Sen. Jarrett Keohokalole

Establishes the Hawaii Micro-Lending Credit Enhancement Program within the Department of Business, Economic Development, and Tourism to expand micro-lending capacity by providing state‑funded loan loss reserves or other credit enhancement that absorbs first losses on qualified micro-loans made by participating lenders to Hawaii small businesses. Allows borrower fees and state matching contributions to capitalize lender-held loan loss reserve accounts. Establishes the Hawaii Micro-Lending Credit Enhancement Special Fund. Requires reports to the Legislature. Appropriates funds.

Amends the membership and responsibilities of the Public Land Trust Working Group established under Act 226, SLH 2022. Requires the Working Group to submit four reports to the Legislature: by 8/1/2027, a first interim report regarding Act 178, SLH 2006, financial reporting and accounting; by 12/1/2027, a second interim report regarding the public land trust inventory; by 6/1/2028, a third interim report that includes a preliminary draft of findings and recommendations regarding Act 178 financial reporting and accounting and the public land trust inventory; and by 10/1/2028, a final report that includes proposed legislation. Authorizes the Office of Hawaiian Affairs to provide administrative support to the Working Group in coordination with a third-party consultant.

Temporarily increases the total amount of public land trust revenues transferred to the Office of Hawaiian Affairs, while reaffirming the State's obligation to the twenty per cent pro rata share pursuant to the Hawaii State Constitution. Repeals 6/30/2028.

Requires the State Auditor to conduct audits of Medicaid health care insurance contractors and the Department of Human Services and its Med-QUEST division at least once every two years, with the first audits to be conducted by 1/1/2027, and the reports to be submitted no later than twenty days prior to the Regular Session of 2027. Requires the Auditor to conduct audits. Appropriates funds.

Establishes a universal, single payer health care system to be known as "Hawaii Care", to provide comprehensive health care benefits to all state residents and eventually replace all existing health care plans in the State. Designates the Hawaii Health Authority as the responsible agency for the comprehensive planning, implementation, and administration of Hawaii Care. Requires the Hawaii Health Authority to develop and submit a comprehensive implementation and administration plan to the legislature by a certain date. Establishes the Hawaii Care special fund. Requires the Hawaii Health Authority to adopt rules and submit reports to the Legislature. Requires the Governor to appoint members to the Hawaii Health Authority by 12/31/2026. Requires the Department of Human Services to apply for necessary federal waivers. Takes effect 180 days after the approval of the Hawaii Medicaid State Plan and necessary federal waivers. Appropriates funds.

Prohibits a financial risk-bearing entity from administering Medicaid services. Requires the Department of Human Services to contract with one or more administrative services organizations to perform non-risk administrative functions for the operation of the State's Medicaid program. Requires the Department to establish a Medicaid Care Coordination Program to contract with community-based programs to provide care coordination services. Requires physicians, other independent practitioners, hospitals, and other institutional providers to be paid or reimbursed directly by the State's medicaid agency. Requires the Department to establish regional health hubs in each county to serve as localized oversight bodies. Requires the Department to convene a Medicaid Stakeholder Advisory Group to support continuous improvement throughout the transition period. Requires reports to the Legislature. Appropriate funds.

Exempts certain positions in the Developmental Disabilities Division of the Department of Health and Hawaii State Hospital from civil service. Authorizes the Director of Health to appoint two additional associate administrators and two project managers for the Hawaii State Hospital or a secure psychiatric rehabilitation facility.

Requires the Board of Land and Natural Resources to consult with the Office of Hawaiian Affairs before approving a long-term lease of public lands to another government, governmental agency, utility, or renewable energy developer. Prohibits the Board from extending leases allowing the live-fire training and bombing of public lands, except for a one-time extension of up to five years to phase out existing leases allowing the live‑fire training and bombing of public lands. Excludes lands set aside to the Department of Hawaiian Home Lands or lands designated for return to the State from the one-time extension.

By January 1, 2027, requires each law enforcement agency operating in the State to maintain a publicly available policy on the visible identification of law enforcement officers. Adds law enforcement officers to covered public servants who may request any government agency, person, or organization to not make publicly available on the Internet certain covered personal information.

Establishes a family caregiver tax credit for nonpaid family caregivers. Requires the Department of Taxation to submit annual reports to the Legislature. Appropriates moneys. The tax credit applies to taxable years beginning after 12/31/2026.