RELATING TO HEALTH.

SB1041

THE SENATE

S.B. NO.

1041

THIRTY-THIRD LEGISLATURE, 2025

STATE OF HAWAII

A BILL FOR AN ACT

Relating
to health
.

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

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SECTION 1.
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The
legislature finds that the right of every individual to make informed decisions
about their own health care is the foundation of patient autonomy and a
fundamental part of public health policy.
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Access to transparent and comprehensive information about available
medical procedures is essential for enabling patients to make knowledgeable
choices about their care and treatment options.

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The legislature further finds that
nonmedical refusals to provide certain health care services based on nonmedical
reasons, such as sterilization, abortion, contraceptive services, infertility
treatments, or end-of-life care are often rooted in institutional policies or
ideologies that are not explicitly disclosed to patients.
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These refusals disproportionately affect
vulnerable and marginalized populations, including individuals from the LGBTQ+
community, people of low socioeconomic status, and those residing in rural or
underserved areas.

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The legislature also finds that the lack of
disclosure regarding nonmedical service refusals by health care facilities can
lead to delays in treatment, emotional trauma, and increased health risks,
thereby compromising public trust in the health care system.
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Furthermore, the State has a compelling
interest in protecting public health and ensuring that patients receive timely,
accurate, and accessible information about the services that health care
facilities are willing or unwilling to provide.
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Other states, such as Colorado, have
successfully enacted legislation requiring health care facilities to disclose
up‑front the medical services they refuse to provide for nonmedical
reasons, thus promoting transparency to patients.

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Accordingly, the purpose of this Act is to:

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(1)
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Require
the department of health to develop a service availability form to be completed
by covered entities to convey to patients and the public certain health care
services unavailable at the facility and publish and maintain on its website a
list of covered entities and the service availability form for each covered
entity;

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(2)
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Require
the department of health to adopt rules to implement the requirements of this
Act, including a process to receive and investigate complaints and assess fines
against covered entities in violation; and

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(3)
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Require
each covered entity to provide patients with the current service availability
form as part of the informed consent process before initiating a health care
service and maintain a record of the patient's receipt of the form.

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SECTION 2.
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The Hawaii Revised Statutes is amended by adding a new chapter to be
appropriately designated and to read as follows:

"
Chapter

patients'
right to know act

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� -1
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Definitions.

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As used in this chapter:

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"Covered entity" means any
general hospital, community clinic, freestanding emergency department,
maternity hospital, or rehabilitation hospital.
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"Covered entity" does not include a
health care professional.

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"Denial of care" means any
refusal by a covered entity to provide a health care service, or to provide a
referral for a health care service, for nonmedical reasons.
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"Denial of care" includes the
following practices, whether based on formal or informal policies or practices,
that are not based on generally accepted standards of care:

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(1)
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Selective
refusal to provide a health care service to some, but not all, patients based
on race, color, religion, age, sex, including gender identity or expression,
sexual orientation, marital status, national origin, ancestry, disability, the
covered entity's objections to a health care service, or for other nonmedical
reasons; and

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(2)
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A
significant restriction on the availability of health care services.

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"Department" means the department
of health.

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"Health care professional" means
any person who is licensed, certified, registered, or otherwise authorized or
permitted by law to administer health care or dispense medication in the
ordinary course of business or practice of a profession.

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"Health care service" means the
provision of treatment, care, advice or guidance, or services or supplies,
including:

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(1)
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Preventative,
diagnostic, therapeutic, rehabilitative, maintenance, or palliative care;

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(2)
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Counseling,
assessment, procedures, or other services; or

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(3)
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Selling,
dispensing, or administering a prescription or nonprescription drug, device, or
equipment.

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"Nonmedical reasons" means
nonclinical criteria, rules, or policies, whether written or unwritten, that
restrict a health care professional providing health care services at a covered
entity from providing types of care that a health care professional is
authorized under law to provide and that the covered entity is licensed to
provide.

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"Service availability form" means
the form created by the department pursuant to section -2 and
completed by a covered entity.

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� -2
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Department duties; service availability form;
public access to information; complaint process; rules.

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(a)
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No
later than December 1, 2026, the department shall:

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(1)
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Identify
health care services that are or may be subject to denial of care;

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(2)
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Develop
a clear and simple service availability form for the purpose of conveying to
patients and to the public which of the identified health care services are and
are not generally available or are subject to significant restriction at a
covered entity.
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The service availability
form shall include contact information for the covered entity in case a patient
has specific questions about services available at the covered entity; and

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(3)
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Review,
and if appropriate, update the form at least biennially; provided that the
department may develop different versions of the service availability form
appropriate for different categories of covered entities.

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(b)
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No
later than February 1, 2027, the department shall:

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(1)
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Publish
and maintain on its website a current list of covered entities; and

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(2)
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Provide
the service availability form submitted by each covered entity for public
access;

provided
that the department may use various methods to display the information to
enable patients to compare services available at covered entities.

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(c)
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The
department shall adopt rules pursuant to chapter 91 necessary to carry out the
purposes of this chapter; provided that the rules shall include a process for
receiving and investigating a complaint regarding a covered entity that fails
to comply with this chapter and for assessing fines against any covered entity.

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� -3
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Requirements for covered entities; non-compliance;
penalty.

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(a)
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Each covered entity shall submit to the
department:

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(1)
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A
completed service availability form no later than sixty days after the
department issues or updates the service availability form; and

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(2)
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An
updated service availability form no later than thirty days after making a
change to the availability of a health care service identified on the service
availability form.

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(b)
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No
later than February 1, 2027, each covered entity shall adopt a policy to:

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(1)
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Provide
patients with its current service availability form as a part of the informed
consent process before the initiation of the provision of any health care
service to the patient;

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(2)
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Maintain
a record of the patient's receipt of the service availability form; and

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(3)
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Encourage
any health care professional who has privileges with the covered entity to
provide the covered entity's service availability form to the patient or the
patient's representative before any scheduled health care service at the
covered entity.

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(c)
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Beginning
February 1, 2027, each covered entity shall:

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(1)
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Provide
the current service availability form to the patient or the patient's
representative as part of the informed consent process before any provision of health
care service for the patient is initiated; provided that if informed consent is
impracticable due to an emergency or other circumstances, the covered entity
may delay the provision of the service availability form, as appropriate, until
the informed consent process is conducted;

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(2)
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Maintain
a record of the patient's or the patient's representative's receipt of the
service availability form as part of the informed consent process; and

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(3)
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Provide
the current service availability form to any person upon request.

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(d)
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Any
covered entity that violates this section or any rule adopted by the department
pursuant to this section shall be fined not more than $1,000 for each separate violation.

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Each day the violation continues shall
constitute a separate offense.
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Any
action taken to impose or collect the penalty provided for in this subsection
shall be considered a civil action.

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� -4
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Construction; limitation.

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(a)
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Nothing in this chapter shall be construed to:

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(1)
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Permit
or authorize denial of care or unlawful discrimination in the provision of any health
care service; or

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(2)
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Limit
any cause of action under state or federal law, or limit any remedy in law or
equity, against a covered entity, health care facility, or health care
professional.

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(b)
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Compliance
with this chapter does not reduce or limit any potential liability for a covered
entity, health care facility, or health care professional associated with
denial of care or any violation of state or federal law.

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� -5
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Severability.

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If any provision of this chapter or its
application to any person or circumstances is held invalid, the invalidity does
not affect other provisions or applications of this chapter that can be given
effect without the invalid provision or application, and to this end the
provisions of this chapter are severable."

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SECTION 3.
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This Act does not affect rights and duties that matured, penalties that
were incurred, and proceedings that were begun before its effective date.

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SECTION 4.
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This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

DOH;
Patient's Right To Know Act; Unavailable Health Care Services for Nonmedical
Reasons; Service Availability Form; Covered Entity; Penalty

Description:

Requires the Department of Health to develop a service
availability form to be completed by covered entities to convey to patients and
the public certain health care services unavailable at the entity before
12/1/2026, and to publish and maintain on its website a list of covered
entities and the service availability form submitted by each covered entity
before 02/1/2027.
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Requires the Department
of Health to adopt rules, including a process for receiving and investigating
complaints and assessing fines against covered entities in violation.
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Requires each covered entity to submit a
completed service availability form to the Department of Health, adopt certain
relevant policies by 2/1/2027, provide patients with their current service
availability form as part of the informed consent process before initiating a
health care service, and maintain a record of the patient's receipt of the form
beginning 2/1/2027.
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Establishes
penalties.

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