HB 1004 Hawaii House · 2025 Regular Session

RELATING TO HEALTH CARE.

HB 1004 adopts the Uniform Health Care Decisions Act (2023) to replace Hawaii's current laws on health care decision-making (chapters 327E and 327G of the Hawaii Revised Statutes). It directly affects individuals making or appointing others to make health care decisions for them, including through advance directives and healthcare proxies. The bill establishes clear, standardized legal procedures for these decisions, ensuring consistent guidance for patients, families, and health care providers. The law is scheduled to take effect on July 1, 3000.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Jan 2025

Committee Review

Floor Vote

Governor

Introduced Jan 21, 2025 Last action Feb 12, 2025

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What changed between versions

HB1004 → HB1004_HD1 · 7 edits

MODERATE

This bill updates Hawaii's health care decision laws by adopting the 2023 Uniform Health-Care Decisions Act, consolidating separate laws for advance health care and mental health care directives into one unified framework. The changes modernize definitions, clarify capacity standards, and introduce new protections for individuals experiencing psychiatric or psychological events through 'Ulysses clauses' that allow advance directives to remain in effect even when a person temporarily lacks capacity.

Scope change

The bill expands the scope by unifying previously separate advance health care and mental health care directive laws into a single chapter, while adding new provisions for default surrogates and enhanced protections for individuals with psychiatric conditions.

DEFINITION

Consolidated and updated definitions for advance health care directives, advance mental health care directives, capacity, and related terms to align with the 2023 Uniform Law Commission model.

Expanded definitions to include new categories such as 'cohabitant' (unmarried partners living together for one year) and clarified 'person interested in the welfare of the individual' for surrogate selection purposes.

REQUIREMENT

Introduced 'Ulysses clauses' allowing individuals to specify that their advance mental health care directive remains in effect even when experiencing a psychiatric or psychological event, preventing automatic revocation during temporary incapacity.

Established a formal default surrogate system for individuals lacking capacity who have not appointed an agent, with specific procedures for selection, notification, and disqualification.

Added provisions for electronic records and signatures in advance directives, ensuring digital documents have the same legal effect as paper documents.

Created new requirements for health care professionals to notify individuals and their surrogates of capacity findings and to document objections to incapacity determinations in medical records.

ELIGIBILITY

Updated capacity standards and presumption rules, including new requirements for health care professionals to document findings of incapacity and procedures for individuals to object to such findings.

Floor votes

How they voted

No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Feb 12, 2025

Committee

Reported from HLT (Stand. Com. Rep. No. 512) as amended in HD 1, recommending passage on Second Reading and referral to JHA.

lower

Feb 7, 2025

Lower · Passed

The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 9 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Chun, Marten, Olds, Takenouchi, Alcos, Garcia; Ayes with reservations: none; 0 Noes: none; and 0 Excused: none.

lower

Jan 23, 2025

Committee

Referred to HLT, JHA, referral sheet 3

lower

Jan 23, 2025

Introduced

Introduced and Pass First Reading.

lower

Jan 21, 2025

Introduced

Pending introduction.

lower

1 primary · 0 co-sponsors