Hawaii Legislature adjorns Sine Die, here are the health bills that passed

The Hawaii Legislature adjourned the 2021 Legislature sine die Thursday, following a condensed 55 legislative day session. During the session the legislature passed 270 bills.



House Speaker Scott Saiki convened the 2021 legislative session in the House with three priorities: addressing the budget shortfall, maintaining public health and safely reopening the economy. Saiki praised members of the House for the amount they accomplished.

“Some say that the true test of leadership is how well you function in a crisis. House members rose to the challenge and seized the opportunity to make positive changes for the people of Hawaiʻi.”

At the start of the legislative session, the state was facing a deficit of nearly $2 billion. This deficit was reflected in the Governor’s Budget, where Gov. David Ige presented the legislature with a budget that included cuts to social services programs. Representative Sylvia Luke said the federal funds provided to the state allowed them to save programs that would have otherwise been cut.

“The $1.6 billion in federal funds received through the American Rescue Plan Act enabled us to plug a lot of gaps in the budget. In addition, we sharpened our pencils and looked for every cost savings opportunity and dollar squirreled away in special funds to pass a general fund budget that is about 7 percent less than the fiscal year 2021 base budget.”

The legislature used the budget shortfall as an opportunity to change government operations. Specifically, in SB 628 the legislature transferred O‘ahu’s Leahi Hospital and Maluhia facilities from the Hawai‘i Health Systems Corporation back to the Department of Health (DOH). They also used HB 1281 to transition ambulance services to the City and County of Honolulu to “ensure more aggressive billing and collections practices while enabling more responsive and innovative services through community paramedicine initiatives.”

The major areas where the legislature passed health-related bills included mental health, scope of practice, funding, public health and DOH oversight.

Mental Health

  • House Bill 345: Mandates appointment of a guardian ad litem to represent the best interests of a mentally ill individual in assisted community treatment proceedings. Eliminates the requirement for the office of the public defender to participate in the proceedings.
  • House Bill 1283: Permits the employers of first responder personnel to obtain dementia training for first responder personnel. Permits the Executive Office on Aging to coordinate the dementia training schedules and standards with all public and private entities and agencies responsible for services provided by first responder personnel.

Scope of Practice

  • House Bill 576: Authorizes advanced practice registered nurses to perform medication or aspiration abortions.
  • Senate Bill 970: Authorizes the establishment of a physician-patient relationship via a telehealth interaction if the physician is licensed to practice medicine in the state.
  • Senate Bill 324: Clarifies the definition of the practice of medicine to provide uniformity of practice for both medical physicians and osteopathic physicians.


  • House Bill 311: Extends the nursing facility sustainability program to 2024. Specifies that the fee limit is 5.5% of overall net patient service revenue. Removes the per-resident daily maximum fee of $20 for each facility. Facilities that meet certain exceptions shall pay a reduced daily fee in comparison to other participating facilities. Allows nursing facilities 60 days to pay the nursing facility sustainability fee and appropriates funds. Effective 6/29/2021.
  • House Bill 313: Repeals the requirement that no less than fifty per cent of the physician workforce assessment fees transferred or deposited into the John A. Burns School of Medicine (JABSOM) special fund be expended for purposes identified by the Hawaii Medical Education Council to support physician workforce assessment and planning efforts. Repeals the cap on expenditures from the JABSOM special fund. Authorizes funds from the JABSOM special fund to be expended for loan repayments to physicians who commit to working in certain medically underserved areas as part of the Hawaii state loan repayment program and scholarships to qualifying medical students.
  • House Bill 723: Authorizes use of funds appropriated from the emergency and budget reserve fund, from the amounts received by the State from the CARES Act, for the purchase and distribution of personal protective equipment and industrial hygiene products to state departments and attached agencies.
  • House Bill 1284: Establishes the all-claims, all-payer data center steering committee within the Department of Human Services to oversee the all-claims, all-payer database and data center.
  • Senate Bill 506: Authorizes the issuance of special purpose revenue bonds for long-term debt restructuring of Wahiawa General Hospital.
  • Senate Bill 819: Extends the hospital sustainability program through 6/30/2024. Increases the maximum fee for inpatient care services to five and one-half per cent. Increases the amount of time hospitals have to pay the hospital sustainability fee from thirty days to sixty days. Appropriates moneys. Effective 6/29/2021.
  • Senate Bill 1127: Makes an emergency appropriation from the general revenues of the State of Hawaii for fiscal year 2020-2021 to address the budget shortfall for the general support for the general assistance program (HMS 204) in the Department of Human Services.

Department of Health

  • House Bill 224: Authorizes the Department of Health to perform the duties required of the State Health Planning and Development Agency.
  • House Bill 541: Clarifies that the duties of the working group established by Act 263, Session Laws of Hawaii 2019, within the Department of Health include identifying gaps in services; coordinating funding sources; and establishing and identifying outcome measures for behavioral health, substance abuse, and homelessness.
  • House Bill 991: Authorizes the Department of Health to disclose vital statistics records for public health purposes. Updates eligibility requirements for access to confidential vital statistics records.
  • House Bill 1322: Establishes a trauma-informed care task force within the Department of Health to make recommendations of trauma-informed care in the state.
  • Senate Bill 1139: Authorizes the Department of Health to set patient registration fees by administrative rulemaking. Requires the Office of Medical Cannabis Control and Regulation to convene a task force on the effect of legalization of cannabis on qualifying medical cannabis patients and report to the legislature.
  • Senate Bill 1150: Authorizes the department of health to recognize national accreditation or certification organizations.

The Governor has until June 21, 2021 to provide the legislature with notification of his intent to veto.