Bill Text: HI HB1334 | 2024 | Regular Session | Introduced
Bill Title: Relating To Mental Health Crisis Response.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced) 2023-12-11 - Carried over to 2024 Regular Session. [HB1334 Detail]
Download: Hawaii-2024-HB1334-Introduced.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
1334 |
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THIRTY-SECOND LEGISLATURE, 2023 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
Relating to Mental Health Crisis Response.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The Legislature finds that the need for crisis mental health services is increasing. One proven strategy for helping those in crisis with mental health and substance abuse needs is a threefold program. First, an easy way to reach out for help. Then, a quick crisis response system that can respond in person, or by telehealth, if needed. And lastly, stabilization bed units readily available.
The Legislature further finds that the first step has been taken by the launching of the National 988 Mental Health 24/7 Hotline in July of 2022. This hotline has increased the number of people seeking help in Hawaii. Calls referred from the national hotline to the Hawaii CARES (Coordinated Access Resource Entry System) have increased 15% to an average of 324 calls per day in the first two weeks of the 988 system being activated. This initial uptick in call volume is expected to increase as more people become aware of the 988 system.
The second and most important aspect of this valuable mental health response system is having a Crisis Mobile Outreach team available to dispatch to callers when necessary. Denver in 2020 piloted a crisis response team in 8 precincts of the city. Of the 911 calls they received 2/3rds of the calls were handled by their STAR (Support Team Assisted Response) team. In the eight precincts that piloted this program, it resulted in a decrease in crime of 34% and the direct cost was four times less than the traditional 911/police response. The STAR pilot program results were so positive they expanded the STAR program to the whole city.
The CAHOOTS program in Eugene, OR was started in 1989 and is estimated to annually save $8.5 million for public safety spending and $14 million on emergency medical costs, including ambulance transport and emergency room services. The department of health adult mental health division has CMO teams that are available on most islands, although limited in response time by distance and units available. The Counties also have similar units, like the C&C of Honolulu's new CORE (Crisis Outreach Response and Engagement) teams. The City and County of Honolulu piloted CORE in December 2021 and it is serving Downtown, Moiliili, and Waikiki. Currently they have four response vehicles, twelve mental health workers and fifteen EMTs working the program which is mostly Federally funded. Like Denver, they have had encouraging success and are looking to expand the service island wide and bring the program into the City budget when the Federal funding ends.
The Legislature understands that providing crisis mental health response is best done by mental health professionals, and usually does not need a police or ambulance response. By providing mental health services, basic medical first aid, transportation, and connection to other wrap around services these crisis response teams free up police, ambulance, and 911 resources.
The third step to this strategy is having access and availability to crisis stabilization beds which are short-term housing for mental health patients in crisis that provide limited medical services and wrap-around case management. Currently the state has 38 beds available on Oahu and 8 on Hawaii. As a directive of Acts 90 and 263 of 2019, the DOH convened working groups to look at the state's mental health system. The working group(s) produced a report with recommended changes to make the mental health system better serve the needs of Hawaii's people. The report details specific changes that would make the crisis mental health system more responsive to clients, more efficient, and cost effective. The outcome of implementing these changes would be a reduced use of Emergency Rooms and jails as holding areas for those in crisis. More targeted mental health and social service outreach rather than police response. Longer lasting positive outcomes for patients. And reduced costs by limiting ambulance and emergency room services to those with acute medical needs.
Accordingly, the purpose of this Act is to implement some of the recommended policies:
(1) Fully fund Hawaii CARES to increase staffing in order to have minimal hold time for callers. And to incorporate telehealth options when appropriate.
(2) Expand the reach of the state's CMO teams on all islands, create a coordinator position, and provide additional support for the County crisis response teams.
(3) Increase the crisis stabilization beds statewide, ensuring that each island has the resources it needs to serve its population.
SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 for the expansion of the Hawaii CARES program. Funding to be used to reduce caller wait times and to broaden the response scope to use telehealth services when warranted.
SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 to establish 1 (FTE) position within the department of health adult mental health division for a coordinator of statewide crisis mobile outreach teams position, and the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 to expand the current reach of the crisis mobile outreach teams to 24/7 in all counties. The coordinator shall consider inclusion of telehealth services where needed in rural areas.
SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2023 to increase mental health crisis stabilization bed capacity in all counties. The crisis mobile outreach team coordinator shall work with the counties and applicable state agencies to determine where bed capacity increases are needed.
The sum appropriated shall be expended by the department of health for the purposes of this Act.
SECTION 5. This Act shall take effect on July 1, 2023.
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INTRODUCED BY: |
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Report Title:
Mental Health Crisis Response; DOH AMHD coordinator position; appropriations
Description:
Appropriates funds for three areas of Mental Health Crisis Response: Increased funding for 988 Hawaii CARES, creates a position for a statewide crisis mobile outreach coordinator with the goal to have statewide response 24/7, funding to increase mental health crisis stabilization bed capacity in all counties.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
