disclosure of prior authorization standards and processes (SB287)
  • Requirements for network adequacy (SB387)
  • Allowing employer-sponsored high deductible health plans in conjunction with Prepaid-compliant plans (HB407)

Legislation that didn’t make the cut this year includes bills that would be controversial and unlikely to pass:

  • Fluoridating the public water supply (SB125/HB264). Virtually none of Hawaii’s water is fluoridated – no wonder the rate of dental caries for our kids is among the worst in the nation.
  • Discouraging obesity by establishing a fee on sugar-sweetened beverages (SB375/HB1210). It’s a shame these measures didn’t get a hearing, considering the role thoughtful public policy can play in improving health status.

Or that would require new funding commitments:

  • Creating and funding a Hawaii Health Corps (SB735)
  • Reshaping and funding a statewide primary care training program (SB730)
  • Appropriating funds for Project ECHO (SB1045)
  • Providing a bump in payment to nursing homes that care for complex patients (SB374/HB93)