HB1831

SECTION 1. The legislature finds that thousands of people in Hawaii are cited or arrested each year for offenses such as drinking liquor in public, loitering in public parks after hours, and camping on sidewalks, beaches, and other restricted public places. Most of these people suffer from issues relating to drugs, alcohol, or mental illness. Many of those cited do not appear in court, leading courts to issue bench warrants for their arrests. Time and resources are expended bringing people to court, and the court system, prosecutors, and police are caught in a never-ending revolving door situation. In response to this situation, mental health service providers have been working with appropriate law enforcement agencies and the criminal justice system to implement a crisis intervention program on the island of Oahu.

Accordingly, the purpose of this Act is to establish a behavioral health crisis center pilot program in the department of health to redirect persons experiencing a mental health crisis who are involved with, or at risk for involvement with, the criminal justice system to the appropriate health care system and services.

SECTION 2. (a) There is established a behavioral health crisis center pilot program within the adult mental health division of the department of health to redirect persons experiencing a mental health or substance use disorder crisis who are involved with, or are at risk for involvement with, the criminal justice system to the appropriate health care system and services.

(b) The pilot program shall establish two behavioral health crisis centers from which to treat and redirect patients pursuant to the pilot program, one to be located on Oahu and one at a site on a neighbor island; provided that the department of health shall determine the most appropriate sites for the behavioral health crisis centers. The department of health may lease or acquire property for the establishment of these behavioral health crisis centers.

(1) Address mental health and substance use disorder crisis issues;

(2) Screen, assess, admit for stabilization, and redirect a client to ongoing care in the most appropriate and least restrictive community setting available, consistent with the client's needs;

(3) Provide services twenty-four hours a day, seven days a week;

(4) Provide services regardless of the client's ability to pay, subject to subsection (d);

(5) Offer a dedicated first responder drop-off area;

(6) Not require medical clearance before admission of the client but rather provide assessment and support for the client's medical stability while at the behavioral health crisis center;

(7) Have the capacity to assess physical health needs and deliver care for most minor physical health challenges;

(8) Be staffed at all times with a multidisciplinary team capable of meeting the needs of clients experiencing all levels of mental health or substance use disorder crises; and

(9) Screen clients for suicide or violence risk and complete more comprehensive risk assessments and planning when clinically indicated.

(d) No person shall be denied services at a behavioral health crisis center operated under the pilot program because of inability to pay; provided that subject to section 334-6, Hawaii Revised Statutes, the behavioral health crisis center shall make every reasonable effort to collect appropriate reimbursement for the cost of providing services to persons with the ability to pay for services, including insurance or third-party payments.

(e) The department shall collaborate with law enforcement agencies, courts, mental health providers, and community stakeholders for the execution and implementation of the pilot program.

(f) The adult mental health division of the department of health shall submit a report to the legislature no later than twenty days prior to the convening of the regular sessions of 2025 and 2026. Each report shall include progress updates on the establishment of the behavioral health crisis centers, contracting of crisis intervention services and diversion activities, actual delivery and utilization of crisis intervention services, outcomes of services and diversion activities at the behavioral health crisis centers, and collection of reimbursements for the cost of providing treatment or services, including reimbursements from insurance or third-party payments.

(g) The behavioral health crisis center pilot program shall cease on December 31, 2026.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $9,500,000 or so much thereof as may be necessary for fiscal year 2024-2025 for the establishment of the behavioral health crisis center pilot program, including the leasing or acquisition of property and contracting for crisis intervention and diversion services, pursuant to this Act.

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

SECTION 4. In accordance with section 9 of article VII of the Hawaii State Constitution and sections 37‑91 and 37‑93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in H.B. No. , will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. In addition, the appropriation contained in this Act will cause the general fund expenditure ceiling for fiscal year 2024‑2025 to be further exceeded by $ or per cent. The combined total amount of general fund appropriations contained in only these two Acts will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. The reasons for exceeding the general fund expenditure ceiling are that:

(1) The appropriation made in this Act is necessary to serve the public interest; and

(2) The appropriation made in this Act meets the needs addressed by this Act.

SECTION 5. This Act shall take effect on July 1, 2024.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	1831
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII