REQUESTING THE DEPARTMENT OF HEALTH TO CONVENE A COMPLEX NEEDS PATIENT WORKING GROUP TO ADDRESS THE NEEDS, SERVICES, AND FUNDING FOR COMPLEX NEEDS PATIENTS WHO HAVE MULTIPLE SIGNIFICANT BUT NOT SEVERE DIAGNOSES OF CHRONIC CONDITIONS, INCLUDING SUBSTANCE USE DISORDERS, MENTAL HEALTH DISORDERS, OR CHRONIC PHYSICAL ILLNESS CONDITIONS.

HCR76

HOUSE OF REPRESENTATIVES

H.C.R. NO.

76

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

requesting the Department of Health to convene a complex NEEDS
patient working group to address the needS, services, and funding for complex
NEEDS patientS who have multiple SIGNIFICANT BUT NOT SEVERE diagnoses of
chronic conditions, INCLUDING substance use disorders, mental health disorders,
or chronic physical ILLNESS conditions
.

����
WHEREAS, complex
needs patients � those with co-occurring substance use disorders, mental health
disorders, and chronic physical illness conditions � represent a high-need,
high-cost population that requires a modern, integrated care strategy; and

����
WHEREAS, complex
needs patients often cycle through fragmented, siloed health care systems that
fail to produce meaningful outcomes while generating significant costs, leading
to frequent emergency room visits, repeated hospitalizations, justice system
involvement, homelessness, and poor health outcomes, placing an outsized burden
on social services, including Medicaid and Medicare; and

����
WHEREAS, in
Hawaii, approximately fifty-four thousand adults have chronic conditions of
co-occurring mental health and substance use disorders, often coupled with
chronic physical illnesses resulting in two or more multiple chronic
conditions, and if left untreated, these conditions become severe; and

����
WHEREAS, residential,
therapeutic living, and intensive outpatient programs for complex needs patients
achieve better outcomes when treated simultaneously in integrated care models
that combine medical, behavioral, and social treatments in coordinated care
plans delivered by multidisciplinary teams; and

����
WHEREAS, an
evidenced-based pilot program would position Hawaii to compete for federal
grants, and align Medicaid and Medicare funding to support integrated services
that would effectively close the gaps in care; and

����
WHEREAS, the
infrastructure already exists because substance use disorder treatment models
have staff with expertise to treat co-occurring "severe" mental
health disorders and substance abuse; and

����
WHEREAS, some
substance abuse treatment programs have integrated models that also treat
chronic physical illness conditions but only address patients with severe
mental illness; and

����
WHEREAS, a working
group convened by the Department of Health would help to develop collaborative
processes between the Department of Health and appropriate agencies; and

����
WHEREAS, this
body believes developing integrated approaches to treat substance abuse, mental
health, and chronic disease conditions in one setting would improve engagement,
reduce fragmentation, lower relapse and hospitalization rates, and support
long-term recovery; now, therefore,

����
BE IT
RESOLVED by the House of Representatives of the Thirty-third Legislature of the
State of Hawaii, Regular Session of 2026, the Senate concurring, that the
Department of Health is requested to convene a Complex Needs Patient Working
Group to address the needs, services, and funding for complex needs patients
who have multiple significant but not severe diagnoses of chronic conditions, including
substance use disorders, mental health disorders, or chronic physical illness
conditions; and

����
BE IT FURTHER
RESOLVED that the Director of Health, or the Director's designee, is requested
to chair the Complex Needs Patient Working Group, work with various departments,
and invite members that could provide assistance, such as from the Hawaii
Substance Abuse Coalition, other substance use or mental health disorder
providers, or health care facilities, as appropriate, as determined by the
Director of Health or the Director's designee; and

����
BE IT FURTHER
RESOLVED that the Complex Needs Patient Working Group is requested to consider
the following:

����
(1)
�
The need, evidenced-based services to address
the need, and recommendations for funding to operate, or contract for the
operation of one or more integrated residential treatment and therapeutic
living facilities to serve complex needs patients;

����
(2)
�
Comprehensive substance use disorder
treatments via residential and therapeutic living programs, including
medication-assisted treatment;

����
(3)
�
Mental health evaluation, medication
management, psychotherapy, and crisis stabilization;

����
(4)
�
On-site or immediately available primary health
care, chronic disease management, and coordination with specialty medical care providers;

����
(5)
�
Integrated nursing services;

����
(6)
�
Care coordination, case management, and
discharge planning;

����
(7)
�
Peer support services;

����
(8)
�
Recovery-oriented, trauma-informed, and
culturally responsive programming;

����
(9)
�
Philosophy regarding the pursuit of abstinence
to improve functionality; and

���
(10)
�
Assistance with housing, employment, and
social determinants of health; and

����
BE IT FURTHER
RESOLVED that the Department of Health is requested to submit a report of its
findings and recommendations, including any proposed legislation, to the
Legislature no later than twenty days prior to the convening of the Regular
Session of 2027; and

����
BE IT FURTHER
RESOLVED that a certified copy of this Concurrent Resolution be transmitted to the
Director of Health.

OFFERED BY:

_____________________________

Report Title:
�

DOH;
Complex Needs Patient Working Group; Mental Health Disorders; Substance Use
Disorders; Chronic Physical Illness