Healthcare (Hospitals)

Authorizes the issuance of general obligation bonds to the Department of Health for construction defect remediation at the Hawaii State Hospital. Establishes one full-time equivalent (1.0 FTE) building manager position at the Hawaii State Hospital. Appropriates funds.

Eliminates the certificate of need requirement for all health care facilities and health care services except for nursing homes, hospices, intermediate care facilities for individuals with intellectual disabilities, and ambulance service providers.

Amends the definition of "dangerous to self". Defines the terms "gravely disabled" and "psychiatric deterioration". Broadens the term of "imminently dangerous to self and others". Increases the maximum period of emergency hospitalization.

Allows foreign medical school graduates applying for a license to practice medicine and surgery to substitute one year of required medical training or experience in a hospital with one year of fellowship training where the parent program or hospital is accredited by the Accreditation Council for Graduate Medical Education.

Requires any hospital with an operating room licensed by the Department of Health to adopt and implement policies to prevent exposure to surgical smoke.

Establishes a statewide system for the collection, audit, and public release of de‑identified hospital discharge data. Requires the State Health Planning and Development Agency to convene a Hospital Discharge Data Working Group. Appropriates funds. Effective 7/1/3000. (HD1)

Requires each hospital to establish a Hospital Registered Nurse Staffing Committee by 9/1/2026. Requires the Staffing Committee to adopt and file a Staffing Committee Charter with the Department of Labor and Industrial Relations by 1/1/2027. Requires the Department to develop a Hospital Registered Nurse Staffing Plan Form by 1/1/2027. Requires each Staffing Committee to adopt and file a Staffing Plan, including minimum registered nurse staffing standards, with the Department by 7/1/2027, and annually thereafter. Requires hospitals to implement their Staffing Plan by 7/1/2027, and post the Staffing Plan and staffing schedules in publicly accessible areas. Requires Staffing Committees to receive, review, evaluate, and respond to reports and complaints regarding deviations from the Staffing Plan. Establishes a variance process allowing hospitals to temporarily deviate from their minimum registered nurse staffing standards. Establishes an enforcement framework to be administered by the Department, including review of Staffing Plans, complaint investigations, administrative appeals, and civil penalties for violations. Prohibits retaliation against certain persons who report staffing concerns or participate in enforcement proceedings. Increases the membership of the Center for Nursing Advisory Board to include three elected officers or governing board members of a labor organization representing registered nurses in the State. Requires the Center for Nursing to develop and maintain an online dashboard of staffing standards recommended by certain professional specialty organizations. Requires the Department to adopt rules. Appropriates funds.

Establish certain minimum registered nurse-to-patient ratios for hospitals. Establishes a process to obtain a variance from the minimum registered nurse staffing standards. Requires hospitals to establish hospital registered nurse staffing committees by 9/1/2025 to develop and adopt registered nurse staffing plans. Requires the staffing committees to submit a charter to the Department of Labor and Industrial Relations. Beginning 7/1/2026, requires hospitals to submit their registered nurse staffing plan on an annual basis, and implement the staffing plan. Establishes a complaint and appeals process and penalties. Appropriates funds.

Authorizes physicians to practice at organized ambulatory health care facilities even if the physician does not have hospital privileges at a licensed hospital in the same geographic location as the ambulatory facility. Provides that a written transfer agreement is not required to transfer a patient from an organized ambulatory health care facility to a licensed hospital.

Exempts from the general excise tax, gross receipts received by a hospital, infirmary, medical clinic, health care facility, pharmacy, or a practitioner licensed to administer drugs to an individual, from the sale of hearing aids. Effective 12/31/2050. Sunsets 1/1/2027. (SD1)