STAND. COM. REP. NO. 2308

Honolulu, Hawaii

RE: S.B. No. 2034

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2022

State of Hawaii

Sir:

Your Committee on Health, to which was referred S.B. No. 2034 entitled:

"A BILL FOR AN ACT RELATING TO HEALTH,"

begs leave to report as follows:

The purpose and intent of this measure is to require the assessment of certain patients subject to emergency hospitalization to determine if a surrogate or guardian should be appointed to make appropriate health care decisions for the patient.

Your Committee received testimony in support of this measure from the Institute for Human Services, Inc.; Hawaii Substance Abuse Coalition; and three individuals. Your Committee received comments on this measure from the Adult Mental Health Division of the Department of Health, Hawai‘i Pacific Health, The Queen's Health Systems, and one individual.

Your Committee finds that when individuals are in crisis and suffering from an acute serious mental illness, it is necessary to achieve a balance between ensuring that they can be treated during a time where they lack decision making capacity and honoring their right to self-determination. Requiring an assessment to determine whether a surrogate or guardian is needed to make appropriate health care decisions when an individual lacks decisional capacity supports this balance. Accordingly, this measure requires such an assessment by a psychiatrist or advanced practice registered nurse with prescriptive authority and certain certification in psychiatric specialization.

Your Committee acknowledges the testimony of various health care providers who offered amendments clarifying this measure and authorizing other qualified staff members to conduct the assessment.

Therefore, your Committee has amended this measure by:

(1) Authorizing emergency room physicians and psychologists to assess whether the patient is suffering from a mental illness or substance abuse disorder, and whether the patient lacks decisional capacity;

(2) Inserting an effective date of July 1, 2050, to encourage further discussion; and

(3) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

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. 2034, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 2034, S.D. 1, and be referred to your Committee on Judiciary.

Respectfully submitted on behalf of the members of the Committee on Health,

________________________________

JARRETT KEOHOKALOLE, Chair