RELATING TO MENTAL HEALTH.

SB2089

THE SENATE

S.B. NO.

2089

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to mental health
.

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

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SECTION 1.
�
The
legislature finds that the State faces a severe shortage of licensed mental
health professionals, resulting in long waitlists for mental health services
and significant barriers to care for medicaid beneficiaries.
�
The legislature further finds that allowing
unlicensed, pre‑licensed, or trainee mental health professionals to
provide services under the clinical supervision of a licensed mental health
professional, and ensuring these services are eligible for medicaid prospective
payment system reimbursement, will expand the State's mental health workforce
and improve timely access to care.

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The legislature finds that enabling
supervised pre-licensed mental health professionals to serve medicaid
recipients will increase the number of qualified providers available to low‑income
individuals and families, help reduce waitlists, and fill critical gaps in the
behavioral health system.
�
The
legislature also finds that medicaid reimbursement will provide needed income
stability for pre-licensed mental health professionals, who often cannot bill
insurance while completing required clinical hours, and lead to a stronger mental
health care workforce pipeline in the State.

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The legislature further finds that
expanding medicaid prospective payment system reimbursement to services
provided by supervised pre‑licensed mental health professionals promotes
mental health equity by ensuring financial status does not impede access to
necessary services.
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Additionally,
working with medicaid populations provides valuable training and professional
development opportunities for early-career mental health professionals,
contributing to a more skilled and culturally responsive mental health
workforce.

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Accordingly, the purpose of this Act is to:

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(1)
�
Expand
the services eligible for medicaid prospective payment system reimbursement to
include certain services furnished by a federally qualified health center or
rural health clinic and provided by mental health professionals under the
clinical supervision of a licensed mental health professional; and

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(2)
�
Require
the department of human services to adopt rules to allow medical assistance
reimbursement payments for services provided to recipients eligible for medicaid
benefits under any plan under medicaid managed care programs in the State by
unlicensed mental health professionals under the clinical supervision of a licensed
mental health professional.

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SECTION

2
.
�
Section 346-53.64, Hawaii Revised Statutes,
is amended by amending subsection (a) to read as follows:

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"
(a)
�
Services eligible for prospective payment
system reimbursement are those services that are
furnished by a federally qualified health center or rural health clinic that
are:

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(1)
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Within the legal authority of a
federally qualified health center to deliver, as defined in section 1905 of the
Social Security Act;

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(2)
�
Actually provided by the federally
qualified health center, either directly or under arrangements;

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(3)
�
Covered benefits under the medicaid program,
as defined
in
section 4231 of the State Medicaid
Manual and the Hawaii medicaid state plan;

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(4)
�
Provided to a recipient eligible for medicaid
benefits
;

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(5)
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Delivered exclusively by health care
professionals
,
including
[
physicians,
]
:

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(A)
�
Physicians,

physician's assistants, nurse practitioners, nurse midwives, clinical social
workers, clinical psychologists, and other persons acting within the lawful
scope of their license or certificate to provide services;

or

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(B)
�
Mental
health professionals, as defined in section 577-29; provided that the mental
health professional shall be under the clinical supervision of a licensed
mental health professional, as defined in section 577-29;

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(6)
�
Provided
at the
federally qualified health center's practice site, a hospital emergency room,
in an inpatient setting, at the patient's place of residence, including long
term care facilities, or at another medical facility; and

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(7)
�
Within the scope of services provided
by the State under its fee-for-service medicaid program and its medicaid
managed care program, on and after August 1994, and as amended from time to
time.
"

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SECTION
3.
�
The department of human services
shall adopt rules pursuant to chapter 91, Hawaii Revised Statutes, to allow
medical assistance reimbursement payments to recipients who are eligible for
medicaid benefits under any plan under medicaid managed care programs in the
State by a mental health professional under the clinical supervision of a
licensed mental health professional.

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For
the purposes of this section, "mental health professional" and
"licensed mental health professional" have the same meanings as those
terms are defined in section 577-29, Hawaii Revised Statutes.

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SECTION 4.
�

The department of human services shall seek waivers and any additional
approvals from the Centers for Medicare and Medicaid Services necessary to
implement this Act.

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SECTION
5
.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.

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SECTION
6
.
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This Act shall take effect on July 1, 2026
; provided
that sections 2 and 3 of this Act shall take effect upon approval by the Centers
for Medicare and Medicaid Services
.

INTRODUCED
BY:

_____________________________

Report Title:

DHS;
Medicaid
; Prospective Payment System;
Reimbursement
;
Mental
Health Services; Mental Health Professionals;
Rules

Description:

Expands the services eligible for Medicaid Prospective
Payment System reimbursement to include certain services furnished by a federally
qualified health center or rural health clinic and provided by mental health
professionals under the clinical supervision of a licensed mental health
professional.
�
Requires the D
epartment of
H
uman
S
ervices
to
adopt
rules to allow medical assistance reimbursement payments for services provided to
recipients eligible for
M
edicaid
benefits under a
ny plan under M
edicaid managed care program
s
in the State

by

unlicensed
mental
health professionals
under the clinical supervision of a licensed mental
health professional
.
�
Requires the D
epartment of
H
uman

S
ervices
to
seek
necessary
waivers and any additional approvals from the Centers for
Medicare and Medicaid Services.

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