SB1004

SECTION 1. The legislature finds that community health workers connect rural, underserved communities with programs and services that impact social determinants of health and address factors such as access to health care, prevention, outreach, and training. Community health workers often serve in rural, underserved communities and spend a significant portion of their time doing telehealth and behavioral health, outreach such as assisting individuals to apply for medical insurance, providing health education resources, and locating work opportunities. Community health workers may also serve as translators, assisting their communities to navigate health care and social service systems.

The legislature further finds that there is a great need for community health workers, especially in rural and underserved communities that do not have reliable access to health education resources or job opportunities. As a critical intermediary between residents and health care and social services, community health workers have a unique understanding of their community needs and accessibility to services. Establishing a pilot program for community health workers with clear parameters, including major responsibilities and scope of work, will allow community health workers to continue their valuable work in communities statewide.

Therefore, the purpose of this Act is to establish a three-year rural community health worker pilot program to provide outreach, education, training, and navigation to individuals residing in rural communities and address social determinants of health.

SECTION 2. (a) The department of health shall establish and administer a three-year rural community health worker pilot program for community health workers to provide outreach, education, training, and navigation to individuals residing in the State's rural communities and address social determinants of health.

(b) Community health workers participating in the rural community health worker pilot program may provide health education and outreach, individual support and assistance, cultural competency and advocacy, and data collection and reporting within the State's rural communities.

(1) Health education and outreach shall include:

(A) Health education programs that promote health awareness, disease prevention, and healthy lifestyle practices; and

(B) Information on health care services, resources, and programs that are available to rural community members;

(2) Individual support and assistance shall include:

(A) Assistance to individuals in navigating the health care system, including accessing health care facilities, appointments, and follow-up care; and

(B) Guidance and support for individuals in managing chronic conditions, medication adherence, and lifestyle modifications for improved health outcomes;

(3) Cultural competency and advocacy shall include:

(A) Cultural sensitivity and competence during interactions with diverse populations within a rural community; and

(B) Advocating for the health needs and concerns of rural community members to health care providers, institutions, and policymakers; and

(4) Data collection and reporting shall include:

(A) Maintenance of accurate records of educational activities and individual interactions; and

(B) Submission of periodic reports on rural community health trends, needs, and program effectiveness to relevant health authorities or agencies.

(d) The department of health shall enter into a contract with a nonprofit organization to recruit, train, assign, and supervise community health workers and oversee the pilot program. The nonprofit organization contracted under this subsection shall have:

(1) A history of providing community empowerment, capacity building, collaborative partnerships, and health education to the State's rural communities;

(2) The knowledge and experience necessary to provide community health worker services to program participants;

(3) The capacity to provide culturally competent training and services; and

(4) A board of directors and staff team consisting of a majority of residents who currently reside in a rural community in the State.

(e) Existing department of health personnel may be assigned to fulfill administrative and fiscal responsibilities of the rural community health worker pilot program.

(f) The department of health, in conjunction with the nonprofit organization contracted under subsection (d), shall submit interim reports on the development and administration of the rural community health worker pilot program, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular sessions of 2026, 2027, and 2028. Each interim report shall include a record of pilot program activities and accomplishments, including:

(1) Outreach and training of community health workers; and

(2) Services provided to program participants by a community health worker.

(g) The department of health shall submit a final report on the rural community health worker pilot program, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2029. The final report shall include:

(1) A record of pilot program activities and accomplishments, including:

(A) Outreach and training of community health workers; and

(B) Services provided to program participants by a community health worker; and

(2) A recommendation on whether to extend the pilot program beyond three years.

(h) As used in this section:

"Community health worker" means a frontline health worker who is a trusted member of the community in which the community health worker lives, is from the community, or who has an unusually close understanding of the community served that enables the community health worker to:

(1) Build trusted relationships;

(2) Serve as a liaison between health care and social services and the community;

(3) Facilitate access to services; and

(4) Improve the quality and cultural competence of service delivery.

"Program participant" means a resident of a rural community in the State who requests services by a community health worker through the rural community health worker pilot program.

"Rural" means an area that is currently served by a critical access hospital as defined in section 346-1, Hawaii Revised Statutes.

SECTION 3. 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 2025-2026 and the same sum or so much thereof as may be necessary for fiscal year 2026-2027 for the rural community health worker pilot program established pursuant to section 2 of this Act.

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

SECTION 4. This Act shall take effect on July 1, 2025.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	1004
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII