RESOLUTION

WHEREAS, access to mental health care often depends on health insurance coverage, and lack of health insurance coverage is associated with lower access to and utilization of health care; and

WHEREAS, disparities often exist in the provision of adequate and effective mental health care for Pacific Islanders and other minorities due to unavailable or inaccessible of culturally competent and effective services; and

WHEREAS, patients of Hawaii's federally qualified health centers include the uninsured (36 percent), the poor (56 percent), native Hawaiians (27 percent, of which 60 percent are in rural areas), other Pacific Islanders (7 percent), and the homeless (5 percent); and

WHEREAS, timely, efficient, and cost-effective treatment of mental illnesses in federally qualified health centers could avoid the significantly greater social, economic, and medical costs of non-treatment for these underserved populations; and

WHEREAS, Asian and Pacific Islanders show higher levels of depressive symptoms than do white Americans; and

WHEREAS, many of the patients served by federally qualified health centers are from high-need and vulnerable populations such as people who are homeless, have substance abuse problems, and would not otherwise seek mental health care; and

WHEREAS, Asian and Pacific Islanders that are matched with therapists of the same ethnicity are less likely to drop out of treatment than those without an ethnic match; and

WHEREAS, shame and stigma are believed to figure prominently for Asian and Pacific Islanders by their extremely low utilization rates of mental health services; and

WHEREAS, for Asian and Pacific Islanders who do utilize mental health services, the severity of their mental disturbances tends to be high because they delay seeking treatment until symptoms reach crisis proportions; and

WHEREAS, research data indicates that there is not enough mental health care available to serve the needs of all people in Hawaii, and that the economically disadvantaged and medically underserved would receive little or no mental health services were it not for the care provided by clinical psychologists at federally qualified health centers; and

WHEREAS, since 1988, federal law has recognized the extraordinarily poor health of native Hawaiians, and native Hawaiians in Hawaii have rates for untreated medical and psychological concerns that are higher than other indigenous and minority groups in the United States; and

WHEREAS, crystal methamphetamine addiction and other related substance abuse issues are prevalent in areas with high concentrations of native Hawaiians such as Waianae, Molokai, and Waimanalo, and has contributed significantly to an unprecedented demand for services from an already overtaxed mental health system; and

WHEREAS, the United States Congress, through the Native Hawaiian Health Care Professions Scholarship program, requires recipients to work in federally designated medically underserved areas for a duration equivalent to the number of years they received scholarship funding; and

WHEREAS, through the program, there are now psychologists of native Hawaiian ancestry delivering health care in a culturally appropriate manner to other native Hawaiians in federally qualified health centers, native Hawaiian health systems clinics, and other federally designated health clinics in medically underserved areas; and

WHEREAS, the American Psychological Association has developed a model curriculum for the education and training of prescribing psychologists; and

WHEREAS, independent evaluations of the Department of Defense Psychopharmacological Demonstration Project by the United States General Accounting Office and the American College of Neuropsychopharmacology have found that appropriately trained medical psychologists prescribe safely and effectively; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-third Legislature of the State of Hawaii, Regular Session of 2005, the Senate concurring, that an interim Task Force on the Accessibility of Mental Health Care (Task Force) is established to consider the feasibility of the State authorizing trained and supervised medical psychologists to prescribe psychotropic medications for the treatment of mental illness; and

BE IT FURTHER RESOLVED that the Task Force be led by the Chairperson of the House Committee on Health or the Chairperson's designee, and the Chairperson of the Senate Committee on Health or the Chairperson's designee; and

BE IT FURTHER RESOLVED that the members of the Task Force shall include but not be limited to the:

and

BE IT FURTHER RESOLVED that the Task Force is requested to gather information and provide possible solutions and proposed legislation on the feasibility of psychologists providing psychotropic medications for mental health treatment in federally qualified health centers or other licensed health clinics located in federally designated medically underserved areas of the state; and

BE IT FURTHER RESOLVED that the Task Force submit a report of its findings and recommendations, including proposed legislation, to the Governor and the Legislature no later than 20 days prior to the convening of the Regular Session of 2006; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Speaker of the House of Representatives, President of the Senate, Chief of the Department of Health Child and Adolescent Mental Health Division, President of the Hawaii Psychological Association, Executive Director of the Hawaii Primary Care Association, Executive Director of the National Association of Social Workers, Executive Director of the Hawaii Psychiatric Medical Association, and President of the Hawaii Medical Association.

Report Title:

Task Force; Psychologists; Prescriptive Authority