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SB2285
THE SENATE
S.B. NO.
2285
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
RELATING
TO COMPLEX PATIENT TREATMENT
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION
1.
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The legislature finds that complex
patients � those with co-occurring substance use disorders, mental
health disorders, and chronic physical conditions � represent a high-need,
high-cost population that requires a modern, integrated care strategy.
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Yet these individuals frequently face adverse
social determinants of health, including housing instability, food insecurity,
early trauma, limited transportation, poverty, chronic stress, and limited
social support.
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Systemic barriers, such
as historical underinvestment, fragmented services, stigma, and limited
provider incentives, further restrict access to high-quality integrated care,
resulting in only a small percentage of complex patients receiving appropriate treatment.
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Complex
patients often cycle through fragmented, siloed health care systems that fail
to produce meaningful outcomes while generating significant costs.
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This leads 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.
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In many cases, jails and
prisons become default providers of behavioral health services, and the lack of
treatment contributes to higher rates of recidivism.
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The
legislature further finds that in Hawaii, approximately seventy-five thousand
adults have co-occurring mental health and substance use disorders, with over
fifty-four thousand experiencing chronic conditions.
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About twenty-one thousand adults in this
population are diagnosed with severe mental illness, which is treated by the
adult mental health division of the department of health.
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Many individuals remain untreated until their conditions
become severe, which often results in chronic physical illnesses and triple
diagnosis cases.
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Approximately 161,000
adults in the State have untreated substance use disorders, with roughly thirty-six
per cent classified as complex patients.
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In Hawaii,
high health care costs are driven primarily by cardiovascular disease,
diabetes, cancer, and asthma, with cardiovascular disease accounting for over eighteen
thousand hospitalizations annually.
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The
State also has above-average rates of methamphetamine and alcohol use, frequent
polysubstance use, prescription drug misuse, and emerging fentanyl-laced
methamphetamine risks, which highlights the urgent need for coordinated
prevention and treatment efforts.
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The
legislature additionally finds that patients with overlapping behavioral and
physical health conditions achieve better outcomes when treated simultaneously
in integrated care models.
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Effective
treatment combines medical, behavioral, and social supports in coordinated care
plans delivered by multidisciplinary teams, including psychiatrists,
physicians, nurses, counselors, case managers, and peer recovery staff.
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Residential and intensive outpatient programs
that integrate substance use, mental health, and chronic disease care improve
engagement, reduce fragmentation, lower relapse and hospitalization rates, and
support long-term recovery and well-being.
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The
legislature believes that developing a statewide, evidence-based complex
patient model is needed to close gaps in care, improve outcomes, reduce
emergency and inpatient utilization, position Hawaii to compete for federal
grants, and align medicaid and medicare funding to support integrated services.
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The
purpose of this Act is to establish a statewide integrated care initiative for
adults with co-occurring substance use disorders, mental health disorders, and
chronic physical health conditions by appropriating funds for the alcohol and
drug abuse division of the department of health to contract with
community-based organizations for a behavioral health complex patient model.
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SECTION
2.
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(a)
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The alcohol and drug abuse division of the department of health may
contract with community-based organizations for a behavioral health complex
patient model.
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(b)
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The department of health shall submit a
report to the legislature no later than twenty days prior to the convening of
the regular session of 2027.
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The report
shall include but not be limited to:
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(1)
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The manner in which funds appropriated
pursuant to this Act have been expended;
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(2)
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The service providers that have received
funding pursuant to this Act;
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(3)
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The number of persons served and a description
of the services provided;
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(4)
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Any measurable outcomes; and
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(5)
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Any proposed legislation.
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SECTION 3.
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There is appropriated out of the general
revenues of the State of Hawaii the sum of $3,000,000 or so much thereof as may
be necessary for fiscal year 2026-2027 for the alcohol and drug abuse division
of the department of health to contract with community-based organizations for
a behavioral health complex patient model.
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The sum
appropriated shall be expended by the department of health for the purposes of
this Act.
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SECTION 4.
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This Act shall take effect on July 1, 2026.
INTRODUCED BY:
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Report Title:
DOH;
Behavioral Health Complex Patient Model; Community-Based Organizations; Report;
Appropriation
Description:
Appropriates
funds to the Alcohol and Drug Abuse Division of the Department of Health to
contract with community-based organizations for a behavioral health complex
patient model.
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Requires a report to the
Legislature.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.