HB816

SECTION 1. The legislature finds that the opioid crisis in the State continues to take lives, devastate families, and strain the State's health care system. In 2022, Hawaii recorded over two hundred eighty overdose deaths, reflecting an age-adjusted rate of 18.6 deaths per one hundred thousand people, a rate that continues to rise. Emergency departments across the State have reported increasing opioid-related visits, with opioids surpassing stimulants and heroin as the leading cause of overdose-related emergency department visits in 2022.

The legislature further finds that emergency medical technicians (EMTs), including EMT-paramedics, are often the first responders during overdose emergencies. The State's current emergency response protocols allows first responders to administer an opioid antagonist that reverses opioid overdoses. However, administration of an opioid antagonist has unintended side effects that can cause acute withdrawal symptoms in individuals and lead to severe distress, refusal of further treatment, or increased risk of repeat overdoses.

The legislature additionally finds that the medication buprenorphine is proven to prevent withdrawal symptoms that may discourage engagement with recovery services. The administration of buprenorphine after an opioid antagonist may reduce the risk of repeat overdoses and provide a bridge to treatment, significantly increasing the likelihood of long-term recovery.

The legislature also finds that many other states have recognized the public health benefits of using buprenorphine in their emergency medical services protocols. In California, the EMS buprenorphine use pilot program implemented in Contra Costa County allows paramedics to administer buprenorphine to patients in the prehospital setting, with results showing the administration of buprenorphine can effectively initiate opioid use disorder treatment in the field. New Mexico's EMS bridge program, which allows EMTs to administer buprenorphine in the field, shows evidence that patients receiving buprenorphine were eighty per cent more likely to connect with addiction treatment services. Finally, Massachusetts and Rhode Island have enacted similar measures that allow certain first responders to administer buprenorphine to individuals experiencing an opioid overdose, with each state reporting measurable declines in opioid overdose deaths and improved continuity of care.

The legislature believes that incorporating the administration of buprenorphine into the State's emergency medical services protocols can:

(1) Equip first responders with the tools to provide comprehensive, life-saving care;

(2) Modernize the State's emergency medical services protocols to algin with proven national models;

(3) Treat opioid overdoses with the urgency and care they require; and

(4) Reduce the number of unnecessary visits to the emergency department and hospital readmissions, thereby reducing the burden on the State's health care system.

Accordingly, the purpose of this Act is to:

(1) Authorize EMTs in the State to administer buprenorphine after the administration of an opioid antagonist during an opioid overdose response; and

(2) Require the department of health to adopt rules, allocate resources for EMT training, and coordinate with emergency medical services providers in the State, to incorporate the administration of buprenorphine after the administration of an opioid antagonist as a standard component of emergency medical services' protocols during an opioid overdose response.

SECTION 2. Section 329E-3, Hawaii Revised Statutes, is amended to read as follows:

"[[]§329E-3[]] Opioid antagonist administration; emergency personnel and first responders. (a) Beginning on January 1, 2017, every emergency medical technician licensed and registered in [~~Hawaii~~] the State and all law enforcement officers, firefighters, and lifeguards shall be authorized to administer an opioid antagonist as clinically indicated.

(b) Every emergency medical technician licensed and registered in the State shall be authorized to administer buprenorphine after the administration of an opioid antagonist pursuant to subsection (a).

(1) Adopt rules to:

(A) Classify an opioid-related drug overdose as a life-threatening emergency, equivalent to heart attacks and strokes, requiring standard protocols designed to stabilize the affected individual's physical conditions and reduce the risk of repeat occurrences; and

(B) Incorporate the administration of buprenorphine after the administration of an opioid antagonist as a standard component of emergency medical services' protocols during an opioid-related drug overdose response in alignment with national best practices, including guidelines for coordinating with hospitals and treatment providers for patients transitioning into recovery services.

(2) Allocate resources to train emergency medical technicians in buprenorphine administration; and

(3) Coordinate with emergency medical services providers in the State to implement this section."

SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

Report Title:

DOH; EMTs; EMT-Paramedics; Buprenorphine; Opioid Antagonist; Training; Rules

Description:

Authorizes emergency medical technicians in the State to administer buprenorphine after the administration of an opioid antagonist during an opioid-related drug overdose response. Requires the Department of Health to adopt rules, allocate resources for EMT training, and coordinate with emergency medical services providers in the State, to incorporate the administration of buprenorphine after the administration of an opioid antagonist as a standard component of emergency medical services' protocols during an opioid-related drug overdose response.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

HOUSE OF REPRESENTATIVES	H.B. NO.	816
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII