STAND. COM. REP. NO. 36
Honolulu, Hawaii
RE: S.B. No. 731
S.D. 1
Honorable Shan S. Tsutsui
President of the Senate
Twenty-Sixth State Legislature
Regular Session of 2011
State of Hawaii
Sir:
Your Committee on Health, to which was referred S.B. No. 731 entitled:
"A BILL FOR AN ACT RELATING TO MENTAL HEALTH,"
begs leave to report as follows:
The purpose of this measure is to:
(1) Add crisis substance abuse and alcohol treatment as a covered benefit;
(2) Change the term "serious mental illness" to "severe mental illness" and amend the definition of that term to include major depressive disorders, anxiety disorders, and borderline personality disorders;
(3) Require the Department of Health to include trained and certified professionals in its crisis hotline program for emergency intervention services;
(4) Prohibit the Department of Health from limiting the number of hours of treatment per patient and requires case managers to be assigned based on the Diagnostic and Statistical Manual of Mental Health Disorders, DSM IV, of the American Psychiatric Association;
(5) Establish an assertive community treatment program under the Department of Health; and
(6) Appropriate funds to the Department of Health to establish a community care crisis center.
The intent of this measure is to make beneficial changes to the mental health delivery system throughout the State.
Your Committee received testimony in support of this measure from The Queen's Medical Center, Mental Health America of Hawai‘i, Safe Haven/Mental Health Kokua, Mental Health Hawaii, Helping Hands Hawai‘i, Hawaii Disability Rights Center, National Alliance on Mental Illness Hawaii, National Association of Social Workers, and seven private citizens. Your Committee received testimony in opposition to this measure from the Department of Health. Your Committee received comments on this measure from the Department of Commerce and Consumer Affairs; HMSA Blue Cross Blue Shield of Hawaii; Hale Na‘au Pono, Waianae Coast Community Mental Health Center, Inc.; Hawaii Association of Health Plans; and two private citizens.
Your Committee finds that the expansion of covered benefits to include substance abuse and alcohol treatment is important to better protect the residents of the State from the problems associated with these diseases. Your Committee further finds that including major depressive disorders, anxiety disorders, and borderline personality disorders within the definition of "severe mental illness" will allow many more individuals to seek critical treatment services. According to testimony received from the Department of Health, the measure could be improved by allowing the Department of Health to assess its service needs and to further study the provision of mental health services for people with severe mental illness throughout the State to better access the way the Department of Health structures its resources.
Additional testimony indicated that the current practice of limiting case management services to three and a half hours per month for each consumer provides inadequate care and support for that consumer. Reduced case management hours often result in an increase in hospital admissions, homelessness, crisis situations, and crime and substance abuse recidivism. Your Committee finds that requiring the Department of Health to provide no less than seven hours of case management services per consumer per month significantly increases the provision of case management services and will help combat the negative impacts associated with insufficient case management service hours.
Your Committee has amended this measure by:
(1) Adding language requiring the Department of Health to provide no less than seven hours of case management services per month to each patient;
(2) Requiring the Department of Health to convene a mental health working group to determine how the State can improve and reformat the provision of its mental health services and to report its findings to the legislature no later than twenty days prior to the convening of the regular session of 2012;
(3) Inserting an effective date of July 1, 2050, for the appropriation for the establishment of a community care crisis center, to allow for further discussion of this section; and
(4) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.
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 S.B. No. 731, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 731, S.D. 1, and be referred to the Committee on Ways and Means.
Respectfully submitted on behalf of the members of the Committee on Health,
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____________________________ JOSH GREEN, M.D., Chair |
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