001aloha and welcome to the hawaii state senate and i'm senator jarrett joho chair of the health committee this is our friday march 18th uh 1 pm joint agenda between the senate committee on health and the senate committee on higher education i'm joined by a vice chair senator baker and our other health members are likely to be joining us shortly senator kim would you like to introduce your members [Music] is thank you very much this meeting is being streamed live on youtube and in the unlikely event that we need to abruptly end this hearing due to technical difficulties the committees will try to reconvene to discuss outstanding business on monday march 21st at 205 pm and a public notice will be posted on the legislature's website uh for those individuals testifying in person i'll be calling
002you first and for uh those participating remotely uh your video and audio will be muted and disabled until it is your turn we are going to stick to a strict two-minute testimony limit because we have multiple agendas today and i i would like to vote out all the measures and not leave them to uh be deferred to later days uh we apologize if the closed captioning doesn't accurately transcribe your names the first measure on this agenda is hb 1548 hd1 relating to graduate medical education this appropriates funds to the johnny burns school of medicine to expand medical school and residency training first up we have the university of hawaii in support aloha everyone thank you so much i'm lee buenken seholam from the jabsom i'm the associate dean for academic affairs and we stand on
003our testimony and thank you very much for considering it and for your support previously thank you very much next week the healthcare association of hawaii and support good afternoon chair thank you for hearing this bill we'll stand on our testimony in strong support thank you thank you very much uh that's all the registered testimony we have is there anyone else in the room or on the internet okay i'd like to note for the record the written testimony of uh department of budget and finance with comments in the following individuals and organizations in support all in support hhsc hawaii pacific health hawaii psychiatric medical association white primary care association queen's health systems michel kanimori adam kusick and sunny ma members any questions okay we'll move to the next measure on the agenda hb 1550 hd1 relating
004to hawaii medical education special fund this establishes the hawaii medical education special fund to be administered by the john a burns school of medicine first up again the university of hawaii in support aloha everyone thank you so much we stand in strong support of our written testimony thank you very much that's all the registered testimony we have is there anyone else okay department of health uh comments and support bnf with comments hhsc and support hoyt medical association hawaii pacific health hawaii primary care association hawaii psychiatric medical association all in support members any questions okay seeing none i'll turn it over to the higher education chair for the last measure on this agenda thank you very much um house bill 2220 house draft one relating to nurses appropriate funds to the university of hawaii to increase
005the state's capacity to train new nurses and project future nursing workforce needs our first justifier is clemencia zaria yulip from the university of hawaii in support department of health and support craig urai with comments uh and and pereira is you see that last name let's talk to you in support uh laura reichard hawaii nursing center for nursing and support laura are you here uh paige uh heckathorn from health association of hawaii in support saying hello oh sorry i'm sorry paige is it laura yeah yes this is laura reichard i apologize for the technical difficulty the hawaii state center for nursing stands with our written testimony and support and i just want to thank you very much for the attention um to this bill and your consideration uh nursing education is in dire need right now
006so we can support our future nurses on the current mission workforce but in order to do so we need more faculty and this will help us move in the right direction both for our schools and nursing but also for nursing in our state thank you very much uh paige thank you chair and thank you to laura i think you can tell that we work together quite closely with laura at the healthcare association of hawaii and i just want to emphasize that when we're talking about nursing faculty and nurse education it's really important for our hospitals but it's it's it's increasingly important for our post-acute care also our nursing homes our home health our hospice this will really strengthen the entire continuum so thank you for hearing this bill thank you and jc mccollum from the
007queen's health system and support anyone else wishing to testify on this measure hearing and seeing none uh members any questions senator keegan thank you i'm not sure if the university is on to answer my questions is there anyone from the university this is laura reichert so the university or the center for nursing is a statewide entity we are actually within the uh manoa school of nursing and i'd be happy to answer questions if i'm able yes so so my question is where is this program going to be because i have concerns that you know there was a nursing program out of west oahu and without us knowing the program was terminated you know in a time and place when it was needed so i want to make sure that this program is going to be
008um embraced by the university and supported and who can assure them the center for nursing i worked with each of the uh schools of nursing uh the community colleges as well as the universities to identify their unmet nursing uh instructor needs and so this bill the 39 instructors actually includes instructor lines for each of the current university programs that are university of hawaii programs that offer nursing education the program that you're referring to out at west oahu was in partnership with uh and this uh this measure does include instructors for uh hilo um but does that embrace uh west oahu where there is also a great need i i can't speak to that i understand the university campuses are undergoing negotiations um but what i can say is that it will support all of the
009nursing schools that are present and how they um how they stand up plans are also you know to expand nursing education requires these instructors and so any future plans will be supported by this initiative so what do you guys do to encourage the university and community colleges to have the programs the center for nursing we provide nursing workforce support or i'm sorry nursing workforce research which looks at the nursing distribution by island and also setting in specialty we also work with our schools of nursing to identify education capacity which includes looking at how many interested and qualified applicants are being turned away from nursing programs to look at that um the excess of interest in nursing education and nursing careers as well as downstream we have to make sure that there's number of jobs available
010and paige alluded to the fact that we have jobs both in acute care but in post-acute and long-term care and so we work to um just we collect the data but we also describe and help our partners analyze that as it relates to their program needs we also work particularly on oahu but increasingly on other islands to secure clinical placements when the west oahu program was around we worked to help them garner the needed clinical relationships and secure those clinical partnerships and those clinical placements so their students would get the education experiences they needed to thrive in their nursing careers and without such programs i mean the education is really a challenge so we've reached out to west oahu um and we continue to work with all of the other schools of nursing on that
011regard yeah and that's my point is that um without your help you know these programs can't flourish but what's concerning is that we at the legislature never heard anything that this program was discontinued and um you know had to hear it from uh students who were not you know able to then participate so i guess i want some insurance that this is going to include uh west oahu because there's a great need out there we have a lot of care homes out there and without without this happening you know i you know they cannot pursue something that's easy to access so i'm just asking for some kind of maybe feedback after this and um you know if you're getting any push back from uh west oahu that they don't want to do the program i'd
012like to know why because when it was stopped it was a flourishing program i do know that thank you certainly i'll certainly connect with west oahu again specifically and be sure to respond to you so let me just follow up on that so was it your estimation that the program was no longer needed or had the man at west oahu the program at west oahu as i understood it um and i believe was yeah and the way i understood was communicated to the legislature during the info briefings was my understanding as well which is that it was a grant that was funding that initiative and with the grant that discontinued the um the program wasn't uh funded outside of those grant funds i guess you can say i think a contributing factor in all honesty
013is the faculty shortage and the challenge of securing the needed faculty um so the needs to to support nursing education whether it is specifically at west oahu or in the state in general um is a number of kind of it's almost like a constellation and so we need to have qualified applicants which thankfully we have we need high quality nursing faculty and right now we have a shortage of that workforce so we need to support them and we need clinical placements and we've had a reduction in clinical placements part of that is driving the need for this measure um when you have a reduction of clinical placements they're taking hospitals are taking to your students because of the shifting and changing environment at the hospital settings they needed to change their working environment and that
014has impacts on the schools of nursing uh which resulted in a almost 150 percent increase in fact faculty line so when you're starting off i think nursing education is very complex and when you're starting off with developing a nursing program some of those challenges are are pretty daunting i i can say i think the relationship using a program that was well experienced with running education and partnering creating that model of mentoring and modeling was novel and i think was a good effort by uh west oahu and we have been working to connect since the beginning of the legislative session to understand how to respond to the needs that you all have identified but we know exist as well we know we need more nursing students because we know we need more nurses and we have
015to be creative and solution oriented in the way that we approach those those needs so let me ask lee when consejo can you respond to this as a representative of the university of hawaii um i'm sorry senator and i don't feel controversial but this one doesn't seem to involve jefferson okay so if we were to deny this appropriation do you think that might get the attention and we might get some response and having somebody here from the university that can since nursing is so important okay so i guess we could then deny this okay thank you okay we have no other questions [Music] okay let's recess for decision making recess okay we are reconvening this joint committee hearing to vote on uh three measures the first is hb 1548 hd1 uh this is an appropriation
016to jabsom for medical school and residency training uh through the va the recommendation here is to pass this measure out with amendments uh we have some technical non-substantive amendments and we're gonna defect the effective date to july 1 2015. members any discussion okay seeing none vice chair hb 1548 hd1 with amendments chair votes aye maestro votes eye senator mary walkey aye senator sandler ventura senator fabella excused share your recommendations adopted thank you for the committee on higher education it's the same recommendation that we amend house bill 1548 hd1 hello hospital 1548 recommendation to pass with amendments terrible side vice chair vote senator keith agaron yes senator wakai excused senator favela excuse measures adopted madam chair thank you thank you very much next measure is hp 1550 hd1 relating to the hawaii medical education special fund
017recommendation on this measure again is to pass with amendments we have technical non-substantive amendments and uh will defect the effective date to july 1 2015. any discussion okay seeing none vice chair passing with amendments chair votes aye [Music] thank you very much uh for house bill 1550 hd1 same recommendation for higher education committee to men with technical amendments and defecting the date chairwood sign very votes i vice chair both sides senator keith agaron yes senator yes senator fabella is excused thank you thank you thank you thank you for the last measure i'll turn it over to thank you for hospital two two two zero house draft one relating to nursing appropriating the funds in university hawaii to increase the state's capacity to train new nurses and project future nursing workforce needs recommendation is to amend
018uh and put in a provided that the nursing program be reinstituted at west oahu as well as technical amendments and redefecting the date to 7 1 20 55 any discussion numbers cheerful sign for house bill 2220 hd one recommendation this is passed with amendments chair votes i vice chair votes eye senator keith agaron yes senator wakai yes senator favela excuse me thank you members thank you for the for the health committee same recommendation passing with amendments chair bow tie vice chair roadside senator maria walkey aye senator sampling ventura senator favela is excused share your recommendations thank you very much and thank you to our colleagues from the higher ed committee we are adjourned fifteen okay we're gonna gabble into our friday march 18th 2022 1 15 pm joint agenda between the senate health committee and
019the senate committee on higher hawaiian affairs to hear hb 1894 hd3 relating to human remains this accommodates the use of both traditional native hawaiian burial practices and environmentally friendly burial practices by including water cremation in the treatment and disposal of human remains first up we have the department of health offering comments good afternoon chairs vice chairs my name is lauren kim i'm the policy and planning officer for department of health it's uh great to see you all in three dimensions it's been a while but it does uh we will stand on our testimony offering comments but i would like to highlight one area that the legislature may consider and it's in our uh testimony about the classification of remains from alcohol and hydrolysis so half the jurisdictions that i polled um the offices of vital
020records classify it as its own um disposition so uh you know that is distinct from flame cremation uh you are left with the different products there obviously are native hawaiian burial practices and implications so is if there's an interest in classifying it or authorizing the department to classify it as its own um disposition is something that i i think the legislature can ponder um i'll be available for questions thank you thank you very much uh next up we have dean fisher in support this is on zoom mr fisher are you available please proceed i'm trying to get on can can you hear me we can hear you please go ahead okay wonderful good good afternoon chair vice chairs and committee members uh dean fisher here i stand in strong support of my written testimony i
021i like how this current version of the bill is written i think it's clean and it's following our current standards for cremation it doesn't add any extra burden or oversight to the department of health or the env as we continue to work with both of them and address any issues or concerns that they may have um the only item that i feel that needs to be changed would be the start date and i would like to see that pushed up to july 1st of this year and the reason for that it would send a clear and strong signal to the citizens of hawaii that it's coming you know it might not be everyone's choice but it still adds a new choice and it and it will appease a lot of of the citizens of hawaii
022to me this is a choice in implementing the future instead of it continuing to install the past so i hope you guys feel the same way and i support this bill and i hope to assist you in any way that i can thanks for your time thank you very much in support okay aloha everybody i was unable to start my video for some reason oh here we go um thank you for letting me speak um all i wanted to say is they stand by my written testimony and i concur with dean fisher that the effective date should be moved up to july 1st of 2022 i really would like to offer this service as soon as possible to anybody that would look for it especially our native hawaiian community and i would just like you
023folks to consider that as an option i also concur with doh that maybe classifying it as a new this position might be in favor however um the data will show that the disposition as cremation and as the bone content would uh solidify into both calcium even if a small amount of pressure is placed onto the bone so i just wanted to add that into there other than that thank you very much have a beautiful day aloha thank you very much pono ledford in support aloha this is pono ledford i'm a physician in hilo and yes i do uh support this i stand by my written testimony thank you very much mililani trask in support aloha can you hear me yes yes i can can you activate your video um trying oh there we go please
024please aloha senators uh i'm so happy to be here this year to again support this measure i'm very very happy to see it come forward i'll stand on my testimony and ask only for one change and that is that the effective date uh be made to be 71 uh i don't know senators if you had a chance to see what was recently announced just in the last 48 hours but china and some companies some countries in europe have announced that the kovid has spread in their community because it was found in the ground water when alkaline hydrolysis was developed more than 20 years ago what drove it at the u.n was the mad cow disease they didn't know if they incinerated the cattle's remains if the pandemic would go into the air and they didn't
025know if that would happen if the cattle were then buried in the ground but now we see that that in fact has occurred with covid i'm very happy to see our state bring this in and we need to do it sooner than later because we may ourselves in the future find that covid will resurge here in hawaii and it may be because it has gotten into our water system i pray to thakua that's not the case but this news was just released in the last 48 hours thank you so much senators for helping us in this mahalo thank you very much that's all the registered testimony i have on this measure is there anyone else in the room or on the internets that would like to testify okay seeing none i'd like to note for
026the record the written submitted testimony from the city and county of honolulu and the hawaii funeral and cemetery association both testified offering comments and the following organizations and individuals who testified and support the council for native hawaiian advancement dayna ellen godby carson kenneth conklin and chung paula aila luana alapa phyllis kyan stephen labrosh pili aloha liloy carmen hulu lindsey and hina wong kalu members any questions okay seeing none shimabukuro i am uh i do not have quorum so i think what we're going to do is recess yes i i meant as vice chair of your committee we do not have but now we do so okay all right well uh members on this anyone has uh any questions i'm ready to make a recommendation are we okay okay so noting the testimony i'd like to
027recommend that we move this measure out with amendments and to just make the date effective upon approval any discussion okay seeing none uh vice chair hp 1894 hd three passing with amendments chair votes aye vice chairman's eye senator mauriwaki aye senator san buena ventura all right senator femilla is excused share your recommendations adopted thank you very much [Music] um [Music] okay thank you very much members uh passing with amendments chair shimon bokoro vice chair goes i senator ocasio hi senator favela is excused recommendation adopted thank you very much members this uh 1 15 pm agenda is adjourned okay we're going to open on our friday march 18th 2022 1 30 pm agenda to consider one measure hp 1638 hd2 making an appropriation for a kona hospital site assessment this appropriates monies to the hawaii health
028systems corporation to conduct a site assessment to identify and evaluate viable locations for a new hospital site in north kona on the island of hawaii first up we have hhsc west hawaii region in support mr lee are you there okay uh are there any other okay hello would you like to testify okay okay one more call for testifiers that's all the registered live testimony we have on this measure so one more call for individuals in person or on the internet who'd like to testify on hb 1638 hd2 okay seeing none we have comments from the department of budget and finance and supporting testimony from the office of the mayor county of hawaii caitlyn shirai douglas perrin john luft and tiffany kurozawa members any questions okay none i'm in with your indulgence we can go right
029into decision making having reviewed the testimony i'm going to recommend that we add the needs assessment language suggested by the hhsc west hawaii region add the suggested amount of the appropriation in the committee report but leave that appropriation amount blank and and move this on to wham and also redefect the effective date to july 1st 2015 any discussion okay scene none vice chair hb 16 38 hd2 passing with amendments chair votes aye hi star votes i senator murray walkey aye senator sanborn ventura aye senator favela's excuse share your recommendations adopted thank you very much uh we do have a 1 31 pm agenda members to consider one bill as soon as our co-chair from the education committee joins us then we will gavel back in and until then we're on recess okay good afternoon uh
030we're here for our friday march 18th 2022 1 31 pm a joint agenda between the senate committees on health and committee on education to consider one measure hp 1570 hd1 relating to the youth vaping epidemic and uh because this bill is a big deal i'm gonna go back through the briefing one one more time this meeting is being streamed live on youtube in the unlikely event that we have to abruptly end this hearing due to technical difficulties the committees will try to reconvene to discuss any outstanding business on monday march 21st at 205 pm and a public notice will be posted on the legislature's website uh for those uh testifying in person and remotely online the individuals who are in the room i will call on first and those participating remotely shortly thereafter you have
031two minutes to share your testimony we only have the room until 2 30 and i do intend to vote out this measure make a recommendation and vote on the measure today so we have received all of your written testimony i've reviewed all of it and so i would recommend that you stand on your testimony unless you have anything new that you'd like to add or uh or respond to if you're online your audio and video will be muted and disabled until shortly before it is your turn to testify and if there are technical glitches in your during your testimony we may come back to you i will try to come back to you but we might move on in the interest of time uh and if the closed captioning doesn't accurately transcribe your name i
032know the feeling please excuse us first up department of health and opposition thank you and vice chair baker and chair kadani it is with great pleasure that i get to see you in person i'm lola irvin representing dr elizabeth charth for the department of health so as you know the department of health is opposing the current version hb 1570 house draft one we find that the nine admin amendments are unreasonable and make the current version untenable however the department does recommend the original language of hp 1570 be restored along with the preamble that was crafted with the youth and also proposed amendments the federal government and president biden on tuesday signed h.r 2471 the consolidated appropriations act 2022 that includes them new authority for the fda to regulate synthetic nicotine products under the tobacco products
033definition so we have used that approach and our proposing amendments and you'll find an attachment to our testimony that shows then what happens if we delete the nine amendments go back to the preamble created with the youth and then go ahead and use the fda new authorization to include synthetic nicotine under under the tobacco products definition that really greatly simplifies then the approach in the original hp 1570. thank you very much for the opportunity to provide testimony thank you very much next we have aloha care with comments aloha chairs place shows members of the committee peggy miroswell with aloha care our comments very much match the departments of health and asking for the restoration of the original language of the bill and also want to thank the committee for hearing this measure i also wanted
034to just highlight that um this we have members excuse me who are children under the age of 10 who have been addicted to nicotine because of electronic smoking devices and beyond that just personally the rate of electronic smoking devices in the schools in our district for both my son in elementary school my daughter in middle school have been heightening to where uh you know they are sending letters home now and it's continues to be a problem in the community so really thankful that you're here listening to this bill today hopefully that um you'll move it forward with the original language thank you so much thank you very much next we have the american cancer society cancer action network in opposition miss al okay american heart association vice chair baker and members of the committee uh
035we offer comments similar to the department of health we originally supported this bill and it's an original form but the changes that were made to it uh became problematic for us we're concerned that uh those those amendments were not evidence-based and potentially could uh drain from existing resources that are being used by the state to address youth uh tobacco addiction problems and so we would like to see this revert back to its original form um just a few key points i want to highlight in my written testimony uh the importance of this being a comprehensive bill to cover all tobacco products and to cover all flavors including menthol is very important because we've seen it from experiences in other communities that have already done this that if you leave loopholes and exempt certain products even
036when the fda was not comprehensive in eliminating flavors from all cigarettes the industry quickly responds by creating new marketing campaigns to try to push kids to those products that aren't that were exempted and that still allow flavors and so it's very important that this be comprehensive if we're going to do it and want to be effective we know about the problem you see listed in our our testimony uh the problems that nicotine can have on kids brains develop brain development i think you'll hear from other testifiers about how that's affecting their ability to learn in schools but you'll hear from the industry that e-cigarettes are safer products than cigarettes but from a cardiovascular standpoint the evidence that we've seen so far and we're still doing a lot of research on this but it's showing that
037they're at least as harmful to cardiovascular disease risk as regular cigarettes if not more harmful and that's a that's a big problem because heart disease remains our number one cause of death in our state stroke number three and we impose a disability um it's important also because hawaii children's action network speaks in support aloha chairs vice chairs members of the committees thank you for this opportunity to talk to you in person oh we i reflect the testimony of a lot of the prior speakers we supported strongly the original bill and we find the amendments to be extraneous and not not evidence-based so we really hope you'll return it to its original version thank you thank you very much the boy primary care association and opposition mr abe uh hawaii public health institute with comments good
038afternoon chairs vice chairs members of the committee amanda fernandez on behalf of hawaii public health institute we've offered comments on this measure and asking for the committees to restore it to its original intent and i know that others have specified it before this committee report about the need for these types of regulations and the end of the sale of flavor tobacco products we know that from a 2021 survey conducted by ward research that 20 or 73 percent of registered voters in hawaii support prohibiting flavor tobacco products um i wanted to highlight a point that hasn't been made super clear in previous hearings and that is if the fda does approve a flavored product for cessation purposes that would not be banned under this bill so it does leave a pathway forward doesn't close the possibility
039of any electronic cigarettes being used association products moving forward it's just that right now the commercial use is almost completely unregulated so we have offered amendments um to this measure others have spoken to the amendments that were made in the house health committee um we do find that the enforcement mechanisms containing those amendments are untested and vetted and unlike any in any jurisdiction that has considered or passed a similar measure and we've also offered a friendly amendment to mirror like the department of health testified the most recent actions at the federal level to enclose the loophole on synthetic synthetic nicotine products we are available for any questions thank you thank you very much hsta and support chairs and members of the committee laverne moore speaking on behalf of also junior president of the hawaii state
040teachers association we support this bill with our suggested amendments we request that this bill be reverted back to its original language and you have the help data and everything i want to give the educational data i'm a special ed education teacher and students who are vaping what we find they drop out of school freshman year because they're failing their grades are low they have bad attendance rates and when they do come to school they constantly leaving the classroom to go and vape where they tell us they go into the bathroom but the custodians catch them in the bathroom take away the the vaping pipe but then they go and call another friend out and what's happening is they're sharing these pipes on campus so we as educators are having a difficult time because we're not
041able to teach and their grades are dropping so the state is coming after the educators for not having the students be successful so not only is this the health issue this is more importantly an educational issue that our students are not being prepared for the world of work thank you very much for the opportunity to testify thank you very much zoe duan please correct it if i got it wrong thank you aloha members of the senate committee on health and education i'm zoe a local youth from lulalu liha and i would like to provide comments on the recent amendments that have been made to hb1570 as per my written testimony i strongly support the original version of the bill but oppose the recent amendments the amendments are not necessary nor are they related to ending
042the sale of flavored tobaccos which is the original intent that youth like me and other supporters of the bill have been advocating for the testing requirements outlined in the amendments are unwarranted no other state has implemented a flavor ban that has testing requirements like those in the amendments by creating the extra requirements the amendments detract from the main intent of the bill and instead create a burden for other agencies so much so that they have to force they have to pull their support from the bill and so really lastly as a youth who has been actively actively involved in advocacy of the favorite band for the past four years it's really disheartening when we're told that our voices matter but when our voice our voices are then wrongfully manipulated and twisted in practice during the
043previous hearings of the bill my friends testified solely for ending the flavor tobacco sales but was misrepresented when the bill was amendment with new requirements i hope to see that our youth voice are being heard in its full authenticity so i urge for the removal of the new amendments to bring the bill back to what us youths have been fighting for all along thank you mahalo thank you very much lauren simpson gomez good afternoon senator kyo kolova oh sorry uh uh chair senator baker vice chair and members of the committee on health senator kondani chair senator mercado kim vice chair and members on the committee of education thank you for having me here today my name is lauren simpson gomez and i'm a college student at the university of hawaii at manoa studying public health
044over the past two years i have been gathering medical research product research and collecting real-life accounts of individuals who choose to consume flavored tobacco and synthetic nicotine products flavors hook kids in the marketing of flavored tobacco products and their success proves this from my experience on manoa's campus these kids carry on their addictions while into the college level i see freshmen on the dorms ranging from ages 17 to 19 years old who can't function without their vape with them in the exact same way they can't leave the house without their cell phones or their wallets they experience immediate irritability loss of patience short temperament and lack of focus in the classroom they're addicted to the nicotine in these products the same way an alcoholic is to alcohol and a drug addict is to their drug
045of choice nationally 81 percent of youth who start using flavored tobacco products and any tobacco products at all always start with the flavor and 97 of the youth who do vape always use a flavored tobacco product before i quit the only flavors i had access to were cigarillos and mental flavored tobacco products if i were to have access to the nearly 16 000 flavored products that are on market right now i for sure would have consumed these products at a much higher rate than i did cigarettes and cigarettes myself passing this bill would help mitigate the high number of youths who started using tobacco products because of the attractions of flavors and those who would become addicted and possibly for the rest of their lives in order for this bill to have a chance to
046pass however the onerous amendments put in the house healthcare need to be removed the amendments are an unnecessary and are opposite of the transparency that the chair claims to be championing championing none of the other more than 300 jurisdictions that have have that have flavor bans have requirements that are added so i urge you to return this bill and to be more in line with its original intent and language thank you for the opportunity to testify today thank you very much moving to zoom attorney general's office in opposition hello can you hear me yes please proceed okay sorry about that um good afternoon vice chairs members of the committees i'm deputy attorney general stacy of tobacco enforcement unit uh the attorney can you move your camera down we're we're just catching the topic thank you
047very much okay new camera um as indicating our testimony the department of the attorney general appreciates and supports the intent of the original bill the department is committed to supporting the fight against the youth vaping epidemic we do however oppose this bill in its current form and ask that it be reverted to the original form with uh some suggestions made we do point out several concerns in the testimony which i don't think i need to list here i see your timer but some of them include single subject title issues the current version gets into using tobacco settlement special funds causing reports further responsibilities for department of health inspiring the attorney general one of one of our main purposes in my unit is to enforce the master settlement agreement and we always have concerns when there
048are additional responsibilities that might put hawaii's receipt of the annual money at risk currently after many years of arbitration washington and missouri just lost recently and they're looking at losing well over 100 million dollars each and that'll be decided shortly so we are always concerned about that so we would ask that if it goes forward if you refer to the original form with some suggestions i'm available for questions mahalo thank you very much american lung association in hawaii with comments aloha chairs vice chairs pedro harold association uh appreciate the time to be able to uh provide our comments which is to revert the bill back to its original form as many testifiers are talking about one of the things that i did want to highlight from a written testimony is that mental is a flavor
049so it's very important that the final form of the spill includes mental as a favor uh what we have seen from research from across the nation is that when flavor restrictions happen if mental is not included rather than quitting they switch to mental because it is a flavor so it is really important that if we're going to have comprehensive legislation that will move the needle for the vaping pandemic for for the vaping epidemic for youth that it includes menthol thank you so much thank you very much coalition for tobacco-free hawaii's youth council joshua ching and members of the senate committees on health and education my name is joshua ching and i'll be providing comments for hp 1570 on behalf of the coalition for tobacco-free hawaii's youth council all the way from new york city during
050my spring break trip um but i digressed our coalition strongly supports the original version of this bill but questioned the amendments added by the house committee on health these amendments placed requirements on multiple departments that none of the five states or more than 300 other jurisdictions have included in their flavor bans doing nothing to protect hawaii's youth from predatory marketing from the tobacco industry we strongly urge a return to not only the original language but original intent of this bill ending the sale of flavored tobacco products in the most efficient way possible the bottom line is senators that our coalition of youth have worked tirelessly on this issue for years and for me this would be my fourth today 70 percent of hawaii residents a majority of oahu's neighborhood boards and over 100 organizations across
051the state have supported an end to the sale of flavor tobacco the only thing we don't have is hundreds of thousands of dollars to spend every year lobbying and donating donating to political campaigns it's time to work for the public interest it's time to stand up to big tobacco it's time to prioritize the health and safety of our communities over boosting the coffers of an industry that profits off of our addiction mahalo thank you very much and thank you for identifying your location i thought i was in a time warp questions i'm a tobacco treatment specialist here at hamakua kohala health centers on hawaii island we strongly support the original language and intent of house bill 1570 and we would like to provide comments to restore it to its original version not as it stands
052now with amendments we urge you to please for the protection of our keiki and our youth to restore this bill to its original version to ban flavors including menthol and tobacco products as a tobacco treatment specialist for the past six years i have witnessed and spoke to hundreds of students who are either vaping flavored e-juice or around it at school every day some students are so addicted that they cannot even go half an hour without vaping they are addicted to these vaping devices they are scared and they are unable to take back control if they are not enticed to try them with flavored e-juice and vape devices our children will not even want to try them i am also a mother of four children a teenager who sees it daily at school classmates and friends
053who are addicted i have an 11 year old whose classmates are getting in trouble for using and bringing these devices to school to share with her friends 11 years old more and more every day as these children have not only access but easy access to these favorite vaping devices are wanting to try them because it's the cool thing because it tastes good our kkr future please help keep our kiki healthy and ban all flavors in tobacco products including manto they do not know how harmful these products and e-juice are to their health for short and long-term effects i come before you today with much desperation in keeping our keiki and our people of hawaii healthy to restore house bill 1570 to its original version with much humility mahalo piha for your time thank you very
054much hawaii copd coalition valerie chang with comments hoy food industry association chairs oh sorry oh miss chang okay we have you go ahead when you're ready good afternoon chairs and vice chairs uh and members of the committee i'm valerie chang i'm the executive director of the hawaii copd coalition i'm on the board of the copd foundation and i'm vice chair of the u.s uscopd coalition and we all very very strongly support the original version of 1570 which would protect our keiki and the people of hawaii there are already 300 million people in the united states in the world that have suffered uh lung disease because of tobacco and we really don't need any more in hawaii we already have over 45 000 people that have copd chronic obstructive pulmonary disease and we really are trying
055to decrease our numbers not increase them uh one other thing i'd like to highlight is that uh 78 of the uh native hawaiian and pacific island smokers are using menthol cigarettes so we really need to make sure that we include menthol cigarettes in the smoking ban and i am available for any questions and thank you so much for taking this measure seriously this is really important mahalo thank you very much and thank you also for giving back some of your time like i said we have a two minute limit but there are 12 more testifiers so i appreciate the summaries uh next we have the hawaii food industry association with comments mrible okay hawaii petroleum marketers association happy aloha friday chairs vice chairs members of the committees on behalf of the hawaii petroleum associate marketers
056association we offer brief comments with respect to the organization which represents two over 200 gas stations and convenience stores um know the hpma wholeheartedly supports uh the strict enforcement of laws and prohibits the sale and distribution of tobacco products under the age of 21. while we understand that the committees may intend to pass this measure we do ask respectfully that the committees consider the inclusion or exclusion of mental and methylated products we believe that this is um definitely a major revenue source to continue operating a lot of the gas stations um along all the counties so we do ask that the committee's consideration and thank you for the opportunity to testify thank you thank you very much honolulu youth commission with comments for the opportunity to speak with stan on our written comments and i
057don't think um the commission itself would have a problem with all the previous requested um changes to the better restore the intent um so doing such um would not be a problem in really our comments as well as our support for um ending this um vaping and tobacco usage epidemic here in hawaii for our youth mahalo thank you very much retail merchants of hawaii and opposition miss yamaki volcano vape shops in opposition vice chairs members of the committee my name is scott rasik i'm the ceo of volcano we're a locally owned retail chain here in the state of hawaii we have 16 locations and we employ just under 100 people here i'm speaking on behalf of not only our organization but our customer base and our industry as well who many of who can't unfortunately
058attend today but you know we really stand in overwhelming support of harsh restrictions and measures and laws to restrict the use of vapor products among youth but quite frankly uh flavor prohibitions have not and will not yield the results that i think lawmakers are proposing so in that case we strongly oppose hb 1570. i'd like to reiterate some points in my testimony um if you can just reference the san francisco flavor ban there are some really good analytics in there to look at in hindsight is a really big benefit for us right now so please take a look at that in addition there will be a pro proliferation of a black market so something we're super concerned about as well right now the products are legally being purchased and used by adults ages 21 and
059over so to remove that pathway is something we're super concerned about lastly i want to also um discuss what lola spoke about earlier about synthetic nicotine falling under the fda so this is a very new development um and this is something that the fda is going to be pushing synthetic nicotine products through their pathway and they have 120 days to complete that cycle so thank you for the opportunity to testify and we're here with any questions thank you thank you very much celia chang with comments aloha senator chair and committee members my name is celia chang and i'm currently attending college on the mainland but i was born and raised in hawaii and i just wanted to first thank you for hearing our comments on the bill i strongly support the original wording of the
060hb 1570 bill as the availability of the flavored tobacco products has a severe negative impact on today's use as these constantly new and changing flavors are what entice the youth youth addiction to these tobacco products is a huge problem and the flavors of these tobacco products are a large part of the problem as the flavors specifically target like my youth council peers i respectfully ask for the amendments to the hb 1570 bill to be removed as these amendments are quite cumbersome and take away from the ultimate goal the youth that have testified for this bill myself included have worked hard to show that flavor tobacco products are doing significant harm on today's youth and even among our own peers and sometimes our words get twisted but our end goal remains the same to pass the
061originally worded hv 1570 bill and end the sale of flavor tobacco products because this would make a significant difference in the growing youth vaping epidemic thank you very much shelley ogata with comments aloha chairs vice chairs shelly okata i i'm the chair current chair of the tobacco-free hawaii island coalition um offering comments again to please it's very simple please restore the original bill language our coalition has been receiving calls from elementary schools dealing with younger and younger kids and vaping on their campuses um i'm also involved with uh other organizations and other and my other capacities where we are als we continue to receive calls from elementary schools as well so please do the right thing do a comprehensive flavor ban and we restore this bill to its original intent thank you very much julian
062lipscher with comments aloha chairs vice chairs members of the committee my name is julian lipscher testifying as an individual providing comments despite decades of progress in tobacco control and some of the strictest and most comprehensive protections the current practice of vaping most often with flavored tobacco products has resulted in significant rates of delivery of nicotine to our youth potentially addicting a new generation the bill as amended removes the preamble that provides a clear public health rationale and adds amendments that are not based on clear public health practice in which the testimony by the departments of the attorney general health and education conclude are not either based on proven and effective methods or are able to be implemented going forward it would be best to return to the original language flavored tobacco products entice youth menthol
063the predominant flavor has the ability to disguise the harshness of tobacco making it easier to start and once addicted harder to quit ending the sale of flavored tobacco products is a matter of health equity the industry has long marketed menthol products to low-income communities especially the people of color if our objective is to protect hawaii's children and reverse the current trends in youth vaping we need to eliminate flavored tobacco products including menthol kindly consider returning the bill to its original form thank you for the opportunity to testify thank you very much carol agard with comments austin tucker in support austin we had you and we lost you okay oh okay can you hear me yes we can hear you you're coming in and out but you can proceed once you're uh once you're ready okay
064members of the senate committee on health and education my name is austin tucker and i'm a junior at mckinley high school i personally have a lot of experience with vape usage and i'm currently addicted to nicotine you would be amazed by the amount of students in middle and high school vape i know a lot of different people in my school and i can still confidently say that 50 of them are doing it it's to the point where kids are leaving the classroom to go vape like what um the faculty of mckinley said earlier it's always been like that it's just kids asking their friends if they can use their vapes or random people asking other random teenagers if they can use the vape that they don't even know they have that's how common it is
065something like that really shows you like the abundance of vaping and flavor usage people who don't even own vapes are addicted to nicotine because they're everywhere because why not just take one hit right the one hit is what is what uh what's the word kind of entices these teenagers to vape the most commonly asked question when students use other students vapes is what flavor is this my personal favorite flavor is grape ice and i know others like different fruity flavors as well some also like menthol but for the for the sake of generations to come please get rid of flavored vapes in addition please remove the amendments to this bill and keep its original version mahalo thank you very much mr tucker next we have misa lane with comments good afternoon senator chair and committee
066members my name is misa mullen and i'm a senior at radford high school i support the original version of sb1570 i believe these new amendments sidetrack from the initial objective of the bill i strongly support the using factual and objective strategies that have been proven in helping to end the use of tobacco-related products by youth so many peers have easy access to tobacco products the flavor of these tobacco products strongly appeal to my age group as a teen i have seen this vaping in the epidemic take over high schools the availability the availability and the targeting of these products has caused great harm to hawaii youth it is important to take action against all flavored tobacco products with this i urge you to advance the original form of the bill thank you thank you very
067much logan lau in support um thank you for this opportunity today and i just wanted to um actually just provide brief comments and really just share a personal story of one of my friends who was a high school student and he actually got addicted to vaping via flavored tobacco products but more specifically menthol and this soon grew into a much larger nicotine addiction which actually led him to the use of many other drugs and as we all know nicotine rewires the brain and it makes users more likely to use and become addicted to other drugs and this is quite literally what happened the nicotine addiction that he had soon turned into this very very hard drug addiction and while he was extremely smart he graduated went on to usc within a matter of months he
068was actually expelled and he was sent back home because of his hardcore drug addiction all that started from simple flavors and this story really doesn't end here um he now actually has a prison record and he lives on the streets so again like uh to reiterate this someone was a very close um family friend of mine and um we don't really hear too much of him nowadays but i think this is really emphasizes the point of how addictive these substances are and i'm really here before you testifying today to ensure that this cannot happen to anyone else thank you so much thank you very much for your testimony that's all the registered testimony we have on this measure is there anyone in the audience who would like to testify please come forward good afternoon good
069afternoon thank you so much for allowing me to testify my name is noah chang and i come from aina haina and i'll be providing comments on hp 1570. it's very important to me that flavored e-cigarettes are regulated the same as other tobacco products since they they have the same amount of nicotine if not more that really addicts generations of youth as well as it just makes it harder for students to quit i'm currently a high school senior but when i was in middle school that's really when my school started to have a pretty big problem um with vaping students would start acquiring these vape pens and it was very distracting to other students in the class and it was very detrimental to their own health i'm very sad to say that right now it is
070the worst it's ever been with currently in our state one in three high school students use e-cigarettes and eight out of the ten youth who currently use tobacco products started with a flavored product also i would like to provide my concerns on the recently added amendments um i believe that they distract from the original intention of hb 1570 and if possible i would like it to be returned to its original wording thank you so much thank you very much is there anyone else okay please come forward good afternoon my name is jamie ray turnbull my daughter is a freshman at hawaii pacific university i'm actually here on holiday but took the time to tell you about her experience and also what led me to be here um she is struggling with the epidemic with vaping
071thought it was going to be better here and i'm here because i also founded with a young man in michigan a non-profit called fight for wellness um this young man started baking without ever owning a vape at age 16. his name is daniel lament and he ended up on life support and having the first double lung transplant due to vaping he still struggles has a short life expectancy and has been working very hard for outreach and trying to avoid this from happening we're seeing younger and younger kids he speaks to schools but it's not enough and i'm hoping that we take a serious look at this amendment are these amendments and have them reverted and i hope that people understand how serious this is to have a young man who was meant to go to
072the naval academy had a 4.5 uh grade point average was an athlete and overnight is now his trajectory is completely different so um again i urge all of you to take this very seriously to help what's happening to our youth thank you thank you very much is there anyone else in the room who would like to testify please come forward for those of you who are testifying now please make sure you register with our click so that we can have your names for the record as well please proceed good afternoon chair vice chair and members of the committee my name is jesus cho and i'm testifying on behalf of my organization cares we are a social service providing education services to students i support the bill in its original form the amendments include reporting and
073testing requirements from state agencies that may lead to observed results one substantial addition would require the doh to develop a standardized and scientific testing process to detect the presence of flavors in tobacco products and to report it online the house said the changes were necessary to safeguard the state from potential legal challenges that is true as lawmakers one needs to look ahead to see what complications and challenges may arise legally the amendments perhaps were not intentional in poisoning the bill they thought perhaps the changes will help it to be a stronger legislation but there is a big possibility of a veto if it reaches the governor in its amended form to ensure the legislation makes it as an act i'd like to request the legislature to consider restoring the bill legislation should be held to
074the highest standards of the law yet when it comes to something simple like flavor one doesn't have to be so technical flavor is so simple it's something you can sense by smell or taste it can't be a hidden flavor that you have to test for because the flavor then wouldn't exist and so therefore it's not a flavor and it would not be regulated massachusetts in 2019 became the first state to ban all flavored tobacco and vaping products massachusetts defines the flavor as a distinguishable taste or aroma imparted or detectable before or during consumption no other jurisdiction have needed similar testing requirements like that of hawaii's current amendments to be fair there are instances when one does need to be technical with legal language for example 2337 the legislature found that there is a need to
075amend the definition of drugs for driving violations in chapter 291e of the hrs it pertains to the use of substances while operating a vehicle in order to convict someone of an offense the prosecution must prove beyond a reasonable doubt that the person was intoxicated drugs begin to be manufactured rapidly and avoid law enforcement when they change the chemical composition of an existing drug for that reason it was difficult thank you very much thank you any other members of the public wishing to testify okay anyone else on zoom wishing to testify on this measure okay members any questions okay if not we'll go into recess for a decision cherokee donny [Music] thank you what i don't understand is it's illegal for young people to purchase this so how are you guys getting products um well from
076my personal experience talking with people in the dorms as well since i have friends who are ras which are residential advisors who oversee the responsibilities of all of those freshmen and sophomores that are living on campus a lot of the time they're getting them from black market sellers there's people who order them online because of the lack of online regulations in the state of hawaii you can order them online at age 18 and just have them get shipped to your house so you can order in bulk and then from there the people who do sell them on the black market especially on campus especially in the freshman dorms because it's a high target actually it's super easy for anyone to get their hands on it especially with snapchat and social media and things like that
077also it's super easy to ask any kind of adult who really just doesn't care to just say hey can you go grab me one they'll come out of the gas station or whatever and just hand it off i've seen it many times i live in waikiki i see it all the time in all the 7-elevens abc stores all the gas stations out there i walk up and down i work in waikiki i see kids who are on vacation all the time even with vapes my sister vapes and she's in high school all of her friends vape it's super easy actually for them to get their hands on everything most of the time so that's just from my personal experience and just from discussing with others thank you for that you have a different story i'm
078just wondering how do you know have you heard where your friends are yeah um i personally don't do any substances and that's because like my personal history like family history we actually have a history of being having like addictions my grandpa actually passed away from tobacco use which is why i'm here and so passionate about the issue but my friends in middle school i went to public middle school and i know that they often got it from adults in their lives who like um lawrence said he they would not really care and they would be able to just walk into another shop and buy it for them and just be able to pass it along and so like really the flavors are what's attracting these kids from asking all of these adults because the adults
079can get access to the flavors right and so they want those flavors to be able to use and you know have that to their pleasure but then um the adults might not necessarily know that this is what they're actually doing with it um in middle school even i'd walk into the bathrooms and you would just be hit with disgusts of cotton candy and strawberry and vanilla and you you can smell it in the air and some kids they bring like febrezes in their backpack and they sneak it into the bathroom and try to spray it to make the smell go away but you like you can't get rid of that and so you can actually smell it and so even in middle school when i was like sixth seventh grade i've been exposed to all
080this and like it's been around and i know that a lot of people do it but i personally don't and i just really wish that it can stop because my grandpa we see that it's like a generational problem so we need to have it end with our generation thank you very much thank you um department of health so hearing these young people letting us know how they're getting it what does the department need to try and find a way to stop thank you so much um since 2014 the department of health has asked for oh thank you i need to project okay i use my mommy voice through the mask since 2014 the department of health has been asking for a two-pronged evidence-based policy approach that has worked with cigarettes and so one we don't
081have flavored cigarettes except for menthol and that really greatly reduced youth use of cigarettes two we increase the price of cigarettes and we ban the online shipping and handling of cigarettes and so we have asked that e-cigarettes be included in the tobacco tax regulation right now those who sell e-cigarettes do not have to have permitting licensing and they is not an increased price to e-cigarettes so our youth can buy them for 99 cents they can go online buy them at that low price and then sell it to their classmates so who have you asked we have been going through the governor's package but also we have worked with senator baker so sb 2278 was a bill that was introduced by senator baker and unfortunately it was not heard at the next joint committee where it
082was supposed to be heard so it has died this year thank you okay okay let's recess briefly for decision making okay we're back for decision making on this friday march 18th 1 31 pm joint agenda on hb 1570 hd1 after reviewing the testimony and conferring with the members the recommendations are as follows the first is to replace the contents of this measure with uh sb3118sd2 which is the senate version i appreciate the request of the testifiers to replace the contents with the house version but we like the senate version better i after conferring with the members i'm also going to recommend that we exempt pre-market tobacco application products and defect the effective date to july 1 2050. members any discussion okay seeing none vice chair passing with amendments chair bow tie vice trip outside senator
083mariwaki aye senator uh san buena ventura reservations senator favela excuse chair your recommendations thank you very much and for the uh chair and education education committee we do not have quorum right now we do have a 3 pm agenda at which time we will be voting on this bill and the recommendation of the chair will be the same as the recommendation of the chair thank you very much so we're going to adjourn and then it we're ready to go in okay we're going to gable in on our 2pm health agenda for decision making on hb 1980 hd2 this is relating to telephonic services this permits but does not require or prohibit medicaid health insurers mutual benefits societies and hmos to cover telephonic behavioral health services under certain circumstances after conferring with the committee the recommendations
084are as follows we're going to adopt the offered amendments from the hawaii primary care association uh which bring the the bill into conformity with cms they're also technical non-substantive amendments and i'm going to recommend that we defect the effective date to july 1 2015. remember there's any discussion seeing none vice chair hp 1980 hd2 passing with amendments chair votes eye vice chair vote side senator mauriwaki aye senator sam buenaventura senator bella is excused share your recommendations adopted thank you very much we are adjourned you