Hawaii 2025 Regular Session

Hawaii House Bill HB819 Compare Versions

Only one version of the bill is available at this time.

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1	1	HOUSE OF REPRESENTATIVES H.B. NO. 819 THIRTY-THIRD LEGISLATURE, 2025 STATE OF HAWAII A BILL FOR AN ACT relating to disability health disparity. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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3	3	HOUSE OF REPRESENTATIVES H.B. NO. 819
4	4	THIRTY-THIRD LEGISLATURE, 2025
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7	7	HOUSE OF REPRESENTATIVES
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9	9	H.B. NO.
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13	13	THIRTY-THIRD LEGISLATURE, 2025
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17	17	STATE OF HAWAII
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31	31	A BILL FOR AN ACT
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37	37	relating to disability health disparity.
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43	43	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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47	47	SECTION 1. The legislature finds that adults with intellectual or developmental disabilities experience disproportionate health disparities compared to those without disabilities. Individuals with intellectual or developmental disabilities are more likely than their peers without disabilities to have fair or poor health, be considered obese, and be diagnosed with chronic diseases, such as diabetes. Intellectual and developmental disabilities are life-long differences that typically arise before adulthood and can uniquely influence the trajectory of an individual's life, including their physical, intellectual, behavioral, and emotional development. The state council on developmental disabilities was created to advocate for and improve and protect the lives of individuals with intellectual or developmental disabilities in the State. Decades of research has clearly established that people of minority groups living in the United States receive poor health care and have poor health outcomes resulting from social determinants of health. On a national level, racial and ethnic disparities in access to health care and health outcomes are a persistent, pervasive public health problem. In the State, underserved populations, such as Native Hawaiian and Pacific Islanders, have been historically underrepresented in health care, as data does not accurately reflect the health disparities currently faced by this group. Additionally, individuals from the neighbor islands are also underrepresented and underserved, as access to health care resources and services are limited. However, even less is known about the extent of racial and ethnic health disparities among adults with intellectual or developmental disabilities. Accordingly, there is an urgent need to create an updated, accurate set of data that reflects the State's unique needs to assist certain agencies to better understand the needs of individuals with intellectual or developmental disabilities in their communities. The legislature further finds troubling gaps in the health disparities of people with intellectual or developmental disabilities and their social determinants of health in the State. Certain recent health surveys in the State and existing related initiatives do not segregate data pertaining to individuals with intellectual or developmental disabilities, nor is the data publicly available. Presently, the State relies on prevalence rate data from the federal government published in 1994-1995 that does not reflect the State's population and its specific needs. The State's prevalence rate is 1.58 per cent, which equals approximately twenty-two thousand people who have an intellectual or developmental disability. Additionally, the only substantial data the state council on developmental disabilities collects on intellectual or developmental disabilities is through the medicaid waiver program, which serves approximately three thousand people. As there is a gap of approximately nineteen thousand people who may have an intellectual or developmental disability in the State, there is little information on quality of life, health care access, and health care outcomes for unaccounted individuals with intellectual or developmental disabilities. Accordingly, further research is needed to understand the health disparities of people with intellectual or developmental disabilities and their social determinants of health. It is therefore imperative for the State to establish fundamental baseline data for service evaluation, policy development, and research to serve the current and future needs of individuals with intellectual or developmental disabilities. Accurate, current data will also help the State provide culturally appropriate health care, address barriers to health care access, reduce health disparities, increase employment opportunities, and support individuals with developmental or intellectual disabilities to live healthy lives in the community. Therefore, the purpose of this Act is to appropriate funds and require the state council on developmental disabilities to study the health disparities experienced by individuals with intellectual or developmental disabilities in the State to yield much needed results to help guide the future of public health policy and practice. SECTION 2. (a) The state council on developmental disabilities shall collect comprehensive data to identify gaps in social determinants of health, especially in the areas of health care access and quality and economic stability, that affect health outcomes and health disparities experienced by individuals with intellectual or development disabilities in the State that can be addressed with policy, legislative, or stakeholder action, and shall submit a report to the legislature no later than twenty days prior to the convening of the regular session of 2027. The report shall include: (1) A definition of the State's intellectual or developmental disability population for public health administration purposes, including the health conditions, duration, and level of severity required to qualify for disability status; (2) A definition of the social determinants of health as used by the United States Department of Health and Human Services; (3) Population-level differences in the State between individuals with and without intellectual or developmental disabilities on health indicators and social determinants of health, including: (A) Access to necessary health care; (B) Access to preventive health care, including wellness programs and emotional support services; (C) Health behaviors, including the percentage of individuals who engage in physical activities or smoke cigarettes; (D) Health status and outcomes, including the percentage of individuals who are considered obese or diagnosed with chronic diseases, including diabetes, hypertension, and cardiovascular diseases; (E) Drivers of health outcomes, including the impetus to seek health care and how individuals seek health care; (F) Emergency preparedness, including evacuation planning and ability; (G) Health insurance coverage; (H) Social determinants of health and health outcomes, including household income, employment status, education level, access to health information technology tools and systems, access to transportation, and the social and community environment; and (I) Other indicators and determinants that contribute to an individual's physical and mental health; (4) Factors contributing to the population-level differences, including race, ethnicity, gender, age, county of residence, and economic and social disadvantages and discrimination; (5) A determination of the population-level differences and contributing factors that are preventable or avoidable; (6) Any other information that would assist the State in determining safe, equitable, and culturally appropriate public health actions that would improve health care and address the health disparities experienced by individuals in the State with developmental or intellectual disabilities; and (7) Proposed legislation, including best practices, for the State to reduce the health disparities experienced by individuals in the State with developmental or intellectual disabilities. (b) In preparing the report, the state council on developmental disabilities may consult with community stakeholders on the following: (1) Improvements to provider training about intellectual or developmental disabilities; (2) Life experiences of individuals with intellectual or developmental disabilities; (3) Accessibility mandates for health infrastructure that include the needs of individuals with intellectual or developmental disabilities; (4) Communication guidelines and standards for health care providers to communicate with individuals with intellectual or developmental disabilities; and (5) Other topics as deemed relevant by the state council on developmental disabilities. (c) For the purposes of this Act: "Health disparities" means population-level differences in health outcomes that are related to a history of social, economic, or environmental disadvantages that are avoidable and not primarily caused by underlying health conditions that led to the disability. "Intellectual or developmental disabilities" means a lifelong difference that typically arises before adulthood that uniquely influences the trajectory of the individual's physical, intellectual, behavioral, and emotional development and impacts how individuals experience the world around them. 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 2025-2026 and the same sum or so much thereof as may be necessary for fiscal year 2026-2027 for the state council on developmental disabilities to collect comprehensive data and compile and submit to the legislature a report focused on the health disparities experienced by individuals with developmental or intellectual disabilities in the State prior to the convening of the regular session of 2027. The sums appropriated shall be expended by the department of health for the purposes of this Act. SECTION 4. This Act shall take effect on July 1, 2025. INTRODUCED BY: _____________________________
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49	49	SECTION 1. The legislature finds that adults with intellectual or developmental disabilities experience disproportionate health disparities compared to those without disabilities. Individuals with intellectual or developmental disabilities are more likely than their peers without disabilities to have fair or poor health, be considered obese, and be diagnosed with chronic diseases, such as diabetes. Intellectual and developmental disabilities are life-long differences that typically arise before adulthood and can uniquely influence the trajectory of an individual's life, including their physical, intellectual, behavioral, and emotional development. The state council on developmental disabilities was created to advocate for and improve and protect the lives of individuals with intellectual or developmental disabilities in the State.
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51	51	Decades of research has clearly established that people of minority groups living in the United States receive poor health care and have poor health outcomes resulting from social determinants of health. On a national level, racial and ethnic disparities in access to health care and health outcomes are a persistent, pervasive public health problem. In the State, underserved populations, such as Native Hawaiian and Pacific Islanders, have been historically underrepresented in health care, as data does not accurately reflect the health disparities currently faced by this group. Additionally, individuals from the neighbor islands are also underrepresented and underserved, as access to health care resources and services are limited. However, even less is known about the extent of racial and ethnic health disparities among adults with intellectual or developmental disabilities. Accordingly, there is an urgent need to create an updated, accurate set of data that reflects the State's unique needs to assist certain agencies to better understand the needs of individuals with intellectual or developmental disabilities in their communities.
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53	53	The legislature further finds troubling gaps in the health disparities of people with intellectual or developmental disabilities and their social determinants of health in the State. Certain recent health surveys in the State and existing related initiatives do not segregate data pertaining to individuals with intellectual or developmental disabilities, nor is the data publicly available. Presently, the State relies on prevalence rate data from the federal government published in 1994-1995 that does not reflect the State's population and its specific needs. The State's prevalence rate is 1.58 per cent, which equals approximately twenty-two thousand people who have an intellectual or developmental disability. Additionally, the only substantial data the state council on developmental disabilities collects on intellectual or developmental disabilities is through the medicaid waiver program, which serves approximately three thousand people. As there is a gap of approximately nineteen thousand people who may have an intellectual or developmental disability in the State, there is little information on quality of life, health care access, and health care outcomes for unaccounted individuals with intellectual or developmental disabilities.
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55	55	Accordingly, further research is needed to understand the health disparities of people with intellectual or developmental disabilities and their social determinants of health. It is therefore imperative for the State to establish fundamental baseline data for service evaluation, policy development, and research to serve the current and future needs of individuals with intellectual or developmental disabilities. Accurate, current data will also help the State provide culturally appropriate health care, address barriers to health care access, reduce health disparities, increase employment opportunities, and support individuals with developmental or intellectual disabilities to live healthy lives in the community.
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57	57	Therefore, the purpose of this Act is to appropriate funds and require the state council on developmental disabilities to study the health disparities experienced by individuals with intellectual or developmental disabilities in the State to yield much needed results to help guide the future of public health policy and practice.
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59	59	SECTION 2. (a) The state council on developmental disabilities shall collect comprehensive data to identify gaps in social determinants of health, especially in the areas of health care access and quality and economic stability, that affect health outcomes and health disparities experienced by individuals with intellectual or development disabilities in the State that can be addressed with policy, legislative, or stakeholder action, and shall submit a report to the legislature no later than twenty days prior to the convening of the regular session of 2027. The report shall include:
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61	61	(1) A definition of the State's intellectual or developmental disability population for public health administration purposes, including the health conditions, duration, and level of severity required to qualify for disability status;
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63	63	(2) A definition of the social determinants of health as used by the United States Department of Health and Human Services;
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65	65	(3) Population-level differences in the State between individuals with and without intellectual or developmental disabilities on health indicators and social determinants of health, including:
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67	67	(A) Access to necessary health care;
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69	69	(B) Access to preventive health care, including wellness programs and emotional support services;
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71	71	(C) Health behaviors, including the percentage of individuals who engage in physical activities or smoke cigarettes;
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73	73	(D) Health status and outcomes, including the percentage of individuals who are considered obese or diagnosed with chronic diseases, including diabetes, hypertension, and cardiovascular diseases;
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75	75	(E) Drivers of health outcomes, including the impetus to seek health care and how individuals seek health care;
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77	77	(F) Emergency preparedness, including evacuation planning and ability;
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79	79	(G) Health insurance coverage;
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81	81	(H) Social determinants of health and health outcomes, including household income, employment status, education level, access to health information technology tools and systems, access to transportation, and the social and community environment; and
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83	83	(I) Other indicators and determinants that contribute to an individual's physical and mental health;
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85	85	(4) Factors contributing to the population-level differences, including race, ethnicity, gender, age, county of residence, and economic and social disadvantages and discrimination;
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87	87	(5) A determination of the population-level differences and contributing factors that are preventable or avoidable;
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89	89	(6) Any other information that would assist the State in determining safe, equitable, and culturally appropriate public health actions that would improve health care and address the health disparities experienced by individuals in the State with developmental or intellectual disabilities; and
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91	91	(7) Proposed legislation, including best practices, for the State to reduce the health disparities experienced by individuals in the State with developmental or intellectual disabilities.
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93	93	(b) In preparing the report, the state council on developmental disabilities may consult with community stakeholders on the following:
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95	95	(1) Improvements to provider training about intellectual or developmental disabilities;
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97	97	(2) Life experiences of individuals with intellectual or developmental disabilities;
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99	99	(3) Accessibility mandates for health infrastructure that include the needs of individuals with intellectual or developmental disabilities;
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101	101	(4) Communication guidelines and standards for health care providers to communicate with individuals with intellectual or developmental disabilities; and
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103	103	(5) Other topics as deemed relevant by the state council on developmental disabilities.
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105	105	(c) For the purposes of this Act:
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107	107	"Health disparities" means population-level differences in health outcomes that are related to a history of social, economic, or environmental disadvantages that are avoidable and not primarily caused by underlying health conditions that led to the disability.
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109	109	"Intellectual or developmental disabilities" means a lifelong difference that typically arises before adulthood that uniquely influences the trajectory of the individual's physical, intellectual, behavioral, and emotional development and impacts how individuals experience the world around them.
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111	111	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 2025-2026 and the same sum or so much thereof as may be necessary for fiscal year 2026-2027 for the state council on developmental disabilities to collect comprehensive data and compile and submit to the legislature a report focused on the health disparities experienced by individuals with developmental or intellectual disabilities in the State prior to the convening of the regular session of 2027.
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113	113	The sums appropriated shall be expended by the department of health for the purposes of this Act.
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115	115	SECTION 4. This Act shall take effect on July 1, 2025.
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119	119	INTRODUCED BY: _____________________________
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121	121	INTRODUCED BY:
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123	123	_____________________________
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129	129	Report Title: SCDD; Developmental Disabilities; Intellectual Disabilities; Health Disparities; Health Equity; Report; Appropriations Description: Requires the State Council on Developmental Disabilities to collect data and submit to the Legislature a report focused on the health disparities experienced by individuals with intellectual or developmental disabilities in the State prior to the convening of the Regular Session of 2027. Appropriates funds. The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
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137	137	Report Title:
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139	139	SCDD; Developmental Disabilities; Intellectual Disabilities; Health Disparities; Health Equity; Report; Appropriations
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143	143	Description:
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145	145	Requires the State Council on Developmental Disabilities to collect data and submit to the Legislature a report focused on the health disparities experienced by individuals with intellectual or developmental disabilities in the State prior to the convening of the Regular Session of 2027. Appropriates funds.
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153	153	The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.