SB 1322 Hawaii Senate · 2025 Regular Session

RELATING TO MENTAL HEALTH.

Summary

Requires the Department of Health to submit annual reports to the Legislature on emergency transportations and assisted community treatment petitions and orders, based on information provided by service providers and the Department of the Attorney General. Clarifies the procedures for emergency transportation, examination, and hospitalization for individuals who may be mentally ill or suffering from substance abuse who are imminently dangerous to self or others. Requires treatment providers to provide relevant information to the Attorney General for purposes of preparing an assisted community treatment petition. Amends the procedures for involuntary hospitalizations and assisted community treatment petitions. Clarifies the circumstances under which a subject of an assisted community treatment order can be administered medication over objection. Allows a single psychiatrist, rather than a panel of three, to provide administrative authorization for medical treatment over the objection of a patient who is in the custody of the Director of Health and in a psychiatric facility. (CD1)

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Jan 2025

Committee Review

Apr 2025

Senate Passage

Apr 2025

House Passage

Apr 2025

Signed into Law

Jun 2025

Introduced Jan 21, 2025 Signed Jun 25, 2025

Maddy AI version diff · 5 comparisons

What changed between versions

SB1322_SD1 → SB1322_SD2 · 10 edits

MAJOR

This bill updates Hawaii's mental health laws to modernize emergency procedures, clarify liability protections, and improve notice requirements for involuntary hospitalization. It introduces new emergency transport protocols, expands who can initiate emergency examinations, and modifies how patients are notified during crises. The changes aim to streamline mental health interventions while protecting patient rights and reducing legal risks for healthcare providers and government entities.

Scope change

The bill expands the scope of emergency procedures to include new categories of personnel who can initiate emergency transport and examination, and clarifies the role of crisis intervention officers in mental health emergencies.

REQUIREMENT

Added new emergency procedures for transporting individuals who may be mentally ill or dangerous to themselves or others, including specific protocols for law enforcement, court orders, and healthcare providers.

Modified notice requirements for emergency hospitalization to include health care surrogates and clarify when family notification can be waived by adult patients.

Removed the family court's authority to appoint legal guardians in involuntary hospitalization proceedings, leaving such appointments to chapter 560 requirements.

Modified administrative authorization for medical treatment over patient objection to be decided by a single psychiatrist rather than a panel.

Removed the requirement that psychiatric facilities wait for responses from interested parties before discharging patients under involuntary hospitalization.

Added requirements for assisted community treatment providers to coordinate with the department of the attorney general for petitions and treatment information sharing.

ELIGIBILITY

Modified criteria for involuntary hospitalization to require clear and convincing evidence for certain findings while maintaining beyond reasonable doubt standards for core criteria.

ENFORCEMENT

Added liability limits for state and local governments and healthcare professionals when performing emergency mental health procedures in the course of employment.

TIMELINE

Modified discharge timelines for emergency hospitalization from 72 hours to maintain the same timeframe but clarified procedures for when the clock resets.

DEFINITION

Added new definitions for 'qualified psychiatric examiner' and 'surrogate' to clarify who can conduct examinations and make healthcare decisions.

SB1322_HD2 → SB1322_SD1 · 10 edits

MAJOR

This bill updates Hawaii's mental health laws to clarify and expand emergency procedures for individuals who may be imminently dangerous to themselves or others. It establishes new liability protections for government entities and healthcare providers acting in good faith during emergencies, expands notice requirements to include health care surrogates, and modifies how involuntary hospitalization and assisted community treatment are initiated and administered.

Scope change

The bill expands the scope of emergency procedures to include crisis intervention officers and clarifies the roles of various stakeholders in mental health emergencies. It also removes the family court's authority to appoint legal guardians in involuntary hospitalization proceedings.

REQUIREMENT

Added liability protections for state, county, and healthcare providers acting in good faith during emergency mental health procedures, except in cases of willful misconduct, gross negligence, or recklessness.

Expanded emergency transportation procedures to allow law enforcement officers to temporarily detain individuals when unable to reach mental health emergency workers after three attempts.

Modified emergency hospitalization procedures to allow discharge without waiting for responses from interested parties to notice of intent to discharge.

Added requirements for notice of emergency transportation, examination, and hospitalization to be given to health care surrogates and clarified when family members can waive notice.

Added new administrative authorization process for medical treatment over patient objection that requires review by a single psychiatrist decision-maker rather than a panel.

Modified assisted community treatment procedures to clarify circumstances under which medication can be administered over a subject's objection.

Added requirement that involuntary civil commitment orders be forwarded to the Hawaii criminal justice data center for inclusion in the National Instant Criminal Background Check System database.

DEFINITION

Added new definitions for 'qualified psychiatric examiner' (licensed psychiatrist or advanced practice registered nurse with psychiatric certification) and 'surrogate' (person appointed under power of attorney or court order to make health care decisions).

Modified the definition of 'treatment' to include a broader range of emergency, outpatient, intermediate, domiciliary, and inpatient services and care.

ELIGIBILITY

Removed the family court's authority to appoint legal guardians or conservators in involuntary hospitalization proceedings, leaving such appointments subject to chapter 560, article V requirements.

SB1322_HD1 → SB1322_HD2 · 8 edits

MODERATE

This bill updates Hawaii's mental health laws to improve emergency procedures, reporting requirements, and assisted community treatment processes. It adds new definitions for qualified psychiatric examiners, requires annual reports from the Department of Health on emergency transportations and assisted community treatment outcomes, and clarifies when medication can be administered over a patient's objection. The changes aim to streamline procedures while maintaining patient safety and rights.

Scope change

The bill expands the scope of mental health reporting requirements and clarifies procedures for emergency transportation and involuntary hospitalization, affecting law enforcement officers, mental health providers, courts, and patients.

REQUIREMENT

Requires the Department of Health to submit annual reports on emergency transportations and assisted community treatment outcomes, including metrics on homelessness reduction, law enforcement involvement, and treatment effectiveness.

Clarifies emergency transportation procedures, requiring law enforcement to contact mental health emergency workers before detaining individuals, with specific conditions for temporary detention.

Requires treatment providers to provide relevant treatment information to the Attorney General for preparing assisted community treatment petitions.

Repeals Section 334-59, which previously governed emergency examination and hospitalization procedures, replacing it with more detailed new sections.

DEFINITION

Adds new definitions for 'qualified psychiatric examiner' (licensed psychiatrist or advanced practice registered nurse with psychiatric specialization) and 'surrogate' (person appointed under power of attorney or court order).

ENFORCEMENT

Amends involuntary hospitalization procedures to require more detailed notice to patients and their families, including rights to legal counsel and the ability to waive hearings.

Clarifies circumstances under which medication can be administered over a patient's objection during emergency examination, hospitalization, or assisted community treatment.

ELIGIBILITY

Updates criteria for assisted community treatment to include specific requirements about mental illness, danger to self or others, and inability to make informed decisions about treatment.

SB1322_CD1 → SB1322_HD1 · 8 edits

MODERATE

This bill updates Hawaii's mental health laws to clarify emergency procedures for transporting and examining individuals who may be mentally ill or dangerous to themselves or others. It establishes new liability protections for government entities and healthcare providers, expands notice requirements to include health care surrogates, removes the Family Court's authority to appoint guardians in involuntary hospitalization cases, and allows a single psychiatrist instead of a panel to authorize treatment over a patient's objection.

Scope change

The bill expands the scope of emergency procedures by creating new subparts for emergency transportation, examination, and hospitalization, while removing the requirement that psychiatric facilities wait for responses from interested parties before discharging involuntary patients.

REQUIREMENT

New emergency procedures for law enforcement officers, crisis intervention officers, and health care providers to transport individuals who are imminently dangerous to self or others to psychiatric facilities.

Expanded notice requirements during emergency hospitalization to include an individual's health care surrogate and allowed individuals to waive notice to family members.

Changed administrative authorization for medical treatment over objection from requiring a panel of three psychiatrists to allowing a single psychiatrist to provide authorization.

Removed the requirement that psychiatric facilities wait for responses from interested parties to a notice of intent to discharge before discharging an involuntary patient.

ENFORCEMENT

Liability protections for the State, counties, private organizations, and healthcare professionals from civil lawsuits related to emergency mental health procedures, except in cases of willful misconduct, gross negligence, or recklessness.

Removed the Family Court's authority to appoint a legal guardian or conservator in involuntary hospitalization proceedings.

DEFINITION

Added new definitions for 'qualified psychiatric examiner' and 'surrogate' to clarify who can conduct examinations and make health care decisions.

TIMELINE

Extended the effective date of the Act to December 31, 2050, significantly delaying implementation compared to typical legislative timelines.

SB1322 → SB1322_CD1 · 8 edits

MODERATE

This bill clarifies and updates Hawaii's mental health laws to improve emergency procedures, involuntary hospitalization, and assisted community treatment. It simplifies the process for transporting individuals in crisis, requires annual reporting on emergency transports and treatment outcomes, and allows a single psychiatrist to authorize medication over objection instead of a three-person panel. The changes aim to make mental health services more accessible and efficient while maintaining safety standards.

Scope change

The bill expands the scope of emergency procedures to include clearer protocols for law enforcement, court orders, and healthcare providers in transporting individuals who are imminently dangerous to themselves or others. It also broadens the definition of 'treatment' to include a wider range of services.

REQUIREMENT

Requires the Department of Health to submit annual reports on emergency transportations and assisted community treatment petitions to the legislature.

Changes emergency transportation procedures to allow law enforcement to detain individuals for up to three attempts to contact mental health workers before temporary detention.

Replaces the three-person panel requirement with a single psychiatrist for administrative authorization of medical treatment over patient objection.

ELIGIBILITY

Modifies involuntary hospitalization criteria to use clearer language about mental illness and imminent danger to self or others.

DEFINITION

Adds new definitions for 'qualified psychiatric examiner' and 'surrogate' to clarify who can make health care decisions.

TIMELINE

Extends emergency hospitalization release timeframe from 48 hours to 72 hours unless court proceedings are initiated.

TECHNICAL

Repeals the old Section 334-59 regarding emergency examination and hospitalization procedures and replaces it with new sections.

ENFORCEMENT

Requires treatment providers to share relevant information with the Department of the Attorney General for assisted community treatment petitions.

Floor votes

How they voted

This bill passed the Senate by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Apr 30, 2025

Lower · Passed

Passed Final Reading as amended in CD 1 with Representative(s) Belatti, Poepoe, Shimizu voting aye with reservations; Representative(s) Amato, Chun, Garrett, Grandinetti, Iwamoto, Perruso, Reyes Oda, Souza, Takenouchi voting no (9) and Representative(s) Cochran excused (1).

lower

Apr 30, 2025

Upper · Passed

Passed Final Reading, as amended (CD 1). Ayes, 25; Aye(s) with reservations: none . 0 No(es): none. 0 Excused: none.

upper

Apr 24, 2025

Lower · Passed

Reported from Conference Committee (Conf Com. Rep. No. 87) as amended in (CD 1).

lower

Apr 24, 2025

Introduced

48 Hrs. Notice (as amended CD 1) 04-30-25.

upper

Apr 24, 2025

Upper · Passed

Reported from Conference Committee as amended CD 1 (Conf. Com. Rep. No. 87).

upper

Apr 24, 2025

Lower · Passed

The Conference Committee recommends that the measure be Passed, with Amendments. The votes were as follows: 3 Ayes: Representative(s) Takayama, Garcia; Ayes with reservations: Representative(s) Poepoe; 0 Noes: none; and 0 Excused: none.

lower

Apr 24, 2025

Upper · Passed

The Conference committee recommends that the measure be PASSED, WITH AMENDMENTS. The votes of the Senate Conference Managers were as follows: 3 Aye(s): Senator(s) San Buenaventura, Elefante, Rhoads; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.

upper

Apr 23, 2025

Upper · Passed

Conference committee meeting to reconvene on 04-24-25 3:30PM; Conference Room 329.

upper

Apr 22, 2025

Upper · Passed

Conference committee meeting scheduled for 04-23-25 3:30PM; Conference Room 329.

upper

Apr 10, 2025

Amended

Senate disagrees with House amendments.

upper

Apr 10, 2025

Introduced

Received from House (Hse. Com. No. 680).

upper

Apr 8, 2025

Lower · Passed

Passed Third Reading as amended in HD 2 with Representative(s) Iwamoto voting aye with reservations; none voting no (0) and Representative(s) Cochran excused (1). Transmitted to Senate.

lower

Mar 25, 2025

Lower · Passed

The committee on JHA recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 10 Ayes: Representative(s) Tarnas, Poepoe, Belatti, Cochran, Hashem, Perruso, Takayama, Todd, Garcia; Ayes with reservations: Representative(s) Shimizu; 0 Noes: none; and 1 Excused: Representative(s) Kahaloa.

lower

Mar 19, 2025

Committee

Reported from HLT (Stand. Com. Rep. No. 1367) as amended in HD 1, recommending passage on Second Reading and referral to JHA.

lower

Mar 14, 2025

Lower · Passed

The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 9 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Chun, Marten, Olds, Takenouchi, Alcos, Garcia; Ayes with reservations: none; 0 Noes: none; and 0 Excused: none.

lower

Mar 6, 2025

Committee

Referred to HLT, JHA, referral sheet 19

lower

Mar 4, 2025

Introduced

Received from Senate (Sen. Com. No. 305) in amended form (SD 2).

lower

Mar 4, 2025

Upper · Passed

Report adopted; Passed Third Reading, as amended (SD 2). Ayes, 25; Aye(s) with reservations: none . Noes, 0 (none). Excused, 0 (none). Transmitted to House.

upper

Feb 26, 2025

Upper · Passed

The committee(s) on JDC recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in JDC were as follows: 4 Aye(s): Senator(s) Rhoads, Gabbard, Chang, San Buenaventura; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Awa.

upper

Feb 21, 2025

Upper · Passed

The committee(s) on JDC will hold a public decision making on 02-26-25 9:40AM; Conference Room 016 & Videoconference.

upper

Feb 14, 2025

Committee

Reported from HHS/PSM (Stand. Com. Rep. No. 590) with recommendation of passage on Second Reading, as amended (SD 1) and referral to JDC.

upper

Feb 7, 2025

Upper · Passed

The committee(s) on PSM recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in PSM were as follows: 5 Aye(s): Senator(s) Elefante, Wakai, Fukunaga, Rhoads, DeCorte; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none.

upper

Feb 7, 2025

Upper · Passed

The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 4 Aye(s): Senator(s) San Buenaventura, Aquino, Hashimoto, Keohokalole; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.

upper

Jan 31, 2025

Upper · Passed

The committee(s) on HHS/PSM has scheduled a public hearing on 02-07-25 3:10PM; Conference Room 225 & Videoconference.

upper

Jan 27, 2025

Committee

Referred to HHS/PSM, JDC.

upper

Jan 23, 2025

Introduced

Introduced and passed First Reading.

upper

Jan 21, 2025

Introduced

Pending Introduction.

upper

1 primary · 0 co-sponsors