RELATING TO THE STATE HEALTH PLANNING AND DEVELOPMENT AGENCY.

HB2319

HOUSE OF REPRESENTATIVES

H.B. NO.

2319

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

RELATING
TO THE STATE HEALTH PLANNING AND DEVELOPMENT AGENCY
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

����
SECTION 1.
�
Section 323D-2, Hawaii Revised Statutes, is
amended by adding a new definition to be appropriately inserted and to read as
follows:

����
"
"Health
care" means the improvement of a person's health through the prevention,
diagnosis, treatment, and amelioration or cure of disease, illness, injury, or
other physical and mental impairment, regardless of the setting in which those
services are delivered.
�
Health care
includes oral health, behavioral health, and long-term care.
"

����
SECTION
2.
�
Section 323D-12, Hawaii Revised
Statutes, is amended to read as follows:

����
"
�323D-12

�
Health planning and development
functions; state agency.

�
(a)
�
The state agency shall:

����
(1)
�
Have as a principal function the
responsibility for promoting [
accessibility for all the people of the State
to quality health care services at reasonable cost.
�
The state agency shall conduct such studies
and investigations as may be necessary as to the causes of health care costs
including inflation.
�
The state agency
may contract for services to implement this paragraph.
�
The certificate of need program mandated under
part V shall serve this function.
�
The
state agency shall promote the sharing of facilities or services by health care
providers whenever possible to achieve economies and shall restrict unusual or
unusually costly services to individual facilities or providers where
appropriate;
]
universal access to high-quality, equitable, and
affordable health care for all the people of the State and a shared vision of
Hawaii's health care future;

���
[
(2)
�
Serve as staff to and provide
technical assistance and advice to the statewide council and the subarea
councils in the preparation, review, and revision of the state health services
and facilities plan;

����
(3)
�
Conduct the health planning
activities of the State in coordination with the subarea councils, implement
the state health services and facilities plan, and determine the statewide
health needs of the State after consulting with the statewide council; and
]

����
(2)
�
Conduct the health planning
activities of the State in collaboration with state agencies and with private health
care sector participants to assess and address gaps or concerns affecting
access, quality, and cost including, but not limited to, health insurance
coverage and rates, health insurance benefits and affordability, workforce
development and reimbursement, administrative simplification, and health
information technology including artificial intelligence;

���
[
(4)
]

(3)

�
Administer the state certificate of need
program pursuant to part V[
.
]
, and serve as staff to and provide
technical assistance and advice to the statewide council and subarea councils;
and

����
(4)
�
Establish a state health services,
workforce, and facilities plan and update that plan at least every four years
following consultation with the statewide council.

����
(b)

�
The state agency may:

����
(1)
�
Prepare [
such
] reports and
recommendations on Hawaii's health care costs and public or private efforts to
reduce or control costs and health care quality as it deems necessary.
�
The [
report
]
reports
may include[
,
but not be limited to,
] a review of health insurance plans, the
availability of various kinds of health insurance and malpractice insurance to
consumers,
data-supported analysis and evaluation of the status of statewide
and county health care services adequacy, accessibility, quality, equity, efficiency,
and affordability, including comparisons to national and other state
jurisdictions,
and strategies for increasing competition in the health
insurance field[
.
]
and across the health care delivery system;

���
[
(2)
�
Prepare and revise as necessary the
state health services and facilities plan.

����
(3)
�
Prepare, review, and revise the
annual implementation plan.

����
(4)
]

(2)

�
Assist the statewide council in the
performance of its functions[
.
]
;

���
[
(5)
]

(3)

�
Determine the need for new health services
proposed to be offered within the State[
.
]
;

���
[
(6)
]

(4)
�
Assess existing health care services and
facilities to determine whether there are redundant, excessive, or
inappropriate services or facilities and make public findings of any that are
found to be so.
�
The state agency shall
weigh the costs of the health care services or facilities against the benefits
the services or facilities provide and there shall be a negative presumption
against marginal services[
.
]
;

���
[
(7)
]

(5)

�
Provide technical assistance to persons,
public
���������
or private, in obtaining
and filling out the necessary forms for the development of projects and
programs[
.
]
;

���
[
(8)
]

(6)

�
Prepare reports, studies, and recommendations
on emerging health issues, such as medical ethics, health care rationing,
involuntary care, care for the indigent, and standards for research and
development of biotechnology [
and
] genetic engineering[
.
]
,
telehealth, artificial intelligence, and workforce development; and

���
[
(9)
]

(7)

�
Conduct [
such
] other activities as are
necessary to meet the purposes of this chapter."

����
SECTION
3.
�
Section 323D-54, Hawaii Revised
Statutes, is amended to read as follows:

����
"�323D-54

�
Exemptions from certificate of need
requirements.

�
Nothing in this part
or rules with respect to the requirement for certificates of need applies to:

����
(1)
�
Offices of physicians, dentists, or
other practitioners of the healing arts in private practice as distinguished
from organized ambulatory health care facilities, except in any case of
purchase or acquisition of equipment attendant to the delivery of health care
service and the instruction or supervision for any private office or clinic
involving a total expenditure in excess of the expenditure minimum;

����
(2)
�
Laboratories, as defined in section
321-11(12), except in any case of purchase or acquisition of equipment
attendant to the delivery of health care service and the instruction or
supervision for any laboratory involving a total expenditure in excess of the
expenditure minimum;

����
(3)
�
Dispensaries and first aid stations
located within business or industrial establishments and maintained solely for
the use of employees; provided such facilities do not regularly provide
inpatient or resident beds for patients or employees on a daily twenty-four-hour
basis;

����
(4)
�
Dispensaries or infirmaries in
correctional or educational facilities;

����
(5)
�
Dwelling establishments, such as
hotels, motels, and rooming or boarding houses that do not regularly provide
health care facilities or health care services;

����
(6)
�
Any home or institution conducted only
for those who, pursuant to the teachings, faith, or belief of any group, depend
for healing upon prayer or other spiritual means;

����
(7)
�
Dental clinics;

����
(8)
�
Nonpatient areas of care facilities
such as parking garages and administrative offices;

����
(9)
�
Bed changes that involve [
ten
]
up
to thirty
per cent [
or ten beds of existing licensed bed types,
whichever is less,
] of a facility's total existing licensed beds within a
two-year period;

���
(10)
�
Projects that are wholly dedicated to
meeting the State's obligations under court orders, including consent decrees,
that have already determined that need for the projects exists;

���
(11)
�
Replacement of existing equipment with
its modern-day equivalent;

���
(12)
�
Primary care clinics under the
expenditure thresholds referenced in section 323D-2;

���
(13)
�
Equipment and services related to that
equipment, that are primarily invented and used for research purposes as
opposed to usual and customary diagnostic and therapeutic care;

���
(14)
�
Capital expenditures that are required:

���������
(A)
�
To eliminate or prevent imminent safety
hazards as defined by federal, state, or county fire, building, or life safety
codes or regulations;

���������
(B)
�
To comply with state licensure
standards;

���������
(C)
�
To comply with accreditation standards,
compliance with which is required to receive reimbursements under Title XVIII
of the Social Security Act or payments under a state plan for medical
assistance approved under Title XIX of such Act;

���
(15)
�
Extended care adult residential care
homes and assisted living facilities; [
or
]

���
(16)
�
Health care facilities or services
operated by the department of health; or

��
[
(16)
]

(17)
�
Other facilities or services that the agency
through the statewide council chooses to exempt, by rules pursuant to section
323D-62."

����
SECTION
4.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.

����
SECTION
5.
�
This Act, upon its approval, shall
take effect on July 1, 2026.

INTRODUCED BY:

_____________________________

BY REQUEST

Report Title:

DOH;
SHPDA; Function and Responsibilities; Certificate of Need Exemption

Description:

Amends
the functions and responsibilities of the State Health Planning and Development
Agency.
�
Adds a new definition of
"health care."
�
Amends the
exemption threshold for bed changes to up to thirty per cent of existing
licensed bed types.
�
Exempts the
Department of Health from certificate of need requirements.
�
Effective 7/1/2026.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.