HOUSE OF REPRESENTATIVES	H.C.R. NO.	76
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

 

 

requesting the Department of Health to convene a complex NEEDS patient working group to address the needS, services, and funding for complex NEEDS patientS who have multiple SIGNIFICANT BUT NOT SEVERE diagnoses of chronic conditions, INCLUDING substance use disorders, mental health disorders, or chronic physical ILLNESS conditions.

 

 

 

     WHEREAS, complex needs patients – those with co-occurring substance use disorders, mental health disorders, and chronic physical illness conditions – represent a high-need, high-cost population that requires a modern, integrated care strategy; and

 

     WHEREAS, complex needs patients often cycle through fragmented, siloed health care systems that fail to produce meaningful outcomes while generating significant costs, leading to frequent emergency room visits, repeated hospitalizations, justice system involvement, homelessness, and poor health outcomes, placing an outsized burden on social services, including Medicaid and Medicare; and

 

     WHEREAS, in Hawaii, approximately fifty-four thousand adults have chronic conditions of co-occurring mental health and substance use disorders, often coupled with chronic physical illnesses resulting in two or more multiple chronic conditions, and if left untreated, these conditions become severe; and

 

     WHEREAS, residential, therapeutic living, and intensive outpatient programs for complex needs patients achieve better outcomes when treated simultaneously in integrated care models that combine medical, behavioral, and social treatments in coordinated care plans delivered by multidisciplinary teams; and

 

     WHEREAS, an evidenced-based pilot program would position Hawaii to compete for federal grants, and align Medicaid and Medicare funding to support integrated services that would effectively close the gaps in care; and

 

     WHEREAS, the infrastructure already exists because substance use disorder treatment models have staff with expertise to treat co-occurring "severe" mental health disorders and substance abuse; and

 

     WHEREAS, some substance abuse treatment programs have integrated models that also treat chronic physical illness conditions but only address patients with severe mental illness; and

 

     WHEREAS, a working group convened by the Department of Health would help to develop collaborative processes between the Department of Health and appropriate agencies; and

 

     WHEREAS, this body believes developing integrated approaches to treat substance abuse, mental health, and chronic disease conditions in one setting would improve engagement, reduce fragmentation, lower relapse and hospitalization rates, and support long-term recovery; now, therefore,

 

     BE IT RESOLVED by the House of Representatives of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2026, the Senate concurring, that the Department of Health is requested to convene a Complex Needs Patient Working Group to address the needs, services, and funding for complex needs patients who have multiple significant but not severe diagnoses of chronic conditions, including substance use disorders, mental health disorders, or chronic physical illness conditions; and

 

     BE IT FURTHER RESOLVED that the Director of Health, or the Director's designee, is requested to chair the Complex Needs Patient Working Group, work with various departments, and invite members that could provide assistance, such as from the Hawaii Substance Abuse Coalition, other substance use or mental health disorder providers, or health care facilities, as appropriate, as determined by the Director of Health or the Director's designee; and

 

     BE IT FURTHER RESOLVED that the Complex Needs Patient Working Group is requested to consider the following:

 

     (1)  The need, evidenced-based services to address the need, and recommendations for funding to operate, or contract for the operation of one or more integrated residential treatment and therapeutic living facilities to serve complex needs patients;

 

     (2)  Comprehensive substance use disorder treatments via residential and therapeutic living programs, including medication-assisted treatment;

 

     (3)  Mental health evaluation, medication management, psychotherapy, and crisis stabilization;

 

     (4)  On-site or immediately available primary health care, chronic disease management, and coordination with specialty medical care providers;

 

     (5)  Integrated nursing services;

 

     (6)  Care coordination, case management, and discharge planning;

 

     (7)  Peer support services;

 

     (8)  Recovery-oriented, trauma-informed, and culturally responsive programming;

 

     (9)  Philosophy regarding the pursuit of abstinence to improve functionality; and

 

    (10)  Assistance with housing, employment, and social determinants of health; and

 

     BE IT FURTHER RESOLVED that the Department of Health is requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2027; and

 

     BE IT FURTHER RESOLVED that a certified copy of this Concurrent Resolution be transmitted to the Director of Health.

 

 

 

	OFFERED BY:	_____________________________

Report Title: 

DOH; Complex Needs Patient Working Group; Mental Health Disorders; Substance Use Disorders; Chronic Physical Illness