RELATING TO CERTIFICATES OF NEED.

SB2289

THE SENATE

S.B. NO.

2289

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to certificates of need
.

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

����
SECTION
1
.
�
Section 323D-54, Hawaii Revised Statutes, is
amended to read as follows:

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"
�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;

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(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;

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(3)
�
Dispensaries and first aid stations
located within business or industrial establishments and maintained solely for
the use of employees; provided [
such
]
the
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;

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

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(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;

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(7)
�
Dental clinics;

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

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(9)
�
Bed changes that involve ten 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;

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

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

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(13)
�
Equipment and services related to [
that
]

the
equipment, that are primarily invented and used for research
purposes as opposed to usual and customary diagnostic and therapeutic care;

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(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;
or

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(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
]
the
Act;

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

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(16)
�
Facilities offering substance abuse
treatment programs that employ health care providers or certified substance
abuse counselors;

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(17)
�
Intermediate care facilities for persons
having intellectual disabilities as referenced in section 1905(c) of the Social
Security Act, as amended;

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(18)
�
Hospital beds dedicated to pediatric
and neonatal intensive care unit patients;

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(19)
�
Organized ambulatory health care
facilities that operate as surgical centers;

���
(20)
�
Home care agencies licensed under
section 321‑14.8;

���
(21)
�
Kidney disease treatment centers
including freestanding hemodialysis units;

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(22)
�
Hospice homes as defined in section
321-15.1;

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(23)
�
Services offered in neonatal
intensive care units of hospitals;

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(24)
�
Services offered in burn care units of
hospitals;

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(25)
�
Facilities, and services offered at
facilities, located in federally designated medically underserved rural areas;
and

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[
(16)
]

(26)
�

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

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SECTION 2.
�

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

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SECTION 3.
�

This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

Certificates
of Need; Exemptions

Description:

Exempts
from the certificate of need requirements certain health care facilities and
services that address maternal and pediatric health, serve federally designated
medically underserved rural areas, lower patient costs, are unlikely to be overprescribed,
and assist certain vulnerable populations.

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