HB816 creates a two-year pilot program allowing certain licensed paramedics in a county with a population of 100,000 or less to administer buprenorphine after giving naloxone to a patient experiencing a suspected opioid overdose. The bill is aimed at improving immediate post-overdose care by reducing withdrawal symptoms and increasing the likelihood that patients connect with treatment soon after an emergency medical services encounter.
The measure directs the Department of Health to establish clinical and operational protocols, approve training for paramedics, and designate treatment providers that can accept referrals within 24 to 48 hours. It also requires documentation and data collection so the department can evaluate the pilot and report results to the Legislature, with the possibility of statewide expansion if treatment resources become available. The bill includes a general fund appropriation for fiscal year 2026-2027 and sunsets the new authority on June 30, 2028, after which the prior version of the statute is restored.
Impact
HB816 amends section 329E-3 of the Hawaii Revised Statutes to expand emergency overdose response authority beyond opioid antagonists to include buprenorphine administration by trained paramedics under Department of Health-approved protocols. It also imposes new duties on the Department of Health to adopt rules, maintain a list of treatment providers, coordinate EMS and substance use disorder services, and evaluate the pilot program. The bill affects paramedics, emergency medical services systems, treatment providers, and county-level overdose response operations, while temporarily changing state law through a sunset and reenactment provision.
Sentiment
The overall sentiment appears supportive and pragmatic, with the bill advancing through the Senate Health and Human Services Committee unanimously in the recorded vote and moving forward as amended. The framing of the measure emphasizes the opioid crisis, evidence-based treatment, and the need to connect overdose patients to follow-up care quickly, suggesting broad policy interest in trying the approach through a limited pilot. The referral to Ways and Means indicates that fiscal and implementation details remain part of the legislative process, but there is no indication of strong opposition in the available record.
Contention
The main point of caution is implementation: the Department of Health’s concern that patients who receive buprenorphine in the field must have access to follow-up treatment within 24 to 48 hours. That concern is reflected in the bill’s requirement that treatment centers be designated in advance and that the pilot begin only in a county with a population of 100,000 or less. The limited geographic scope, training requirements, and reporting obligations suggest lawmakers are balancing expanded overdose response tools against concerns about clinical oversight, continuity of care, and whether enough treatment capacity exists to support broader use.
A resolution to direct the Clerk of the House of Representatives to only present to the Governor enrolled House bills finally passed by both houses of the One Hundred Third Legislature.
Relating to nonsubstantive additions to, revisions of, and corrections in enacted codes, to the nonsubstantive codification or disposition of various laws omitted from enacted codes, and to conforming codifications enacted by the 88th Legislature to other Acts of that legislature.