Mental Health Association in Hawai'i

Legislative Report

Mar 30, 2001

Advance Directives
Advance Psychiatric Directives are an important aspect of a consumer's ability to make decisions about their care and treatment, to enhance self-determination, and to build empowerment. Advance Directives are a way of providing an individual with choices regarding their care and treatment in the event that they are no longer able to make those decisions.

The Mental Health Association in Hawai'i's Program Director, Paula Heim, has been devoted to collaborating with various stakeholders in the community to improve Hawai'i's existing law (Act 84-1992) by constructing a bill for this 2001 Legislative Session. Along with consumers, family members, mental health providers, professional groups, legal advocates, the Department of Health, and with financial support from the Hawai'i Community Foundation, HB650 and SB1125 have been introduced and are moving through the legislative process.

Pending passage of this important piece of legislation, individuals will be able to let their preferences about their care and treatment be known in order to promote faster
recovery, and reduce prolonged or unecessary hospitalization, trauma, homelessness, or incarceration.



Parity (Equal Mental Health Coverage)
The Mental Health Task Force has completed its final report, which has been submitted to the Governor. Bringing to the table consumers, health plans, providers, advocates, and business people, the Task Force was charged to look at private insurance and determine the effects of additional mandated mental health and substance abuse benefits. Data gathered from health plans showed that there was not a significant amount of unmet need in the private sector. This information may be viewed in two ways. One is that there is no need for expanded benefits since it there is not a statistically significant number of people who would be affected by an increase. The second, more reasonable way to view this data is that since there is only a small percentage of people who need expanded benefits, the cost would be minimal.
The Task Force provided an opportunity to look at health insurance coverage for mental health and substance abuse and provide for open dialogue between the groups. There is hope to continue communication between various members of the group in order to effectively expand parity efforts.

The Equal Insurance Coalition (=I.C.) has elected Marion Poirier, Executive Director of NAMI-Oahu, and Paula Heim, Program Director at MHA/H, as Co-Chairs of the Coalition, and Randy Hack as an alternate. The =I.C. has been meeting every other week in order to collaborate on parity efforts during this busy legislative session. The following three bills were introduced:

?? HB841: Includes major depression in the definition of a serious mental illness, and eliminates the lifetime caps on substance abuse treatment benefits. (HELD)
?? SB825: Includes major depression in the definition of a serious mental illness, and eliminates the lifetime caps on substance abuse treatment benefits.
?? SB78: Provides comprehensive mental health and substance abuse parity to children twenty-one years of age or younger, regardless of diagnosis.


Other Legislation

While Advance Psychiatric Directives and Parity issues certainly deserve the attention of the mental health community, there are many other issues that come up before Legislators that impact the lives of people with mental illness across the State. Some of these issues include:

Dental Benefits and Services: Consumers throughout the State have voiced their concern about the lack of access to adequate dental services. A direct link exists between dental and physical health. Good dental health increases a person's self-esteem and confidence, giving them a real reason to SMILE! Bills related to dental include: SB184, HB252, SB82, SB235, HB786
Substance Abuse Treatment: Substance abuse assessment and treatment may be mandated for offenders under the custody of the Department of Public Safety with the passage of HB176. The bill addresses the fact that an offender who is not treated for a substance abuse problem may be released back into the community and pose a high rate of criminal recidivism if not provided with proper treatment. This bill would help to identify offenders who have an alcohol or substance abuse problem and channel them to treatment services.
Respite Care: Support in the form of respite services are an important part of a family's capacity to care for an individual with a disability or chronic health problem. HB91 appropriates funds for respite services, which play an essential role in helping families to care for their loved ones.
Discrimination Against Persons with Disabilities: SB720 provides protection to individuals with diverse-abilities from discrimination by public entities. It serves to strengthen the existing law to ensure equal access to all state and county government services, programs, and activities.