RELATING TO EMERGENCY RESPONSE.

Budget Healthcare

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: KEOHOKAPU-LEE LOY, AMATO, MARTEN, OLDS, TAKAYAMA
Last action: 2026-03-23
Official status: Report adopted; Passed Second Reading, as amended (SD 1) and referred to WAM.
Effective date: Not listed

Plain English Breakdown

The official source material does not specify details regarding the expansion of the program or reporting requirements.

Emergency Response Changes

This bill allows emergency medical technicians (EMTs) in counties with fewer than 100,000 people to give buprenorphine after giving an opioid antagonist during an overdose emergency and requires the Department of Health to train EMTs for this task.

What This Bill Does

Allows licensed EMTs in counties with a population of 100,000 or less to administer buprenorphine after administering an opioid antagonist during an opioid-related drug overdose response.
Requires the Department of Health to implement rules and allocate resources for training EMTs on how to administer buprenorphine.

Who It Names or Affects

Licensed emergency medical technicians (EMTs) in counties with a population of 100,000 or less
People who are overdosing on opioids

Terms To Know

Buprenorphine: A medicine that helps treat opioid addiction and can prevent withdrawal symptoms.
Opioid antagonist: A drug used to reverse the effects of an opioid overdose.

Limits and Unknowns

The bill only applies to counties with a population under 100,000.
It is not clear how many EMTs will be trained or if there are enough resources for statewide expansion.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

HD1

Hawaii published version HD1

Plain English: This amendment allows emergency medical technicians (EMTs) in Hawaii to administer buprenorphine after giving an opioid antagonist during an overdose, and requires the Department of Health to create rules for training EMTs and coordinating with other services.

Allows EMTs to give buprenorphine after administering an opioid antagonist during an opioid-related drug overdose.
Requires the Department of Health to develop standard protocols for handling opioid overdoses, including guidelines for buprenorphine administration.
Allocates resources for training EMTs on how to administer buprenorphine safely and effectively.

The effective date mentioned (July 1, 3000) seems incorrect or a placeholder and is not explained further in the amendment text.
Details about specific training requirements for EMTs are not provided in the amendment.

SD1

Hawaii published version SD1

Plain English: This amendment allows paramedics in counties with a population of 100,000 or less to administer buprenorphine after naloxone during suspected opioid overdoses under specific conditions.

Paramedics can now give buprenorphine after naloxone if they are trained and follow certain rules when dealing with suspected opioid overdose cases in small counties.
The Department of Health must set up a list of treatment centers that can see patients within one to two days after an emergency medical service encounter.
A pilot program will start in a county with less than 100,000 people and may expand statewide if more resources are available.

The exact details of the training paramedics need to receive before they can administer buprenorphine are not specified.
The amendment does not provide information on how much funding will be allocated for this pilot program.

Bill History

2026-03-23 S
Report adopted; Passed Second Reading, as amended (SD 1) and referred to WAM.
2026-03-23 S
Reported from HHS (Stand. Com. Rep. No. 3125) with recommendation of passage on Second Reading, as amended (SD 1) and referral to WAM.
2026-03-16 S
The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 3 Aye(s): Senator(s) San Buenaventura, McKelvey, Kanuha; Aye(s) with reservations: none ; 0 No(es): none; and 2 Excused: Senator(s) Keohokalole, Fevella.
2026-03-13 S
The committee(s) on HHS has scheduled a public hearing on 03-16-26 1:10PM; Conference Room 225 & Videoconference.
2026-03-10 S
Referred to HHS, WAM.
2026-03-06 S
Passed First Reading.
2026-03-06 S
Received from House (Hse. Com. No. 9).
2026-03-05 H
Passed Third Reading with none voting aye with reservations; none voting no (0) and Representative(s) Perruso excused (1). Transmitted to Senate.
2026-03-05 H
Reported from FIN (Stand. Com. Rep. No. 846-26), recommending passage on Third Reading.
2026-02-27 H
The committee on FIN recommend that the measure be PASSED, UNAMENDED. The votes were as follows: 15 Ayes: Representative(s) Todd, Takenouchi, Hartsfield, Hussey, Keohokapu-Lee Loy, Kitagawa, Kusch, Miyake, Morikawa, Perruso, Templo, Yamashita, Alcos, Gedeon, Reyes Oda; Ayes with reservations: none; Noes: none; and 1 Excused: Representative(s) Lee, M..
2026-02-24 H
Bill scheduled to be heard by FIN on Friday, 02-27-26 10:00AM in House conference room 308 VIA VIDEOCONFERENCE.
2025-12-08 D
Carried over to 2026 Regular Session.
2025-02-11 H
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) Cochran, Ward excused (2).
2025-02-11 H
Reported from HLT (Stand. Com. Rep. No. 327) as amended in HD 1, recommending passage on Second Reading and referral to FIN.
2025-02-05 H
The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 8 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Chun, Marten, Olds, Takenouchi, Alcos; Ayes with reservations: none; 0 Noes: none; and 1 Excused: Representative(s) Garcia.
2025-01-31 H
Bill scheduled to be heard by HLT on Wednesday, 02-05-25 9:30AM in House conference room 329 VIA VIDEOCONFERENCE.
2025-01-23 H
Referred to HLT, FIN, referral sheet 3
2025-01-23 H
Introduced and Pass First Reading.
2025-01-21 H
Pending introduction.

Official Summary Text

RELATING TO EMERGENCY RESPONSE.
Hawaii State Association of Counties Package; DOH; Paramedics; Buprenorphine; Opioid Overdose; Pilot Program; Report; Appropriation ($)
Authorizes licensed paramedics in a county with a population of 100,000 or less to administer buprenorphine after administration of an opioid antagonist in cases of opioid overdoses, under certain conditions. Requires the Department of Health to implement a two-year phased pilot program beginning in one county with a population of 100,000 or less and authorizes expansion of the program statewide as additional treatment resources become available. Requires a report to the Legislature evaluating program outcomes. Appropriates funds. Sunsets 6/30/2028. (SD1)

Current Bill Text

Read the full stored bill text

HB816

HOUSE OF REPRESENTATIVES

H.B. NO.

816

THIRTY-THIRD LEGISLATURE, 2025

STATE OF HAWAII

A BILL FOR AN ACT

relating
to EMERGENCY response
.

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

����
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.
�
I
n 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).

����
(c)
�
The department of health shall:

����
(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.