STAND. COM. REP. NO. 327

Honolulu, Hawaii

, 2025

RE: H.B. No. 816

H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

Your Committee on Health, to which was referred H.B. No. 816 entitled:

"A BILL FOR AN ACT RELATING TO EMERGENCY RESPONSE,"

begs leave to report as follows:

The purpose of this measure is to:

(1) Authorize emergency medical technicians in the State to administer buprenorphine after the administration of an opioid antagonist during an opioid overdoes response; and

(2) Require the Department of Health to adopt rules that incorporate standard protocols associated with opioid-related drug overdoses and buprenorphine administration, allocate resources for emergency medical technician training, and coordinate with emergency medical service providers in the State regarding buprenorphine administration.

Your Committee received testimony in support of this measure from the Mayor of the County of Hawai‘i; Hawaii Substance Abuse Coalition; Big Island Substance Abuse Council; Hawai‘i Island Fentanyl Task Force; Hawai‘i Health & Harm Reduction Center; and two individuals. Your Committee received comments on this measure from the Department of Health.

Your Committee finds that administration of an opioid antagonist in the case of an opioid overdose can have the unintended consequence of causing acute withdrawal symptoms in individuals, leading to severe distress, refusal of further treatment, or increased risk of repeat overdoses. Your Committee further finds that the administration of buprenorphine has been proven to prevent withdrawal symptoms and the administration of buprenorphine after the administration of an opioid antagonist has been adopted by many other states as part of their emergency medical services protocols. Your Committee believes that authorizing emergency medical technicians to administer buprenorphine after the administration of an opioid antagonist in cases of an opioid overdose may reduce the risk of repeat overdoses and provide a bridge to additional treatment.

Your Committee notes the concerns raised in testimony by the Department of Health that there are a lack of treatment centers in the State that can accept patients who have been administered buprenorphine by an emergency medical technician within a day or two after their emergency medical services encounter for follow up care and additional treatment with buprenorphine.

Your Committee has amended this measure by:

(1) Changing the effective date to July 1, 3000, to encourage further discussion; and

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

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 H.B. No. 816, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 816, H.D. 1, and be referred to your Committee on Finance.

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

____________________________

GREGG TAKAYAMA, Chair