Honorable Calvin K.Y. Say

Speaker, House of Representatives

Twenty-First State Legislature

Regular Session of 2001

State of Hawaii

Sir:

Your Committees on Consumer Protection and Commerce and Judiciary and Hawaiian Affairs, to which was referred H.B. No. 650, H.D. 1, entitled:

beg leave to report as follows:

The purpose of this bill is to establish a mechanism to allow individuals to make their mental health treatment preferences known prior to the loss of their decision-making capacity.

Testimony in support of this bill was received from the Hawaii State Department of Health, the National Alliance for the Mentally Ill, NAMI Oahu, and several individuals. The Mental Health Association (MHAH), Hawaii Nurses Association, and Hawaii Psychological Association submitted testimony in support of the bill with proposed amendments.

Hawaii Psychiatric Medical Association submitted testimony in support of the intent of the bill.

Testimony in opposition to this bill was received from the Office of the Public Defender, State of Hawaii, with proposed amendments.

Your Committees understand that an advanced directive allows a person to make treatment preferences of illness known prior to the loss of decision-making capacity, which can occur as a result of mental illness. Furthermore, allowing advance directives for mental health patients helps to protect the individual's right to self-determination.

Your Committees find that many health patients have long periods of good health but when a bout of mental illness occurs, these patients are sometimes forced to undergo treatment or receive medications in an emergency situation which may not be appropriate for them.

Your Committees also find that the proposed draft received with the testimony from MHAH is meritorious and should be considered for inclusion in the final form of the bill. Due to time constraints, the extensive substantive and technical amendments could not be made to the bill, and important policy decisions could not be thoroughly considered, therefore, your Committees have amended this bill to ensure further discussion by:

1. Changing the effective date to January 1, 2050; and
2. Deleting the date by which the Department of Health shall develop procedures for the implementation of psychiatric advance directives.

As affirmed by the records of votes of the members of your Committees on Consumer Protection and Commerce and Judiciary and Hawaiian Affairs that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 650, H.D. 1, as amended herein, and recommend that it pass Third Reading in the form attached hereto as H.B. No. 650, H.D. 2.