RELATING TO TREATMENT FOR MENTAL ILLNESS.
HB593 establishes a two-year pilot program within the Department of Health’s Adult Mental Health Division to create one intensive mobile team serving up to 40 chronically houseless adults with serious brain disorders, with priority for people diagnosed with schizophrenia or schizoaffective disorder. The team would provide outreach and treatment in the community, including crisis response after hours, emergency room visits, coordination with hospitals and the behavioral health crisis center, medication initiation when appropriate, and efforts to secure housing and assisted community treatment orders. The program also contemplates continued contact if participants are hospitalized at the Hawaii State Hospital and allows the use of social work interns and advanced practice registered nurse students to expand capacity.
The bill requires the department to work with law enforcement, courts, hospitals, providers serving houseless individuals, mental health providers, and other stakeholders. It also directs the program to bill third-party payors, Medicare, or Medicaid when appropriate, and to report to the Legislature in 2026 and 2027 on participant outcomes such as arrests, hospitalizations, housing placements, medication starts, family reconnections, and assisted community treatment orders pursued and granted. The pilot is set to end on June 30, 2028, and the bill appropriates $1.3 million in each of fiscal years 2025-2026 and 2026-2027 to fund operating costs, equipment, and 8.1 FTE positions.
HB593 would create a new, temporary state mental health service model focused on outreach and treatment for a small, targeted population of chronically houseless adults with serious mental illness. It would expand the Department of Health’s responsibilities by authorizing a specialized mobile team, requiring interagency coordination, and establishing reporting obligations to the Legislature. The bill also appropriates general funds and creates specific positions, including clinical, psychiatric, nursing, social work, epidemiology, and program staff, thereby increasing state spending and staffing for behavioral health services.
The bill appears generally supportive in tone, reflecting an effort to address severe mental illness and houselessness through intensive outreach rather than relying solely on emergency or inpatient care. The absence of recorded committee testimony or votes in the provided materials means there is no documented opposition or support from hearings, but the structure of the bill suggests a policy approach aimed at treatment access, housing stabilization, and system coordination. Its referral to HSH/HLT and FIN indicates it was still moving through the committee process.
The main likely points of contention are the bill’s focus on a narrow population, the use of public funds for a pilot program, and the inclusion of law-enforcement-related coordination and assisted community treatment orders. Some stakeholders may question whether the program is sufficiently voluntary or whether it appropriately balances treatment, civil liberties, and public safety. Others may debate the effectiveness of a small pilot with only 40 participants, the reliance on state appropriations, and whether the Department of Health should prioritize this model over broader housing or community mental health investments.