HB2502 SD1

PART I

SECTION 1. The State's experience with the COVID-19 pandemic demonstrates the need for preparation, flexibility, and quick action in the face of ongoing or new risks presented by outbreaks of communicable or dangerous diseases in the State or in other parts of the world. The State has learned from experience that a screening process for travelers is a key component in the containment or mitigation of the spread of disease. This Act serves to enhance the tools available to the State in its effort to contain or mitigate the spread of communicable or dangerous diseases, to enable the use of these tools without a governor's emergency proclamation, and to make the containment or mitigation effort more efficient and flexible in protecting the public health and safety.

This Act authorizes a screening process applicable to travelers at any port of entry to the State whenever it is determined by the director of health, upon consultation with and authorization from the governor, to be necessary to prevent the spread of communicable or dangerous diseases in order to protect the public health and safety, including the health and safety of the traveling public, and to ensure a positive visitor experience, which is critical to sustaining the State's tourism industry.

The screening may apply to any and all travelers, including interisland, domestic, and international travelers, and it may apply to both arrival and departure points within the State of Hawaii. Benefits include the determination of whether quarantine or isolation is necessary for the well‑being of the public, including travelers, travelers' households, and traveling companions, as well as the opportunity for timely treatment to prevent or lessen symptoms or to shorten the duration of the disease. To further enhance the effectiveness of the screening process, and from experience, the legislature also finds it necessary to establish penalties to address individuals who are uncooperative or seek to evade the screening process. This screening process will also authorize the department of health to take certain actions upon completion of traveler screening, including testing, investigating, monitoring, quarantining, and isolating travelers, as determined necessary by the director of health, upon consultation with and authorization from the governor, to protect the public health and safety.

This Act also amends existing law to work more efficiently in conjunction with any emergency proclamation issued to respond to the spread of a communicable or dangerous disease and allows the director of health, upon consultation with and authorization from the governor, to declare a public health emergency if there is, or there is a potential for, an epidemic or serious outbreak of communicable or dangerous disease.

PART II

SECTION 2. Chapter 325, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part . DETECTION, PREVENTION, AND CONTROL OF DISEASE TRANSMISSION

§325-A    Director's authority to declare public health emergency; consultation with governor; powers. ( a) Except when otherwise expressly addressed by the governor or the Hawaii emergency management agency under chapter 127A, when in the judgment of the director there is a potential for an epidemic or serious outbreak of communicable or dangerous disease and after consultation with and authorization from the governor, notwithstanding any other laws, the director may declare a public health emergency, by written declaration, which shall set forth the reasons therefore, and exercise the following powers:

(1) Require provider reporting, screening, testing, contact tracing, quarantine, and isolation of persons deemed by the department to be infected, at higher risk of infection, or at risk for spreading infection;

(2) Require declarations of health status, travel history, and intended lodging or residence plans from travelers;

(3) Require first responders and part or all of the public to implement safeguards designed to prevent infections, including but not limited to physical distancing, temporary closure of schools, temporary closure of businesses and operations,  hygiene procedures, and wearing of personal protective equipment;

(4) Release otherwise confidential information  if the director determines that the disclosure is necessary to protect the public health, safety, and welfare from imminent harm; and

(5) Take other action as deemed necessary by the director to prevent, prepare for, respond to, mitigate, and recover from a serious outbreak of communicable or dangerous disease.

(b) Quarantine and isolation pursuant to this section shall not be subject to the requirements pursuant to section 325-8(a).

(c) Every police officer or state law enforcement officer and the Hawaii emergency management agency  shall aid and assist the department in the enforcement of a declaration of a public health emergency.

(d) The director's declaration of a public health emergency shall be posted on the department's website and shall terminate automatically ninety days after the declaration, unless earlier terminated or extended or revoked by the governor or director in consultation with and authorization from the governor. Any extension shall terminate automatically after ninety days, unless further extended by the governor or director in consultation with and authorization from the governor.

§325-B Detection of communicable or dangerous diseases in travelers; screening, investigating, monitoring, quarantining, isolating, data-sharing, and other actions to protect the public health and safety. (a) Whenever the director, after consultation with and authorization from the governor, determines it is necessary to detect, prevent, prepare for, respond to, mitigate, or recover from the transmission of communicable or dangerous diseases by traveling members of the public, the department may, by order of the director:

(1) Screen interisland, domestic, or international travelers for evidence of communicable or dangerous diseases by using a screening method approved by the department;

(2) Investigate interisland, domestic, or international travelers and persons in contact with those travelers as determined by the director to be necessary to detect, prevent, or control the transmission of a communicable or dangerous disease;

(3) Monitor interisland, domestic, or international travelers after their arrival as determined by the department to be necessary to detect, prevent, prepare for, respond to, mitigate, or recover from the transmission of a communicable or dangerous disease;

(4) Quarantine interisland, domestic, or international travelers after their arrival as determined by the department to be necessary to detect, prevent, prepare for, respond to, mitigate, or recover from the transmission of a communicable or dangerous disease pursuant to section 325-8;

(5) Isolate interisland, domestic, or international travelers after their arrival as determined by the department to be necessary to detect, prevent, prepare for, respond to, mitigate, or recover from the transmission of a communicable or dangerous disease pursuant to section 325-8; and

(6) Enlist the services or collaboration of any other federal, state, county, or private entity to assist with any of the activities in this section.

(b) Travelers arriving in a Hawaii port of entry may be required to provide a completed State of Hawaii traveler questionnaire on a form, or in a manner, approved by the department. Failure to provide a completed State of Hawaii travel questionnaire as directed by the department is a violation of this section.

§325-C Communicable or dangerous diseases, screening, treatment, and isolation.   Upon entry to the State, all persons may be required to submit to a screening for communicable or dangerous diseases as deemed appropriate by the department.  The diseases screened for shall include those deemed a public health and safety risk by the department at the time of the screening.  If the department deems it necessary for the public health, treatment, quarantine, and isolation may be required, at the expense of the person entering the State.

§325-D Administrative rules. (a) No later than June 30, 2022, the department shall adopt rules pursuant to chapter 91 to effectuate the purposes of this part.

(b) No later than October 1, 2020, the department shall adopt interim rules, which shall be exempt from the requirements of chapter 91 and the requirements of chapter 201M, to effectuate the purposes of this part; provided that the interim rules shall remain in effect until rules are adopted pursuant to subsection (a).

(c) The department may amend the interim rules, and the amendments shall be exempt from the requirements of chapter 91 and from the requirements of chapter 201M, to effectuate the purposes of this chapter; provided that any amended interim rules shall remain in effect until rules are adopted pursuant to subsection (a).

(d) The department shall make the adoption, amendment, or repeal of interim rules known to the public by:

(1) Giving public notice of the substance of the proposed rules at least once statewide; and

(2) Posting the full text of the proposed rulemaking action on the Internet as provided pursuant to section 91-2.6.

§325-E Environmental impact statements not required. No action taken by the department to implement this part shall be subject to the provisions of or any requirement in chapter 343.

§325-F Procurement exemption. Contracts for the purchase of goods and services to effectuate the purposes of this part shall be exempt from chapters 103D and 103F.

§325-G Travelers screening special fund. (a) There is established in the state treasury the travelers screening special fund that shall be administered by the department, into which shall be deposited:

(1) Fines collected as penalties pursuant to section 325‑H;

(2) Appropriations made by the legislature to the fund;

(3) All moneys received by the fund from any other source; and

(4) Interest earned on any moneys in the fund.

(b) Moneys in the travelers screening special fund shall be used for the purposes of set forth in sections 325-B and 325‑C regarding the detection of communicable or dangerous diseases in travelers, and related screening, investigating, monitoring, quarantining, isolating, data-sharing, other related actions, and the related costs of operating the fund.

§325-H Penalties. Any person who violates any provision of this part or who violates any rules adopted pursuant to this part shall be guilty of a misdemeanor and fined not more than $5,000. All fines shall be deposited into the travelers screening special fund."

PART III

SECTION 3. Chapter 325, Hawaii Revised Statutes, is amended by adding four new sections to be appropriately designated and to read as follows:

"§325-I Definitions. As used in this chapter:

"Communicable disease" means an illness due to a specific infectious agent or its toxic products that arises through transmission of that agent or its products from an infected person or animal or a reservoir to a susceptible host, either directly, or indirectly through an intermediate animal host, vector, or the inanimate environment. "Communicable disease" includes "infectious disease" and any disease declared to be "communicable" by the director.

"Dangerous disease" means any illness or health condition that might pose a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability.

"Department" means the department of health.

"Director" means the director of health.

"Epidemic" means the occurrence of cases of an illness clearly in excess of normal expectancy, as determined by the director.

"Health care facility" means a facility as defined in section 323D-2.

"Infectious disease" means a disease that spreads from person to person, directly or indirectly, that poses a significant public health risk.

"Isolation" means the physical separation, including the restriction of movement or confinement of individuals or groups confirmed by the department to have been infected with a communicable or dangerous disease, from individuals who are believed not to have been exposed or infected, by order of the director, the governor, or a court of competent jurisdiction. Conditions of isolation may be more restrictive than as for quarantine.

"Quarantine" means the physical separation, including the restriction of movement or confinement of individuals or groups believed to have been exposed to a communicable or dangerous disease, or who otherwise have or create a potential risk of transmitting a communicable or dangerous disease to others from individuals who are believed not to have been exposed or infected, by order of the director, the governor, or a court of competent jurisdiction, based on information collected and reviewed by the department.

"Screening" means a diagnostic tool administered to detect the presence of a communicable or dangerous disease in an individual and may include the measuring of a person's temperature. "Screening" also includes the administration of one or more questionnaires used to conduct surveillance of disease activity or to determine to whom a test or diagnostic tool is to be administered.

§325-J Right to contest. (a) An individual subject to quarantine or isolation pursuant to this chapter may request a hearing in the courts of this State to contest the order of quarantine or isolation, the individual's treatment, or the terms and conditions of the quarantine or isolation. The request shall be in writing and shall be filed as a civil proceeding with the circuit court in the circuit in which the individual is quarantined or isolated. Upon receiving a request, the court shall fix a date for a hearing. The hearing shall take place within ten days of the filing of the request with the court. The request for a hearing shall not alter or stay the order of quarantine or isolation. The department shall be notified of the request for a hearing at least seven days before the hearing by the individual requesting the hearing. If, after a hearing, the court finds that the quarantine or isolation of the individual is not in compliance with this part, the court may fashion remedies reasonable under the circumstances and consistent with this chapter.

(b) Judicial decisions shall be based upon clear and convincing evidence; provided that in hearings to contest the individual's screening, treatment, or the terms or conditions of the quarantine or isolation, judicial decisions shall be based upon a preponderance of the evidence. A written record of the disposition of the case shall be made and retained. If the personal appearance before the court of a quarantined or isolated individual is determined by the director to pose a threat to individuals at the proceeding and the quarantined or isolated individual does not waive the right to attend the proceeding, the court shall appoint a guardian ad litem, to represent the quarantined or isolated individual throughout the proceeding or shall hold the hearing via any means that allow all parties to participate as fully and safely as is reasonable under the circumstances.

(c) Upon written request, the court may, in its discretion, appoint counsel to represent individuals or groups of individuals who are or who are about to be quarantined or isolated pursuant to this section and who are not otherwise represented by counsel. Adequate means of communication between those individuals or groups and their counsel or their guardian ad litem shall be provided by the department, if adequate means of communication is not otherwise available to them.

(d) In any proceeding brought pursuant to this section, in consideration of the protection of the public's health, the severity of the emergency, and the availability of necessary witnesses and evidence, the court may order the consolidation of claims where:

(1) The number of individuals involved or to be affected by an order of quarantine or isolation is so large as to render individual participation impractical;

(2) There are questions of law or fact common to the individual claims or rights to be determined;

(3) The group claims or rights to be determined are typical of the affected individuals' claims or rights; and

(4) The entire group will be adequately represented in the consolidation.

§325-K Collection, receipt, and use of information; disclosure; confidentiality of information. (a) Notwithstanding any other law to the contrary, the department, other governmental agencies, or private entities under contract with the department, who act pursuant to this section, may collect, receive, and use information for the purposes of detecting, preventing, preparing for, responding to, mitigating, or recovering from the transmission of communicable or dangerous diseases. Collection, receipt, and use of the information may include the sharing of the information between or among the department, other governmental agencies, and private entities under contract with the department. Collection, receipt, and use shall not include disclosure of the information to other departments, entities, or individuals except as provided in subsection (b).

(b) The information to be collected, received, and used pursuant to this section may be disclosed by the department to the public only as necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, including the transmission of communicable or dangerous diseases to others.

(c) All information collected, received, or used, pursuant to this section shall be confidential and shall not be used or disclosed, except as allowed by this section or as required by law. Any governmental agency or private entity that collects, receives, or uses information pursuant to this section shall be subject to the same restrictions on collection, receipt, and use of that information as the department.

§325-L Construction and severability. (a) This chapter shall be liberally construed to effectuate its purposes; provided that this chapter shall not be construed as conferring any power or permitting any action that is inconsistent with the Constitution and laws of the United States, but, in so construing this chapter, due consideration shall be given to the circumstances as they exist from time to time.

(b) If any provision of this chapter or its application to any person or circumstance is held invalid, the invalidity shall not affect other provisions or applications of this chapter."

PART IV

SECTION 4. Section 325-2.5, Hawaii Revised Statutes, is amended to read as follows:

"[[]§325-2.5[]] Health care-associated infection reporting. (a) Each health care facility in the State that is certified by the Centers for Medicare and Medicaid Services shall report information about health care-associated infections to the Centers for Disease Control and Prevention's national healthcare safety network, as specified in the rules of the Centers for Medicare and Medicaid Services.

(b) Health care facilities subject to this section shall authorize the Centers for Disease Control and Prevention to allow the department to access health care-associated infection data reported by those health care facilities to the national healthcare safety network.

(c) The department may adopt rules pursuant to chapter 91 to require that health care-associated infections that are multidrug-resistant be reported to the department through the national healthcare safety network. The rules shall specify which health care facilities are required to report those health care-associated infections that are multidrug-resistant through the national healthcare safety network, as well as the patient populations that are to be targeted in the reports. The first year of reporting required under this subsection shall be a pilot test of the reporting system and shall not be reported or disclosed to the public.

(d) The department shall preserve patient confidentiality and shall not disclose to the public any patient-level data obtained from any health care facility.

(e) The department may issue reports to the public regarding health care-associated infections in aggregate data form to protect individual patient identity. The reports may identify individual health care facilities. The reports shall use the methodology or any part of the methodology developed by the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services for national reporting of health care-associated infections.

(f) Health care-associated infection information held by the department as a result of reporting under this section is not subject to subpoena, discovery, or introduction into evidence in any civil or criminal proceeding; provided that health care-associated infection information otherwise available from other sources is not immune from subpoena, discovery, or introduction into evidence through those sources solely because the information was reported as required by this section.

(g) Beginning on June 30, 2013, and no later than June 30 of each year, thereafter, the department shall prepare a public report, in accordance with this section, containing information pertaining to health care-associated infections in the State for the previous calendar year.

[~~(h) For the purposes of this section:~~

~~"Department" means the department of health.~~

~~"Health care facility" means the same as in section 323D‑2.~~]"

SECTION 5. Section 325-8, Hawaii Revised Statutes, is amended to read as follows:

"§325-8 Infected persons and quarantine. (a) [~~As used in this section:~~

~~"Communicable disease" means any disease declared to be "communicable" by the director of health.~~

~~"Dangerous disease" means a disease as defined in section 325-20.~~

"Quarantine" means the compulsory physical separation, including the restriction of movement or confinement of individuals or groups believed to have been exposed to or known to have been infected with a contagious disease, from individuals who are believed not to have been exposed or infected, by order of the department or a court of competent jurisdiction.] By order of the director, the department may quarantine or isolate an individual if:

(1) Any delay in the quarantine or isolation of the individual would pose an immediate threat to the public health;

(2) The individual is reasonably believed to have been exposed to or known to have been infected with a communicable or dangerous disease; and

(3) A quarantine or isolation is the least restrictive means by which the public's health, safety, and welfare can be protected, due to the transmittable nature of the communicable or dangerous disease and the lack of preventive measures, or due to the failure by the individual quarantined or isolated to accept or practice less restrictive measures to prevent disease transmission.

(b) In implementing a quarantine[,] or isolation, the dignity of the individual quarantined or isolated shall be respected at all times and to the greatest extent possible, consistent with the objective of preventing or limiting the transmission of the disease to others. The needs of individuals quarantined or isolated shall be addressed in as systematic and competent a fashion as is reasonable under the circumstances. To the greatest extent possible, the premises in which individuals are quarantined or isolated shall be maintained in a safe and hygienic manner, designed to minimize the likelihood of further transmission of infection or other harm to individuals subject to quarantine[~~. Adequate~~] or isolation; provided that, if an individual is quarantined or isolated in the individual's own home or in a rented premises, the individual shall be responsible for maintaining the premises in a safe and hygienic manner. Access to adequate food, clothing, medication, and other necessities, access to counsel, means of communication with [~~those in and outside these settings,~~] others, and [~~competent~~] appropriate medical care shall [~~be provided~~] not be denied to the person quarantined[.] or isolated, at the person's expense.

To the greatest extent possible, cultural and religious beliefs shall be considered in addressing the needs of quarantined or isolated individuals. The department may establish and maintain places of quarantine and isolation and quarantine or isolate any individual by the least restrictive means necessary to protect the public health.

The department shall take all reasonable means to prevent the transmission of infection between or among quarantined or isolated individuals. The quarantine or isolation of any individual shall be terminated when the director determines that the quarantine or isolation of that individual is no longer necessary to protect the public health.

(c) An individual subject to quarantine or isolation shall obey the department's rules and orders, shall not go beyond the quarantined or isolated premises, and shall not put the individual's self in contact with any individual not subject to quarantine or isolation other than a physician, health care provider, or individual authorized to enter a quarantined or isolated premises by the department. Violation of any of the provisions of this subsection is a misdemeanor.

(d) No individual, other than an individual authorized by the department, shall enter a quarantined or isolated premises. Any individual entering a quarantined or isolated premises without permission of the department shall be guilty of a misdemeanor. If, by reason of an unauthorized entry into a quarantined or isolated premises, the individual poses a danger to public health, the individual may be subject to [~~the~~] quarantine or isolation pursuant to this section.

[(e) Before quarantining an individual, the department shall obtain a written, ex parte order from a court of this State authorizing such action. A petition for an ex parte order shall be filed with the circuit court of the circuit in which the individual resides, is suspected of residing, or is quarantined under subsection (f). Proceedings on or related to a petition for an ex parte order shall be a civil action. The court shall grant an ex parte order upon finding that probable cause exists to believe a quarantine is warranted pursuant to this section. A copy of the ex parte order shall be given to the individual quarantined, along with notification that the individual has a right to a hearing under this section.

(f) Notwithstanding subsection (e), the department may quarantine an individual without first obtaining a written, ex parte order from the court if any delay in the quarantine of the individual would pose an immediate threat to the public health. Following such a quarantine, the department shall promptly obtain a written, ex parte order from the court authorizing the quarantine.

(g) An individual quarantined pursuant to subsection (e) or (f) shall have the right to a court hearing to contest the ex parte order. If the individual, the individual's guardian ad litem, or the individual's counsel requests a hearing, the hearing shall be held within fourteen days of filing of the request. The request shall be in writing and shall be filed with the circuit court in the circuit in which the individual is quarantined. A request for a hearing shall not alter or stay the quarantine of the individual. The department shall be notified of the request for a hearing at least ten days before the hearing. At the hearing, the department shall show that the quarantine is warranted pursuant to this section. If, after hearing all relevant evidence, the court finds that the criteria for quarantine under subsection (i) have been met by clear and convincing evidence, the court shall authorize the continued quarantine of the individual.

(h) On or after thirty days following the issuance of an ex parte order or a hearing as provided for in this section, an individual quarantined pursuant to this section may request in writing a court hearing to contest the continued quarantine. The hearing shall be held within fourteen days of the filing of the request. The request shall be in writing and shall be filed with the circuit court for the circuit in which the individual is quarantined. A request for a hearing shall not alter or stay the order of quarantine. The department shall be notified of the request for a hearing at least ten days before the hearing. At the hearing, the department shall show that continuation of the quarantine is warranted pursuant to this section. If, after hearing all relevant evidence, the court finds that the criteria for the quarantine under subsection (i) have been met by clear and convincing evidence, the court shall authorize the continued quarantine of the individual.

~~(i) A court may order an individual to be quarantined if the court finds that:~~

~~(1)~~ ~~The individual is reasonably believed to have been exposed to or known to have been infected with a communicable or dangerous disease; and~~

~~(2)~~ A quarantine is the least restrictive means by which the public's health, safety, and welfare can be protected, due to the transmittable nature of the communicable or dangerous disease and the lack of preventive measures, or due to the failure by the individual quarantined to accept or practice less restrictive measures to prevent disease transmission.

(j) An individual quarantined pursuant to this section may request a hearing in the courts of this State regarding the individual's treatment and the terms and conditions of the quarantine. Upon receiving a request, the court shall fix a date for a hearing. The hearing shall take place within fourteen days of the filing of the request with the court. The request for a hearing shall not alter or stay the order of quarantine. The department shall be notified of the request for a hearing at least ten days before the hearing. If, upon a hearing, the court finds that the quarantine of the individual is not in compliance with subsection (b), the court may fashion remedies reasonable under the circumstances and consistent with this chapter.

(k) Judicial decisions shall be based upon clear and convincing evidence, and a written record of the disposition of the case shall be made and retained. If the personal appearance before the court of a quarantined individual is determined by the director to pose a threat to individuals at the proceeding and the quarantined individual does not waive the right to attend the proceeding, the court shall appoint a guardian ad litem as provided in article V of chapter 560, to represent the quarantined individual throughout the proceeding or shall hold the hearing via any means that allow all parties to participate as fully and safely as is reasonable under the circumstances.

(l) Upon written request, the court shall appoint counsel at state expense to represent individuals or groups of individuals who are or who are about to be quarantined pursuant to this section and who are not otherwise represented by counsel. Adequate means of communication between those individuals or groups and their counsel and guardians ad litem shall be provided.

(m) In any proceeding brought pursuant to this section, in consideration of the protection of the public's health, the severity of the emergency, and the availability of necessary witnesses and evidence, the court may order the consolidation of claims by individuals involved or to be affected by a quarantine where:

~~(1)~~ ~~The number of individuals involved or to be affected by a quarantine is so large as to render individual participation impractical;~~

~~(2)~~ ~~There are questions of law or fact common to the individual claims or rights to be determined;~~

~~(3)~~ ~~The group claims or rights to be determined are typical of the affected individuals' claims or rights; and~~

~~(4)~~ ~~The entire group will be adequately represented in the consolidation.~~

~~(n)~~] (e) Each individual quarantined shall be responsible for the costs of food, lodging, and medical care, except for those costs covered and paid by the individual's health plan.

(f) By order of the director, the department may inspect, quarantine, or isolate persons, property, places, cities, or counties, and take measures as are necessary to ascertain the nature of the disease and prevent its spread whenever in its judgment the action is necessary to protect or preserve the public health."

SECTION 6. Section 325-20, Hawaii Revised Statutes, is amended to read as follows:

"[[]§325-20[]] Agreements; collaborative assistance in control of disease outbreaks. (a) The director may enter into agreements for collaborative assistance with licensed health care facilities and health care providers in the State to control an epidemic of a dangerous disease[~~, which~~] that requires more physical facilities, materials, or personnel than the department has available.

[~~(b) Whenever used in this section, unless a different meaning clearly appears from the context:~~

~~"Dangerous disease" means any illness or health condition that might pose a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability.~~

~~"Department" means the department of health.~~

~~"Director" means the director of health.~~

~~"Epidemic" means the occurrence of cases of an illness clearly in excess of normal expectancy, as determined by the director.~~

~~"Health care facility" means a facility as defined in section 323D-2.~~

~~"Health care provider" means a provider as defined in section 323D-2.~~

~~(c)~~] (b) Under collaborative agreements, health care facilities or health care providers shall provide prophylactic and treatment services for the epidemic disease in collaboration with and under the general direction of the department and shall seek reimbursement from the individuals who receive medical care, the parties responsible for their care, or their health plans. Persons having health plan benefits shall be responsible for any copayments to the facilities or health care providers.

[~~(d)~~] (c) The agreements may provide that the department shall use reasonable efforts to seek legislative appropriations to reimburse health care facilities and health care providers for the use of physical facilities, professional services, and materials provided to persons without health plan coverage.

[~~(e)~~] (d) Except in cases of wilful misconduct, the following persons shall not be liable for the death of or injury to any person who is provided care pursuant to this section or for damage to property when resulting from any act or omission in the performance of such services:

(1) The State or any political subdivision;

(2) A health care facility or health care provider acting at the direction of the department under an agreement as provided in this section; and

(3) Persons engaged in disease prevention and control functions pursuant to this section or sections 325-8 and 325-9, including volunteers whose services are accepted by any authorized person."

PART V

SECTION 7. Section 706-643, Hawaii Revised Statutes, is amended by amending subsection (2) to read as follows:

"(2) All fines and other final payments received by a clerk or other officer of a court shall be accounted for, with the names of persons making payment, and the amount and date thereof, being recorded. All such funds shall be deposited with the director of finance to the credit of the general fund of the State. With respect to fines and bail forfeitures that are proceeds of the wildlife revolving fund under section 183D-10.5, and fines that are proceeds of the compliance resolution fund under sections 26-9(o) and 431:2-410, and fines that are proceeds of the travelers screening special fund under sections 325-G and 325-H, the director of finance shall transmit the fines and forfeitures to the respective funds."

PART VI

SECTION 8. Section 346-59.1, Hawaii Revised Statutes, is amended by amending subsection (g) to read as follows:

"(g) For the purposes of this section:

"Distant site" means the location of the health care provider delivering services through telehealth at the time the services are provided.

"Health care provider" means a provider of services, as defined in title 42 United States Code section 1395x(u), a provider of medical and other health services, as defined in title 42 United States Code section 1395x(s), other practitioners licensed by the State and working within their scope of practice, and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business, including but not limited to primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians licensed under chapter 453, advanced practice registered nurses licensed under chapter 457, psychologists licensed under chapter 465, and dentists licensed under chapter 448.

"Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, critical access hospital, rural health clinic, federally qualified health center, a patient's home, and other non-medical environments such as school-based health centers, university-based health centers, or the work location of a patient.

"Telehealth" means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities: store and forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site. [~~Standard telephone contacts, facsimile~~] Facsimile transmissions, or e-mail text, in combination or by itself, does not constitute a telehealth service for the purposes of this section."

SECTION 9. Section 431:10A-116.3, Hawaii Revised Statutes, is amended by amending subsection (g) to read as follows:

"(g) For the purposes of this section:

"Distant site" means the location of the health care provider delivering services through telehealth at the time the services are provided.

"Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, health care facility, a patient's home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of a patient.

SECTION 10. Section 432:1-601.5, Hawaii Revised Statutes, is amended by amending subsection (g) to read as follows:

"(g) For the purposes of this section:

"Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, health care facility, a patient's home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of a patient.

SECTION 11. Section 432D-23.5, Hawaii Revised Statutes, is amended by amending subsection (g) to read as follows:

"(g) For the purposes of this section:

"Distant site" means the location of the health care provider delivering services through telehealth at the time the services are provided.

"Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, health care facility, a patient's home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of a patient.

PART VII

SECTION 12. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2020-2021 to be deposited into the travelers screening special fund established pursuant to section 325-G, Hawaii Revised Statutes.

SECTION 13. There is appropriated out of the travelers screening special fund the sum of $ or so much thereof as may be necessary for fiscal year 2020-2021 to carry out the purposes of this Act.

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

PART VIII

SECTION 14. In codifying the new sections added by sections 2 and 3 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 15. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 16. This Act shall take effect on July 1, 2050; provided that parts III and IV shall be repealed on June 30, 2025; provided further that sections 325-2.5, 325-8, and 325-20, Hawaii Revised Statutes, shall be reenacted in the form in which they read on the day prior to the effective date of this Act.

HOUSE OF REPRESENTATIVES	H.B. NO.	2502
THIRTIETH LEGISLATURE, 2020		H.D. 1
STATE OF HAWAII		S.D. 1