| 47 | | - | SECTION 1. The legislature finds that homelessness continues to be one of Hawaii's most challenging social problems. The 2022 Hawaii statewide homeless point-in-time count identified 5,973 persons in the State experiencing homelessness. Although this represents a decrease of 7.5 per cent since 2020 and is the lowest statewide count since 2010, the costs of caring for homeless persons are rising. The legislature recognizes that in the absence of regular medical and dental care, many homeless persons are forced to seek emergency services. Each year, homeless persons in the State make tens of thousands of emergency hospital visits. Hospital stays for homeless persons cost state hospitals hundreds of millions of dollars per year, and many of the hospitals' costs for homeless care go uncompensated. Ambulance services alone for homeless patients can cost up to $1,000 per transport. The legislature notes that many states are now using mobile clinics to address the health care needs of their homeless communities. Large cities like Dallas, Texas; Denver, Colorado; New Orleans, Louisiana; and San Jose, California; use mobile clinics to provide medical care and social services. They offer routine care, dental care, preventive care, disease testing, referral services, and other forms of care to persons who might not otherwise have access. Mobile clinics also allow providers to tailor their services to specific communities and offer flexible care for persons who are isolated, vulnerable, and displaced. The legislature also finds that mobile clinics are more cost-effective than other health services. Estimates show that communities using mobile clinics experience an average of six hundred fewer emergency room visits each year. The routine and preventive care the clinics offer can also reduce the amount of care a person may need over their lifetime. According to Mobile Health Map, for every $1 spent on mobile health, a state will save $12. Accordingly, the purpose of this Act is to appropriate funds to purchase, staff, and operate two mobile clinics to serve homeless persons in the State's ohana zones. SECTION 2. (a) The department of human services shall purchase, staff, and operate two mobile clinics to serve homeless persons residing in ohana zones. The mobile clinic services shall be procured pursuant to chapter 103F, Hawaii Revised Statutes. (b) The staff of each mobile clinic may include: (1) One primary care provider; (2) One nurse; (3) One pharmacist; (4) One psychiatrist; (5) One social worker; (6) One outreach worker; (7) Students pursuing degrees in medicine or nursing; and (8) Other staff as needed. (c) The mobile clinics may provide services including: (1) Non-emergency medical services for chronic, acute, and episodic conditions; (2) Testing for sexually transmitted diseases, human immunodeficiency virus, and hepatitis; (3) Family planning; (4) Child and family services; (5) Behavioral health and substance abuse services; (6) Mental health services; (7) Dental care; (8) Referral services; (9) Shower and laundry services; (10) Clean clothing; (11) Health insurance enrollment; (12) Pharmacy services; (13) Street medicine; and (14) Other assistive services. (d) Subject to the availability of funds, the director of human services may designate other political subdivisions or private organizations to participate in the mobile clinics established pursuant to this Act; provided that moneys provided to any other political subdivision or private organization may be by a grant or grant-in-aid as required pursuant to chapter 42F, Hawaii Revised Statutes. (e) For purposes of this Act: "Ohana zone" means a place: (1) That has a program to address the basic needs of persons experiencing homelessness; and (2) Where wrap-around services, social and health care services, transportation, and other services may be offered with the goals of alleviating poverty and transitioning individuals experiencing homelessness into affordable housing. "Street medicine" means the practice of directly delivering health care and related services to persons found on the streets, in parks, along river banks, on beaches, and in abandoned buildings. 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 to purchase, staff, and operate two mobile clinics to serve homeless persons residing in ohana zones; provided that no funds appropriated pursuant to this Act shall be made available unless matched on a dollar-for-dollar basis by other sources of funding; provided further that the department of human services shall identify and secure other sources of funding, including federal funding, to provide the matching funds. The sum appropriated shall be expended by the department of human services 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 H.B. No. , will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. In addition, the appropriation contained in this Act will cause the general fund expenditure ceiling for fiscal year 2024‑2025 to be further exceeded by $ or per cent. The combined total amount of general fund appropriations contained in only these two Acts will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. 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. 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 ohana zones pilot program established pursuant to Act 209, Session Laws of Hawaii 2018, as amended by Act 128, Session Laws of Hawaii 2019, as amended by Act 235 Session Laws of Hawaii 2022, including expenses relating to staffing, facility construction, provision of services, and administrative costs. The sum appropriated shall be expended by the office of the governor for the purposes of this Act; provided that the governor shall transfer the expenditure authority to designated executive branch departments or agencies within a reasonable time. Notwithstanding any other law to the contrary, the governor may transfer all or a portion of the appropriation in this section to the governor's designated executive branch agencies for expenditures incurred in implementing the ohana zones pilot program. The governor's designated executive branch agencies may expend any appropriation transferred pursuant to this section for the performance of its duties under the ohana zones pilot program. SECTION 2. 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 H.B. No. , will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. In addition, the appropriation contained in this Act will cause the general fund expenditure ceiling for fiscal year 2024‑2025 to be further exceeded by $ or per cent. The combined total amount of general fund appropriations contained in only these two Acts will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. 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 3. This Act shall take effect on July 1, 2024. INTRODUCED BY: _____________________________ |
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| 57 | | - | Accordingly, the purpose of this Act is to appropriate funds to purchase, staff, and operate two mobile clinics to serve homeless persons in the State's ohana zones. |
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| 58 | | - | |
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| 59 | | - | SECTION 2. (a) The department of human services shall purchase, staff, and operate two mobile clinics to serve homeless persons residing in ohana zones. The mobile clinic services shall be procured pursuant to chapter 103F, Hawaii Revised Statutes. |
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| 60 | | - | |
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| 61 | | - | (b) The staff of each mobile clinic may include: |
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| 62 | | - | |
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| 63 | | - | (1) One primary care provider; |
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| 64 | | - | |
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| 65 | | - | (2) One nurse; |
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| 66 | | - | |
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| 67 | | - | (3) One pharmacist; |
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| 68 | | - | |
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| 69 | | - | (4) One psychiatrist; |
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| 70 | | - | |
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| 71 | | - | (5) One social worker; |
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| 72 | | - | |
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| 73 | | - | (6) One outreach worker; |
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| 74 | | - | |
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| 75 | | - | (7) Students pursuing degrees in medicine or nursing; and |
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| 76 | | - | |
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| 77 | | - | (8) Other staff as needed. |
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| 78 | | - | |
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| 79 | | - | (c) The mobile clinics may provide services including: |
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| 80 | | - | |
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| 81 | | - | (1) Non-emergency medical services for chronic, acute, and episodic conditions; |
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| 82 | | - | |
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| 83 | | - | (2) Testing for sexually transmitted diseases, human immunodeficiency virus, and hepatitis; |
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| 84 | | - | |
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| 85 | | - | (3) Family planning; |
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| 86 | | - | |
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| 87 | | - | (4) Child and family services; |
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| 88 | | - | |
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| 89 | | - | (5) Behavioral health and substance abuse services; |
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| 90 | | - | |
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| 91 | | - | (6) Mental health services; |
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| 92 | | - | |
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| 93 | | - | (7) Dental care; |
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| 94 | | - | |
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| 95 | | - | (8) Referral services; |
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| 96 | | - | |
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| 97 | | - | (9) Shower and laundry services; |
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| 98 | | - | |
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| 99 | | - | (10) Clean clothing; |
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| 100 | | - | |
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| 101 | | - | (11) Health insurance enrollment; |
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| 102 | | - | |
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| 103 | | - | (12) Pharmacy services; |
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| 104 | | - | |
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| 105 | | - | (13) Street medicine; and |
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| 106 | | - | |
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| 107 | | - | (14) Other assistive services. |
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| 108 | | - | |
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| 109 | | - | (d) Subject to the availability of funds, the director of human services may designate other political subdivisions or private organizations to participate in the mobile clinics established pursuant to this Act; provided that moneys provided to any other political subdivision or private organization may be by a grant or grant-in-aid as required pursuant to chapter 42F, Hawaii Revised Statutes. |
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| 110 | | - | |
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| 111 | | - | (e) For purposes of this Act: |
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| 112 | | - | |
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| 113 | | - | "Ohana zone" means a place: |
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| 114 | | - | |
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| 115 | | - | (1) That has a program to address the basic needs of persons experiencing homelessness; and |
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| 116 | | - | |
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| 117 | | - | (2) Where wrap-around services, social and health care services, transportation, and other services may be offered with the goals of alleviating poverty and transitioning individuals experiencing homelessness into affordable housing. |
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| 118 | | - | |
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| 119 | | - | "Street medicine" means the practice of directly delivering health care and related services to persons found on the streets, in parks, along river banks, on beaches, and in abandoned buildings. |
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| 120 | | - | |
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| 121 | | - | 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 to purchase, staff, and operate two mobile clinics to serve homeless persons residing in ohana zones; provided that no funds appropriated pursuant to this Act shall be made available unless matched on a dollar-for-dollar basis by other sources of funding; provided further that the department of human services shall identify and secure other sources of funding, including federal funding, to provide the matching funds. |
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| 122 | | - | |
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| 123 | | - | The sum appropriated shall be expended by the department of human services for the purposes of this Act. |
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| 124 | | - | |
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| 125 | | - | 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 H.B. No. , will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. In addition, the appropriation contained in this Act will cause the general fund expenditure ceiling for fiscal year 2024‑2025 to be further exceeded by $ or per cent. The combined total amount of general fund appropriations contained in only these two Acts will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. The reasons for exceeding the general fund expenditure ceiling are that: |
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| 57 | + | SECTION 2. 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 H.B. No. , will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. In addition, the appropriation contained in this Act will cause the general fund expenditure ceiling for fiscal year 2024‑2025 to be further exceeded by $ or per cent. The combined total amount of general fund appropriations contained in only these two Acts will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. The reasons for exceeding the general fund expenditure ceiling are that: |
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