Honorable Calvin K.Y. Say

Speaker, House of Representatives

Twenty-First State Legislature

Regular Session of 2001

State of Hawaii

Sir:

Your Committees on Health and Human Services and Housing, to which was referred H.B. No. 841 entitled:

beg leave to report as follows:

The purpose of this bill is to:

Your Committees understand that mental health problems have become a serious public health issue throughout the United States and that Hawaii is no exception. Nationally, it is estimated that major depression cost $23,000,000,000 dollars in lost workdays alone. Whereas, in Hawaii, major depression, if left untreated, has been estimated to cost $135,600,000 dollars due to lost productivity, absenteeism, and the use of other health care resources.

Your Committees further understand that currently some individuals with mental illness and alcohol or drug dependence problems do not have access to health insurance coverage in either the private or public sector. Passage of this measure attempts to create parity among all persons with mental illness.

Testimony in support of this measure was received from the Equal Insurance Coalition, Hawaii Medical Association, Mental Health Association of Hawaii, National Alliance for the Mentally Ill, Hawaii Psychiatric Medical Association, Hawaii Psychological Association, National Association of Social Workers, psychiatrists, psychologists, social workers, consumer advocates, and concerned citizens.

Both the Department of Health (DOH) and the Department of Human Services (DHS) supported the intent of this measure. However, DOH felt that the limitation of treatment episodes for alcohol and drug dependence should be eliminated from this measure since this was contrary to the nature of the disease of addiction. On the other hand, DHS felt that exemptions of the QUEST program needed to continue so that adults who are severely emotionally disturbed or mentally ill and enrolled in QUEST could continue to receive unlimited services under a special QUEST program. According to the Department of Human Services, without this exemption, these adults would not be able to receive unlimited behavioral health services.

Testimony in opposition to this measure was received from Hawaii Medical Service Association, the Hawaii Business League, and the Chamber of Commerce of Hawaii. These testifiers all pointed to an Insurance Commissioners Task Force on Mental Health and Substance Abuse report, which found that there was no statistical evidence to support the expansion of mental health and substance abuse benefits in the private sector at this time. Kaiser Permanente also opposed this measure, but was concerned with the QUEST issue mentioned above and with a section of the bill they felt may unfairly exempt one insurance provider from a requirement to contribute monies to the insurance regulation fund established by section 431:2-216, Hawaii Revised Statutes.

Your Committees understand all these concerns, but also understand the importance of this measure. Accordingly, your Committees have decided to amend the measure by:

recommend that it pass Second Reading in the form attached