Establishes the Hawaii Health Authority and appropriates funds. Establishes a Youth Suicide Early Intervention and Prevention Program and appropriates funds. Limits use of mercury-containing vaccines in Hawaii. (SB2133 HD2)

A BILL FOR AN ACT

PART I

SECTION 1. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"Chapter

§   -1 Hawaii health authority; establishment. (a) There is established within the department of budget and finance for administrative purposes the Hawaii health authority. The authority shall be an autonomous public body corporate and politic and an instrumentality of the State.

(b) The authority shall be composed of nine members appointed by the governor as provided in section 26-34; provided that three members shall be appointed from a list of nominees submitted by the speaker of the house of representatives and three members shall be appointed from a list of nominees submitted by the president of the senate. All members shall be appointed for terms of four years each.

(c) An executive director shall be selected by the members.

(d) Each member shall hold office until the member's successor is appointed and qualified.

(e) Five members shall constitute a quorum, whose affirmative vote shall be necessary for all valid actions by the authority.

§   -2 Hawaii health authority; duties and responsibilities. (a) The authority shall be responsible for overall health planning for the state and shall be responsible for determining future capacity needs of health providers, facilities, equipment, and support services providers.

(b) The authority shall develop a comprehensive health plan that includes:

(c) The authority may seek waivers of federal law, rule, or regulation necessary to implement and maintain the provisions of this chapter.

(d) The authority shall adopt rules pursuant to chapter 91 necessary for the purposes of this chapter.

(e) The authority shall submit a comprehensive health plan for all individuals in the state, including its findings and recommendations, to the legislature no later than twenty days prior to the convening of the regular session of 2008."

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2006-2007 for the purpose of operating the Hawaii health authority.

The sum shall be expended by the department of budget and finance for the purposes of this part.

PART II

SECTION 3. The legislature finds that more children and young adults die from suicide each year than from cancer, heart disease, AIDS, birth defects, stroke, and chronic lung disease combined. Nationally, over four thousand youth take their lives annually, making suicide the third leading cause of death for persons between the ages of ten and twenty-four.

In Hawaii, suicide is the second leading cause of death among persons fifteen to twenty-four years old. Rates of youth suicide have been on the rise in the last decade among both females and males and among all ethnic groups. In Hawaii, males are more likely than females to commit suicide, and native Hawaiian youth are more likely than youth of other ethnic groups to attempt or commit suicide.

Research demonstrates that youth suicide is linked to underlying mental health problems that can be addressed through early intervention and prevention strategies. The legislature notes that such intervention and prevention strategies have been listed as a national health priority to deal with rising rates of youth suicide. Furthermore, Congress passed federal legislation in 2004 and appropriated $82,000,000 over the next three years for statewide programs designed to help prevent youth suicide. Many states have already developed comprehensive statewide youth suicide and early intervention and prevention strategies that seek to provide effective early intervention and prevention services.

Suicide is a serious public health tragedy affecting children and young adults in Hawaii. The legislature declares that preserving and protecting the lives of children and young adults is a priority for the State. The legislature further finds and declares that preventing youth suicide is necessary for the health, safety, and welfare of the residents of the state. Accordingly, the purpose of this part is to establish a youth suicide prevention program for Hawaii.

SECTION 4. Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§321-    Youth suicide early intervention and prevention program. (a) The department of health shall establish and operate a statewide youth suicide early intervention and prevention program that focuses upon but is not necessarily limited to persons between the ages of ten and twenty-four, to accomplish the following:

(b) The department of health shall provide appropriate research, training, and technical assistance to carry out the purposes of this section, which may include but are not limited to the following:

(c) Research, training, and technical assistance resources shall be provided by but shall not be limited to the following entities:

(d) The department of health may develop and submit proposals for funding from federal agencies and private organizations to support the purposes of this section.

(e) The department of health may adopt rules in accordance with chapter 91 to implement the purposes of this section."

SECTION 5. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2006-2007 for implementation of the statewide youth suicide early intervention and prevention program pursuant to section 321-   , Hawaii Revised Statutes.

The sum appropriated shall be expended by the department of health for the purposes of this part.

PART III

SECTION 6. The legislature finds that thimerosal is a preservative that has been used in some vaccines since the 1930s and consists of 49.6 per cent mercury by weight and is metabolized or degraded into ethylmercury and thiosalicylate. While the use of mercury-containing preservatives has declined in recent years, thimerosal is still used in certain vaccines recommended for adults, pregnant women, and children.

The United States Food and Drug Administration (FDA) acknowledges that: "depending on the vaccine formulations used and the weight of the infant, some infants could have been exposed to cumulative levels of mercury during the first six months of life that exceeded EPA [Environmental Protection Agency] recommended guidelines for safe intake of methylmercury. As a precautionary measure, the Public Health Service (including the FDA, National Institutes of Health, Centers for Disease Control and Prevention and Health Resources and Services Administration) and the American Academy of Pediatrics issued a Joint Statement on July 7, 1999, urging vaccine manufacturers to reduce or eliminate thimerosal in vaccines as soon as possible."

Legislation to ban thimerosal-containing vaccines has been enacted in six states--California, Delaware, Illinois, Iowa, Missouri, and New York. Fourteen other states have introduced similar legislation.

The purpose of this part is to limit the use of mercury-containing vaccines in Hawaii.

SECTION 7. Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§321- Mercury-containing vaccines; prohibited. (a) Depending upon availability in this state, preference during the 2006-2007 influenza season shall be given to children under twelve years of age and pregnant women to receive no vaccine containing more than a trace of mercury, defined as 1.25 micrograms per administered dose amount.

The department of health may seek an exemption from this section only when it determines, and the governor agrees, that an emergency exists and only if there is a shortage of the mercury-free product. In such case, the exemption shall not last longer than six months; provided that any person receiving a vaccine that is not mercury-free shall be informed in advance in writing that the product contains a mercury-based preservative. The exemption shall apply to children under the age of twelve only if the mercury-free, pediatric formulation of influenza vaccine is unavailable. Likewise, exemptions for individuals thirteen years of age and older shall apply only in the absence of the mercury-free adult formulation of influenza vaccine.

The department of health shall immediately notify all vaccine providers of this subsection.

(b) Commencing in the fall, at the onset of the 2007-2008 influenza season, to the greatest extent possible, no person shall be vaccinated with a vaccine or injected with any product that contains, or prior to dilution had contained as an additive, any mercury-based product, whether as a preservative or at a trace amount level.

The department may seek an exemption from this subsection only when it determines, and the governor agrees, that an emergency exists and only if there is a shortage of the mercury-free product. In such case, the exemption shall not last longer than six months; provided that any person receiving a vaccine that is not mercury-free shall be informed in advance in writing that the product contains a mercury-based preservative.

The department of health shall notify all medical providers of this subsection."

PART IV

SECTION 8. New statutory material is underscored.

SECTION 9. This Act shall take effect on July 1, 2020; provided that sections 2 and 5 shall take effect on July 1, 2020.