RELATING TO OPIOID USE DISORDER TREATMENT.

SB2505

THE SENATE

S.B. NO.

2505

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

RELATING
TO OPIOID USE DISORDER TREATMENT
.

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 Hawaii continues to face a growing opioid
crisis, with rising rates of overdose and opioid-related emergency department
visits.
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Paramedics are often the first
health care providers to encounter these patients, providing a critical
opportunity to connect them to evidence‑based treatment.

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The legislature further finds that national
data, including a 2023 study published in the Annals of Emergency Medicine,
demonstrate that the administration of buprenorphine by trained emergency
medical services personnel following naloxone can significantly reduce
withdrawal symptoms and increase the likelihood of patients engaging in opioid
use disorder treatment within thirty days.

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The legislature recognizes the department
of health's concern that it is essential to ensure that patients who receive
buprenorphine in the field have access to follow-up treatment within twenty-four
to forty-eight hours.
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The legislature
therefore intends to establish a phased pilot program, limited initially to
paramedics and counties with identified treatment linkage capacity.

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The purpose of this Act is to:

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(1)
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Authorize
paramedics, under department of health‑approved protocols, to administer
buprenorphine following naloxone in cases of suspected opioid overdose;

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(2)
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Require
the department of health to verify and designate treatment centers that can
accept patients within twenty-four to forty-eight hours of an emergency medical
services encounter;

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(3)
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Implement
the program as a phased pilot program in one or more counties; and

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(4)
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Require
the department to evaluate the program and report outcomes to the legislature.

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SECTION 2.
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Section 329E-3, Hawaii Revised Statutes, is amended to read as follows:

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"
[
[
]�329E-3[
]
]
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Opioid antagonist administration; emergency personnel and first
responders.
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(a)
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Beginning on January 1, 2017, every emergency
medical technician licensed and registered in Hawaii and all law enforcement
officers, firefighters, and lifeguards shall be authorized to administer an
opioid antagonist as clinically indicated.

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(b)
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Beginning July 1, 2026, paramedics licensed in the State may administer buprenorphine,
under protocols established by the department of health and approved by the
state emergency medical services medical director, after administering an
opioid antagonist to a patient experiencing an opioid
‑
related overdose; provided that:

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(1)
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The
paramedic has completed department
‑
approved training in opioid
withdrawal assessment and buprenorphine administration;

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(2)
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The
patient is alert, has regained decision
‑
making capacity, and meets the
clinical criteria for buprenorphine field initiation, as defined by the
protocol;

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(3)
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A
same
‑
day
or next
‑
day
referral is made to a designated treatment provider authorized by the department
of health; and

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(4)
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Documentation
of the administration, withdrawal assessment, and referral is submitted to the
department for program evaluation.

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(c)
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The department of health shall adopt rules
pursuant to chapter 91 to:

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(1)
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Establish
clinical and operational protocols for administration of buprenorphine in the
field by paramedics;

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(2)
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Designate
and maintain a list of treatment centers and providers capable of accepting
referred patients within twenty
‑
four to forty
‑
eight hours; and

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(3)
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Ensure
coordination between emergency medical services, emergency departments, and
substance use disorder treatment programs.
"

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SECTION 3.
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The department of health shall:

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(1)
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Implement
a phased pilot program to implement section 329E-3(b) and (c), Hawaii Revised
Statutes, beginning in at least one county having verified linkage
‑
to
‑
care capacity and may expand
statewide as additional treatment resources become available;

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(2)
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Provide
or contract for the training of paramedics in the assessment, administration,
and documentation of buprenorphine field initiation; and

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(3)
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Submit
a report to the legislature no later than twenty months after the pilot program's
start date, which shall contain an evaluation of:

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(A)
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The
number of patients treated under the pilot program;

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(B)
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Withdrawal
symptom outcomes;

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(C)
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Rates
of engagement with follow
‑
up treatment;

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(D)
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Any
operational challenges or recommendations for statewide expansion; and

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(E)
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Any
proposed legislation.

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SECTION 4.
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Statutory material to be repealed is bracketed and stricken.
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New statutory material is underscored.

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SECTION 5.
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This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

By Request

Report Title:

Hawaii
State Association of Counties Package; DOH; Paramedics; Buprenorphine; Opioid
Overdose; Pilot Program; Report

Description:

Authorizes
licensed paramedics to administer buprenorphine after administration of an
opioid antagonist in cases of opioid overdoses, under certain conditions.
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Requires the Department of Health to
implement a phased pilot program in at least 1 county with verified
linkage-to-care capacity and authorizes expansion of the program statewide as additional
treatment resources become available.
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Requires a report to the Legislature evaluating program outcomes.

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