| 47 | | - | SECTION 1. The legislature finds that community health workers connect rural, underserved communities with programs and services that impact social determinants of health and address factors such as access to health care, prevention, outreach, and training. Community health workers often serve in rural, underserved communities and spend a significant portion of their time doing telehealth and behavioral health, outreach such as assisting individuals to apply for medical insurance, providing health education resources, and locating work opportunities. Community health workers may also serve as translators, assisting their communities to navigate health care and social service systems. The legislature further finds that there is a great need for community health workers, especially in rural and underserved communities that do not have reliable access to health education, resources, or job opportunities. As a critical intermediary between residents and health care and social services, community health workers have a unique understanding of their community needs and accessibility to services. Establishing a pilot program for community health workers with clear parameters, including major responsibilities and scope of work, will allow community health workers to continue their valuable work to communities statewide. Therefore, the purpose of this Act is to establish a three-year rural community health worker pilot program to provide outreach, education, training, and navigation to individuals residing in rural communities and address social determinants of health. SECTION 2. (a) The department of health shall establish and administer a three-year rural community health worker pilot program for community health workers to provide outreach, education, training, and navigation to individuals residing in the State's rural communities and address social determinants of health. (b) Community health workers participating in the rural community health worker pilot program may provide health education and outreach, individual support and assistance, cultural competency and advocacy, and data collection and reporting within the State's rural communities. (c) Services offered by community health workers pursuant to subsection (b) shall meet the following requirements: (1) Health education and outreach shall include: (A) Health education programs that promote health awareness, disease prevention, and healthy lifestyle practices; and (B) Information on available health care services, resources, and programs to rural community members; (2) Individual support and assistance shall include: (A) Assistance to individuals in navigating the health care system, including accessing health care facilities, appointments, and follow-up care; and (B) Guidance and support for individuals in managing chronic conditions, medication adherence, and lifestyle modifications for improved health outcomes; (3) Cultural competency and advocacy shall include: (A) Cultural sensitivity and competence during interactions with diverse populations within a rural community; and (B) Advocating for the health needs and concerns of rural community members to health care providers, institutions, and policymakers; and (4) Data collection and reporting shall include: (A) Maintenance of accurate records of educational activities and individual interactions; and (B) Submission of periodic reports on rural community health trends, needs, and program effectiveness to relevant health authorities or agencies. (d) The department of health shall enter into a contract with a nonprofit organization to recruit, train, assign, and supervise community health workers and oversee the pilot program. The nonprofit organizations contracted under this subsection shall have: (1) A history of providing community empowerment, capacity building, collaborative partnerships, and health education to the State's rural communities; (2) The knowledge and experience necessary to provide community health worker services to program participants; (3) The capacity to provide culturally competent training and services; and (4) A board of directors and staff team consisting of a majority of residents currently residing in a rural community in the State. (e) Existing department of health personnel may be assigned to fulfill administrative and fiscal responsibilities of the rural community health worker pilot program. (f) The department of health, in conjunction with the nonprofit organization contracted under subsection (d), shall submit interim reports on the development and administration of the rural community health worker pilot program, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular sessions of 2025, 2026, and 2027. Each interim report shall include a record of pilot program activities and accomplishments, including: (1) Outreach and training of community health workers; and (2) Services provided to program participants by a community health worker. (g) The department of health shall submit a final report on the rural community health worker pilot program, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2028. The final report shall include: (1) A record of pilot program activities and accomplishments, including: (A) Outreach and training of community health workers; and (B) Services provided to program participants by a community health worker; and (2) A recommendation on whether to extend the pilot program beyond three years. (h) For the purposes of this section: "Community health worker" means a frontline health worker who is a trusted member of the community in which the community health worker lives, is from the community, or who has an unusually close understanding of the community served that enables the community health worker to: (1) Build trusted relationships; (2) Serve as a liaison between health and social services and the community; (3) Facilitate access to services; and (4) Improve the quality and cultural competence of service delivery. "Program participant" means a resident of a rural community in the State who requests services by a community health worker through the rural community health worker pilot program. "Rural" means an area that is currently served by a critical access hospital as defined in section 346-1, Hawaii Revised Statutes. 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 2024-2025 for the rural community health worker pilot program, established pursuant to section 2 of this Act. The sum appropriated shall be expended by the department of health for the purposes of this Act. SECTION 4. In accordance with section 9 of article VII of the Hawaii State Constitution and sections 37-91 and 37-93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in Act 164, Regular Session of 2023, and this Act will cause the state general fund expenditure ceiling for fiscal year 2024-2025 to be exceeded by $ or per cent. This current declaration takes into account general fund appropriations authorized for fiscal year 2024-2025 in Act 164, Regular Session of 2023, and this Act only. The reasons for exceeding the general fund expenditure ceiling are that: (1) The appropriation made in this Act is necessary to serve the public interest; and (2) The appropriation made in this Act meets the needs addressed by this Act. SECTION 5. This Act shall take effect on July 1, 3000. |
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| 47 | + | SECTION 1. The legislature finds that community health workers connect rural, underserved communities with programs and services that impact social determinants of health and address factors such as access to health care, prevention, outreach, and training. Often serving in rural, underserved communities, community health workers spend a significant portion of their time doing telehealth and behavioral health, outreach such as assisting individuals to apply for medical insurance, providing health education resources, and locating work opportunities. Other community health workers may serve as translators, assisting their communities to navigate health care and social service systems. In 2021, the legislature introduced Senate Bill No. 858, Regular Session of 2021, serving as the first attempt to certify all community health workers. However, concerns raised during the legislative process deemed the certification process premature. Subsequently, the legislature introduced Senate Bill No. 2882, Regular Session of 2022 (S.B. No. 2882), which proposed a community health worker certification program to improve the quality of care and access to health care for residents in the state, especially in rural areas. While S.B. No. 2882 intended to recognize the important work community health workers perform for the State, the measure did not pass. However, the legislature adopted Senate Concurrent Resolution No. 2, Regular Session of 2022, which requested the auditor to conduct a sunrise review of the certification and regulation of community health workers. Accordingly, the auditor conducted a sunrise review of the certification and regulation of community health workers in September 2022. The auditor found that existing regulations under the Hawaii Regulatory Licensing Reform Act require professions reasonably relating to health, safety, or welfare of consumers to be subjected to state oversight. Although the auditor noted that S.B. No. 2882 had an intended benefit to the profession of community health workers, regulation is not needed for consumer protection, as the types of services provided by community health workers do not reasonably endanger the health, safety, or welfare of those benefiting from their services. Additionally, the auditor found that there were no past or ongoing complaints against community health workers or unreasonable barriers to entering the profession. Therefore, the auditor determined that mandatory statewide certification for community health workers would be inconsistent with existing state policy relating to the regulation of new professions and vocations. The legislature further finds that there continues to be a great need for community health workers, especially in rural and underserved communities that do not have reliable access to health education, resources, or job opportunities. As a critical intermediary between residents and health care and social services, community health workers have a unique understanding of their community needs and accessibility to services. Establishing a clear role, including major responsibilities and scope of work, will allow community health workers to continue their valuable work to communities statewide. Therefore, the purpose of this Act is to establish a three-year Kaʻū community health worker pilot program. SECTION 2. (a) The department of health shall establish and administer a three-year community health worker pilot program in Kaʻū, Hawaiʻi county, to provide outreach, education, training, and navigation to individuals residing in Kaʻū and to address social determinants of health, by a community health worker. (b) Community health workers participating in the Kaʻū community health worker pilot program may provide the following services: (1) Health education and outreach: (A) Community health workers shall conduct health education programs within the Kaʻū community to promote health awareness, disease prevention, and healthy lifestyle practices; and (B) Provide information on available health care services, resources, and programs to community members; (2) Individual support and assistance: (A) Community health workers shall offer assistance to individuals in navigating the health care system, including accessing health care facilities, appointments, and follow-up care; and (B) Provide guidance and support for individuals in managing chronic conditions, medication adherence, and lifestyle modifications for improved health outcomes; (3) Cultural competency and advocacy: (A) Community health workers shall demonstrate cultural sensitivity and competence in their interactions with diverse populations within their community; and (B) Advocate for the health needs and concerns of community members to health care providers, institutions, and policymakers; and (4) Data collection and reporting: (A) Community health workers shall maintain accurate records of educational activities and individual interactions; and (B) Submit periodic reports on community health trends, needs, and program effectiveness to relevant health authorities or agencies. (c) The services of the pilot program pursuant to this section shall be provided by community health workers who shall be recruited, trained, assigned, and supervised by an entity contracted by the department of health to organize and implement the pilot program. (d) The department of health shall enter into a contract with a nonprofit organization to recruit, train, and supervise community health workers and to oversee the pilot program; provided that existing department of health personnel may be assigned to fulfill administrative and fiscal responsibilities of the pilot program. Any nonprofit organizations contracted under this subsection shall have: (1) A history of providing community empowerment, capacity building, collaborative partnerships, and health education to the Kaʻū community; (2) The knowledge and experience necessary to provide community health worker services to program participants; and (3) A board of directors and staff team consisting of a majority of residents currently residing in Kaʻū, Hawaiʻi county. (e) With the assistance of the nonprofit organization contracted under subsection (d), the department of health shall submit annual reports on the development and administration of the Kaʻū community health worker pilot program, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular sessions of 2025, 2026, and 2027. The report shall include a record of pilot program activities and accomplishments, including: (1) Outreach and training of community health workers; and (2) Services provided to program participants by a community health worker. (f) The department of health shall submit a final report on the Kaʻū community health worker pilot program, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2028. The report shall include: (1) A record of pilot program activities and accomplishments, including: (A) Outreach and training of community health workers; and (B) Services provided to program participants by a community health worker; and (2) A recommendation on whether to extend the program beyond three years. (g) For the purposes of this section: "Community health worker" means a frontline health worker who is a trusted member of the community in which the community health worker lives, is from the community, or who has an unusually close understanding of the community served that enables the community health worker to: (1) Build trusted relationships; (2) Serve as a liaison between health and social services and the community; (3) Facilitate access to services; and (4) Improve the quality and cultural competence of service delivery. "Program participant" means a resident of Kaʻū, Hawaiʻi county, who requests services by a community health worker through the Kaʻū community health worker pilot program. SECTION 3. In accordance with section 9 of article VII of the Hawaii State Constitution and sections 37-91 and 37-93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in Act 164, Regular Session of 2023, and this Act will cause the state general fund expenditure ceiling for fiscal year 2024-2025 to be exceeded by $ or per cent. This current declaration takes into account general fund appropriations authorized for fiscal year 2024-2025 in Act 164, Regular Session of 2023, and this Act only. The reasons for exceeding the general fund expenditure ceiling are that: (1) The appropriation made in this Act is necessary to serve the public interest; and (2) The appropriation made in this Act meets the needs addressed by this Act. 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 2024-2025 for the Kaʻū community health worker pilot program, established pursuant to section 2 of this Act. 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, 2024. INTRODUCED BY: _____________________________ |
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