Bill Text: HI SB3107 | 2018 | Regular Session | Amended

Hawaii Senate Bill 3107 (Prior Session Legislation)

Bill Title: Relating To Chronic Health Conditions.

Spectrum: Partisan Bill (Democrat 13-0)

Status: (Engrossed - Dead) 2018-03-23 - Passed Second Reading as amended in HD 1 and referred to the committee(s) on FIN with none voting aye with reservations; none voting no (0) and Representative(s) C. Lee, Lowen, McDermott, Souki, Tokioka excused (5). [SB3107 Detail]

Download: Hawaii-2018-SB3107-Amended.html

THE SENATE	S.B. NO.	3107
TWENTY-NINTH LEGISLATURE, 2018		S.D. 1
STATE OF HAWAII		H.D. 1

A BILL FOR AN ACT

RELATING TO CHRONIC HEALTH CONDITIONS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

PART I

SECTION 1. The legislature finds that healthcare costs are skyrocketing. The legislature specifically finds that studies indicate that a small percentage of patients consume a disproportionate amount of health care resources. Many of these patients suffer from multiple chronic conditions, including substance use, mental illness, and homelessness. Chronic conditions that go untreated worsen with age. Further, the more chronic conditions an individual has, the greater the risks that individual faces for mortality, poor functional status, unnecessary hospitalizations, adverse drug events, duplicative tests, and conflicting medical advice. Approximately sixty-six per cent of total health care spending is directed toward the approximately twenty-seven per cent of Americans with multiple chronic conditions.

The purpose of this Act is to appropriate funds for the treatment of people with multiple chronic conditions, including but not limited to mental health disorders, substance use disorders, and homelessness.

PART II

SECTION 2. The legislature finds that current guidelines on chronic conditions fail to account for complications posed by additional chronic conditions. Specifically, guidelines for people with mental illness and substance use problems rarely address co-occurrence of other chronic conditions. Developing targeted interventions designed for multiple chronic conditions will help improve access to health care, public health, and other services. Effective treatment of patients with multiple chronic conditions requires heightened coordination of complex medical and psychosocial care, development of accompanying quality metrics, increased involvement of the public health system, strengthening of public-private partnerships, and an increase in qualified staff.

Therefore, the purpose of this part is to require the department of health to establish a comprehensive and coordinated continuum of treatment services for sufferers of substance use disorders who have other chronic conditions.

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 2018-2019 for the treatment of patients with multiple chronic conditions, including substance use disorders, and the creation of a modern, comprehensive, and coordinated continuum of treatment services that includes defined goals and benefits.

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

PART III

SECTION 4. The legislature finds that the department of health has started a pilot program for training primary caregivers to address mild to moderate substance use disorders, by providing screening, brief intervention, and referral to treatment. This primary care strategy provides for early intervention with at-risk substance users before more serious consequences occur.

The legislature also finds that ninety per cent of people with substance use disorders do not receive treatment; of those who do not receive treatment, ninety-five per cent are unaware that they have a problem. Improving primary care can identify substance use disorders early, and reduce health care costs, the severity of drug and alcohol use, and risk of trauma.

The legislature also finds that a centralized referral and treatment process is a key component of substance use treatment. The referral and treatment process includes assisting a patient access specialized treatment, select facilities, and navigate barriers such as cost and transportation, and following up with a patient as needed.

Therefore, the purpose of this part is to appropriate funds for the department of health to establish a pilot project for a comprehensive and coordinated centralized referral system in each county.

SECTION 5. 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 2018-2019 for the department of health to establish a pilot project for a permanent centralized referral center in the city and county of Honolulu, then expand and develop the program to address the needs of other counties.

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

PART IV

SECTION 6. The legislature finds people with mental health disorders or substance use disorders can be particularly vulnerable to becoming homeless or being precariously housed. The legislature further finds that although the chronically homeless represent approximately sixteen per cent of the overall homeless population, they use more than half of services. Approximately two-thirds of the chronically homeless have a substance use disorder or other chronic condition.

The legislature further finds that case managers with the expertise to address substance use disorders and other chronic conditions could better address the chronically homeless who have difficulty accessing housing. These skills include knowledge of theories of addiction, models of recovery, and practices of continuing care; ability to recognize the importance of family and social networks in the treatment process; and understanding of interdisciplinary and multicultural approaches to treatment, among others. Properly trained case managers can deal with special needs, such as HIV infection, poverty, childcare responsibilities, and physical or developmental disabilities. Case managers can also ensure smooth transitions in care and avoid gaps in service.

The legislature also finds that, although case management programs have been recently created, they lack vital funding and resources.

The purpose of this part is to provide funding for case management programs to help those with substance use disorders.

SECTION 7. 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 2018-2019 for the funding of case management programs to help those with substance use disorders throughout the State.

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

PART V

SECTION 8. The legislature finds that peer mentors and coaches assist their peers with setting recovery goals, finding sober housing, making new friends, finding new uses of spare time, and improving job skills. They also provide assistance with other collateral issues. Peer mentors and coaches provide valuable experience to the peers they serve as they have experienced similar recovery paths.

The legislature further finds that peer mentoring and coaching reduce health care costs, facilitate recovery, and promote a sense of community. Peer mentors and coaches model recovery behaviors and connect the person treated with valuable services and resources.

The legislature further finds that many peer mentors and coaches serve as volunteers. As such, they tend to have shorter tenures than paid staff, and require constant supervision, recruitment, and training. Stipends and other compensation are sometimes provided to peer mentors and coaches.

Therefore, the purpose of this part is to appropriate funds to service providers to hire supervisors to supervise and train volunteer peer mentors and coaches, and to develop incentive and stipend programs for volunteer peer mentors and coaches.

SECTION 9. 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 2018-2019 to fund service providers to hire supervisors to supervise and train volunteer peer mentors and coaches to help those with substance use disorders, and to develop incentive or stipend programs for volunteer peer mentors and coaches.

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

PART VI

SECTION 10. This Act shall take effect on July 1, 3000.

Report Title:

Substance Use; Chronic Conditions; Homelessness; Peer Mentors; Case Managers; Referral; Appropriations

Description:

Appropriates funds for programs and other efforts to help persons suffering from multiple chronic conditions, including coordinated treatment, centralized referral, case managers, and peer mentors. (SB3107 HD1)

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