Honorable Robert Bunda

President of the Senate

Twenty-Third State Legislature

Regular Session of 2005

State of Hawaii

Sir:

Your Committee on Health, to which was referred S.B. No. 130 entitled:

begs leave to report as follows:

The purpose of this measure is to authorize the Department of Health to adopt rules to establish an administrative process allowing involuntary medication of psychiatric patients institutionalized at the Hawaii state operated or funded psychiatric facility in order to alleviate mental illness and restore competency while protecting the rights of patients.

The Hawaii Government Employees Association, the Hawaii Psychiatric Medical Association, and one individual submitted testimony in support of this measure. The Office of the Public Defender, the Hawaii Disability Rights Center, and one individual submitted testimony in opposition. The Department of Health submitted comments.

Your Committee finds that mental health patients deserve the same degree of personal autonomy as other citizens when they receive services. This includes participating in the decision-making process regarding their treatment. However, as the proponents noted, there are limited circumstances when involuntary treatment is appropriate and only if the person is at imminent risk of danger to themselves or others.

The Hawaii Government Employees Association testified that the patient population has changed as more forensic patients come through the prison system and the courts. These patients exhibit some form of prison behaviors, such as intimidation of other patients and staff and violence for the purpose of intimidation and control. While the risk of physical attack is not a new development, there is a difference in the premeditation, motivation, and ferocity of attacks. According to one proponent, there have been several unprovoked, brutal assaults on staff members. This measure establishes a process to allow involuntary medication of certain psychiatric patients institutionalized at the Hawaii State Hospital in order to alleviate mental illness and restore competency while protecting the rights of patients.

Upon further consideration and at the recommendation of several stakeholders, your Committee has amended this measure by establishing a streamlined judicial process, in lieu of an administrative process, by which the Department of Health can seek a court order to permit involuntary medication of mental health patients to ensure safety in Department of Health operated or funded psychiatric inpatient facilities.

As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 130, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 130, S.D. 1, and be referred to the Committee on Judiciary and Hawaiian Affairs.