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HOUSE OF REPRESENTATIVES |
H.B. NO. |
2257 |
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THIRTY-THIRD LEGISLATURE, 2026 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO HEALTH CARE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature further finds that these
laws should be updated and consolidated into one unified law regarding health
care decisions to avoid confusion and conflicting provisions. In 2023, the Uniform Law Commission approved
and recommended for enactment in all states the Uniform Health-Care Decisions
Act (2023). While existing state law
addresses advance directives broadly, the Uniform Health-Care Decisions Act
(2023) does so more comprehensively by dividing various types of advance
directives into separate sections for power of attorney for health care, health
care instructions, and advance mental health care directives.
Among other things, the Uniform Health-Care
Decisions Act (2023) expands upon the framework for determining whether an
individual has capacity, removes legal hurdles for creating advance directives,
addresses both advance health care directives and advance mental health care
directives within the same statutory framework, and allows an individual to
assent to a "Ulysses clause" in an advance mental health care
directive, which allows an individual to include an instruction that prevents
the individual from revoking the advance directive if the individual is
experiencing a psychiatric or psychological event specified in the directive.
Therefore, the purpose of this Act is to
update laws concerning advance health care directives and advance mental health
care directives by adopting the Uniform Health-Care Decisions Act (2023) in
amended form.
SECTION 2.
The Hawaii Revised Statutes is amended by adding a new chapter to be
appropriately designated and to read as follows:
"CHAPTER
HEALTH CARE DECISIONS
§
-1 Short title. This chapter may be cited as the Uniform
Health Care Decisions Act (modified).
§
-2 Definitions. As used in this chapter, unless the context
clearly requires otherwise:
"Advance health care directive"
means a power of attorney for health care or health care instruction, or
both. "Advance health care
directive" includes an advance mental health care directive.
"Advance mental health care
directive" means a power of attorney for health care or health care
instruction, or both, created under section
-9.
"Advanced practice registered
nurse" means a person licensed pursuant to section 457-8.5 and who holds
an accredited national certification in an advanced practice registered nurse
psychiatric specialization.
"Agent" means an individual
appointed under a power of attorney for health care to make a health care
decision for the individual who made the appointment. "Agent" includes a co‑agent
or alternate agent appointed under section
-20.
"Capacity" means having capacity
under section -3.
"Civil union partner" means an
individual who is party to a civil union established pursuant to chapter 572B.
"Cohabitant" means each of two
individuals who have been living together as a couple for at least one year
after each became an adult or was emancipated, and who are not married to each
other or are not in a civil union with each other.
"Default surrogate" means an
individual authorized under section
-12 to make a health care decision for another individual.
"Electronic" means relating to
technology having electrical, digital, magnetic, wireless, optical,
electromagnetic, or similar capabilities.
"Emancipated minor" means a minor
deemed to be emancipated pursuant to section 577-25 or order of the family
court.
"Emergency medical services
personnel" has the same meaning as in section 321-222.
"Family member" means a spouse,
civil union partner, adult child, parent, or grandparent, or an adult child of
a spouse, civil union partner, child, parent, or grandparent.
"First responder personnel" has
the same meaning as in section 321-222.
"Guardian" means a person
appointed under chapter 560, article V, part 3, by a court to make decisions
regarding the personal affairs of an individual, which may include health care
decisions. "Guardian" does not
include a guardian ad litem.
"Health care" means care or
treatment or a service or procedure to maintain, monitor, diagnose, or
otherwise affect an individual's physical or mental illness, injury, or
condition. "Health care"
includes mental health care.
"Health care decision" means a
decision made by an individual or the individual's surrogate regarding the
individual's health care, including:
(1) Selection
or discharge of a health care professional or health care institution;
(2) Approval
or disapproval of a diagnostic test, surgical procedure, medication,
therapeutic intervention, or other health care; and
(3) Direction
to provide, withhold, or withdraw artificial nutrition or hydration, mechanical
ventilation, or other health care.
"Health care institution" means a
facility or agency licensed, certified, or otherwise authorized or permitted by
other law to provide health care in this State in the ordinary course of
business.
"Health care instruction" means a
direction, whether or not in a record, made by an individual that indicates the
individual's goals, preferences, or wishes concerning the provision,
withholding, or withdrawal of health care.
"Health care instruction" includes a direction intended to be
effective if a specified condition arises.
"Health care professional" means
a physician or other individual licensed, certified, or otherwise authorized or
permitted by other laws of this State to provide health care in this State in
the ordinary course of business or the practice of the physician's or
individual's profession.
"Individual" means an adult or
emancipated minor.
"Mental health care" means care
or treatment or a service or procedure to maintain, monitor, diagnose, or
otherwise affect an individual's mental illness or other psychiatric,
psychological, or psychosocial condition.
"Minor" means a person under
eighteen years of age.
"Nursing home" means a nursing
facility as defined in section 1919(a)(1) of the Social Security Act (42 U.S.C.
1396r(a)(1)), or skilled nursing facility as defined in section 1819(a)(1) of
the Social Security Act (42 U.S.C. 1395i–3(a)(1)).
"Person" means an individual,
estate, business or nonprofit entity, government or governmental subdivision,
agency, or instrumentality, or other legal entity.
"Person interested in the welfare of
the individual" means:
(1) The
individual's surrogate;
(2) A
family member of the individual;
(3) The
cohabitant of the individual;
(4) A
public entity providing health care case management or protective services to
the individual;
(5) A
person appointed under any other law to make decisions for the individual under
a power of attorney for finances; or
(6) A
person that has an ongoing personal or professional relationship with the
individual, including a person that has provided educational or health care
services or supported decision making to the individual.
"Physician" means an individual
licensed to practice medicine or osteopathic medicine under chapter 453.
"Psychologist" means an
individual licensed to practice psychology under chapter 465.
"Power of attorney for health
care" means a record in which an individual appoints an agent to make
health care decisions for the individual.
"Reasonably available" means
being able to be contacted without undue effort and being willing and able to
act in a timely manner considering the urgency of an individual's health care
situation. When used to refer to an
agent or default surrogate, "reasonably available" includes being
willing and able to comply with the duties under section -17 in a timely manner considering the
urgency of an individual's health care situation.
"Record" means information:
(1) Inscribed
on a tangible medium; or
(2) Stored
in an electronic or other medium and retrievable in perceivable form.
"Responsible health care
professional" means:
(1) A
health care professional designated by an individual or the individual's
surrogate to have primary responsibility for the individual's health care or
for overseeing a course of treatment; or
(2) In
the absence of a designation under paragraph (1) or, if the health care
professional designated under paragraph (1) is not reasonably available, a
health care professional who has primary responsibility for overseeing the
individual's health care or for overseeing a course of treatment.
"Sign" means, with present intent
to authenticate or adopt a record:
(1) Execute
or adopt a tangible symbol; or
(2) Attach
to or logically associate with the record an electronic symbol, sound, or
process.
"State" means a state of the
United States, the District of Columbia, Puerto Rico, the United States Virgin
Islands, or any other territory or possession subject to the jurisdiction of
the United States. "State"
includes a federally recognized Indian tribe.
"Supported decision making" means
assistance, from one or more persons of an individual's choosing, that helps
the individual make or communicate a decision, including by helping the
individual understand the nature and consequences of the decision. "Supported decision making"
includes, but is not limited to, assistance from an individual's supportive
community pursuant to chapter 349F.
"Surrogate" means:
(1) An
agent;
(2) A
default surrogate; or
(3) A
guardian authorized to make health care decisions.
§ -3
Capacity. (a) An
individual shall be deemed to have capacity for the purpose of this chapter if
the individual:
(1) Is
willing and able to communicate a decision independently or with appropriate
services, technological assistance, supported decision making, or other
reasonable accommodation; and
(2) In
making or revoking:
(A) A
health care decision, understands the nature and consequences of the decision,
including the primary risks and benefits of the decision;
(B) A
health care instruction, understands the nature and consequences of the
instruction, including the primary risks and benefits of the choices expressed
in the instruction; and
(C) An
appointment of an agent under a power of attorney for health care or
identification of a default surrogate under section -12(b), recognizes the identity of the
person being appointed or identified and understands the general nature of the
relationship of the individual making the appointment or identification with
the person being appointed or identified.
(b)
The right of an individual who has capacity to make a decision about the
individual's health care shall not be affected by the creation or revocation of
an advance health care directive by the individual.
§
-4 Presumption of capacity;
overcoming presumption. (a) An individual shall be presumed to have
capacity to make or revoke a health care decision, health care instruction, and
power of attorney for health care unless:
(1) A
court has found the individual lacks capacity to do so; or
(2) The
presumption is rebutted under subsection (b).
(b)
A presumption under subsection (a) may be rebutted by a finding that the
individual lacks capacity:
(1) Subject
to subsection (c), made on the basis of a contemporaneous examination by any of
the following health care professionals:
(A) A
physician;
(B) A
psychologist; or
(C) An
advanced practice registered nurse;
(2) Made
in accordance with accepted standards of the profession and the scope of
practice of the health care professional making the finding and to a reasonable
degree of certainty; and
(3) Documented
in a record by the health care professional making the finding that includes an
opinion of the cause, nature, extent, and probable duration of the lack of
capacity.
(c)
The finding under subsection (b) shall not be made by:
(1) A
family member of the individual presumed to have capacity;
(2) The
cohabitant of the individual or a family member of the cohabitant; or
(3) The
individual's surrogate or a family member of the surrogate.
(d)
If the finding under subsection (b) was based on a condition the
individual no longer has or a responsible health care professional subsequently
has good cause to believe the individual has capacity, the individual shall be
presumed to have capacity unless a court finds the individual lacks capacity
pursuant to section -6 or the
presumption is rebutted under subsection (b).
§
-5 Notice of finding of lack of
capacity. (a) As soon as reasonably feasible, a health care
professional who makes a finding under section -4(b) shall inform the individual who is
the subject of the finding or the individual's responsible health care
professional of the finding.
(b)
As soon as reasonably feasible, a responsible health care professional
who is informed of a finding under section ‑4(b) shall
inform the individual who is the subject of the finding and the individual's
surrogate.
§
-6 Judicial review of finding of
lack of capacity. (a) An individual found under section -4(b) to lack capacity, a responsible
health care professional, the health care institution providing health care to
the individual, or a person interested in the welfare of the individual may
petition the family court in the county where the individual resides or is
located to determine whether the individual lacks capacity.
(b)
The court in which a petition under subsection (a) is filed may appoint
a guardian ad litem. The court shall
hear the petition as soon as practicable after the petition is filed. As soon as practicable after the hearing, the
court shall determine whether the individual lacks capacity. The court may determine that the individual
lacks capacity only if the court finds by clear and convincing evidence that
the individual lacks capacity.
§
-7 Health care instruction. (a) An
individual may create a health care instruction that expresses the individual's
preferences for future health care, including preferences regarding:
(1) Health
care professionals or health care institutions;
(2) How
a health care decision will be made and communicated;
(3) Persons
that should or should not be consulted regarding a health care decision;
(4) A
person to serve as guardian for the individual if one is appointed; and
(5) An
individual to serve as a default surrogate.
(b) A
health care professional to whom an individual communicates or provides an instruction
under subsection (a) shall document and maintain the instruction and the date
of the instruction in the individual's medical record or communicate the
instruction and date of the instruction to an administrator with responsibility
for medical records of the health care institution providing health care to the
individual, who shall document and maintain the instruction and the date of the
instruction in the individual's medical record.
(c)
A health care instruction made by an individual that conflicts with an
earlier health care instruction made by the individual, including an
instruction documented in a medical order, shall revoke the earlier instruction
to the extent of the conflict.
(d)
A health care instruction may be in the same record as a power of
attorney for health care.
§
-8 Power of attorney for health
care. (a) An individual may create a power of attorney
for health care to appoint an agent to make health care decisions for the
individual.
(b)
A person shall be disqualified from acting as an agent for an individual
who is found under section -4(b) or by
a court to lack capacity to make health care decisions if:
(1) A
court finds that the potential agent poses a danger to the individual's
well-being, even if the court does not issue a restraining order or injunction
against the potential agent; or
(c)
A health care decision made by an agent shall be effective without
judicial approval.
(d)
A power of attorney for health care shall be in a record, signed by the
individual creating the power, and signed by an adult witness who:
(1) Reasonably
believes the act of the individual to create the power of attorney is voluntary
and knowing;
(2) Is
not:
(A) The
agent appointed by the individual;
(B) The
agent's spouse, civil union partner, or cohabitant;
(C) If
the individual resides or is receiving care in a nursing home or other
residential care facility, the owner, operator, employee, or contractor of the
nursing home or other residential care facility;
(D) Related
to the individual by blood, marriage, or adoption; or
(E) Entitled
to any portion of the estate upon the individual's death; and
(3) Is
present when the individual signs the power of attorney or when the individual
represents that the power of attorney reflects the individual's wishes.
(e)
A witness under subsection (d) shall be considered present if the
witness and the individual are:
(1) Physically
present in the same location;
(2) Using
electronic means that allow for real time audio and visual transmission and
communication in real time to the same extent as if the witness and the
individual were physically present in the same location; or
(3) Able
to speak to and hear each other in real time through audio connection if:
(A) The
identity of the individual is personally known to the witness; or
(B) The
witness is able to authenticate the identity of the individual by receiving
accurate answers from the individual that enable the authentication.
(f)
A power of attorney for health care may include a health care
instruction.
§
-9 Advance mental health care
directive. (a) An individual may create an advance health
care directive that addresses only mental health care for the individual. The directive may include a health care
instruction or a power of attorney for health care, or both.
(b)
A health care instruction under this section may include the
individual's:
(1) General
philosophy and objectives regarding mental health care; and
(2) Specific
goals, preferences, and wishes regarding the provision, withholding, or
withdrawal of a form of mental health care, including:
(A) Preferences
regarding professionals, programs, and facilities;
(B) Admission
to a mental health care facility, including duration of admission;
(C) Preferences
regarding medications;
(D) Refusal
to accept a specific type of mental health care, including medication; and
(E) Preferences
regarding crisis intervention.
(c)
A power of attorney for health care under this section may appoint an
agent to make decisions only for mental health care.
(d)
An individual may direct in an advance mental health care directive
that, if the individual is experiencing a psychiatric or psychological event
specified in the directive, the individual may not revoke the directive or a
part of the directive.
(e)
If an advance mental health care directive includes a direction under
subsection (d), the advance mental health care directive shall be signed by the
individual creating the advance mental health care directive and at least two
adult witnesses who:
(1) Attest
that to the best of their knowledge the individual:
(A) Understood
the nature and consequences of the direction, including its risks and benefits;
and
(B) Made
the direction voluntarily and without coercion or undue influence;
(2) Are
not:
(A) The
agent appointed by the individual;
(B) The
agent's spouse, civil union partner, or cohabitant;
(C) If
the individual resides in a nursing home or other residential care facility,
the owner, operator, employee, or contractor of the nursing home or other
residential care facility;
(D) Related
to the individual by blood, marriage, or adoption; or
(E) Entitled
to any portion of the estate upon the individual's death; and
(3) Are
physically present in the same location as the individual.
§
-10 Relationship of advance
mental health care directive and other advance health care directive. (a) If
a direction in an advance mental health care directive of an individual
conflicts with a direction in another advance health care directive of the
individual, the later direction shall revoke the earlier direction to the
extent of the conflict.
(b)
An appointment of an agent to make decisions only for mental health care
for an individual shall not revoke an earlier appointment of an agent to make
other health care decisions for the individual.
(c)
An appointment of an agent to make decisions only for mental health care
decisions for an individual shall revoke an earlier appointment of an agent to
make mental health care decisions for the individual unless otherwise specified
in the later appointment.
(d)
An appointment of an agent to make health care decisions for an
individual other than decisions about mental health care shall not revoke a
prior appointment of an agent to make only mental health care decisions.
§
-11 Model forms. The department of health, in consultation
with the department of the attorney general, shall develop, publish, and update
as appropriate model forms of advance health care directives and advance mental
health care directives, which shall be posted on the department of health's
website.
§
-12 Default surrogate. (a) A
default surrogate may make a health care decision for an individual who lacks
capacity to make health care decisions and for whom an agent, or guardian
authorized to make health care decisions, has not been appointed or is not
reasonably available.
(b)
Upon determination that an individual lacks capacity to make health care
decisions, a responsible health care professional or the responsible health
care professional's designee shall make reasonable efforts to notify the
individual of the individual's lack of capacity to make health care
decisions. If the individual has not
appointed an agent and the individual retains capacity under section -3(a)(1) and (2)(C), the individual may
identify a person to act as a default surrogate.
(c)
Unless the individual has an advance health care directive that
indicates otherwise or the person identified by the individual under subsection
(b) is designated as a default surrogate, the responsible health care
professional or the responsible health care professional's designee shall make
reasonable efforts to locate as many interested persons as practicable, and the
responsible health care professional or the responsible health care
professional's designee may rely on the interested persons to notify other
family members or interested persons.
Upon locating interested persons, the responsible health care
professional or the responsible health care professional's designee shall
inform the interested persons of the individual's lack of capacity and that a
default surrogate should be selected for the individual.
(d)
Interested persons shall make reasonable efforts to reach a consensus as
to who among them shall act as the individual's default surrogate. If the person selected to act as the
individual's default surrogate is disqualified or becomes disqualified under
section –13, the interested persons
shall make reasonable efforts to reach consensus as to who among them shall act
as the individual's default surrogate.
The person selected to act as the
individual's default surrogate shall be the person who has a close relationship
with the individual and who is the most likely to be currently informed of the
individual's wishes regarding health care decisions.
(e)
If any of the interested persons disagrees with the selection of the
default surrogate or the health care decision by the default surrogate, or, if
after reasonable efforts the interested persons are unable to reach a consensus
as to who should act as the default surrogate, any of the interested persons
may seek guardianship of the individual by initiating guardianship proceedings
pursuant to chapter 551 or 560, as applicable.
Only interested persons involved in the discussions to choose a default
surrogate may initiate such proceedings regarding the individual.
(f)
A responsible health care professional may require a person who assumes
authority to act as a default surrogate to provide a signed declaration in a
record under penalty of law stating facts and circumstances reasonably
sufficient to establish the authority.
The signed declaration shall include the following:
(1) The
name of the person who seeks to assume the authority to act as a default
surrogate;
(2) An
affirmation that the person understands that the statements and affirmations
are made under the penalty of law;
(3) An
affirmation that the person had a relationship with the individual who lacks
capacity before the individual became incapacitated;
(4) A
statement defining that relationship, including identifying the relationship of
the person to the individual;
(5) If
the person is not a family member or cohabitant, a statement describing how the
person exhibited special care and concern for the individual who lacks capacity
and is familiar with the individual's personal values;
(6) An
affirmation that the person understands that the health care professional will
reasonably rely on the person's representations in the declaration to assist in
providing medical treatment; and
(7) A
statement that the declaration was provided under the penalty of law.
(g)
If a responsible health care professional reasonably determines that a
person who assumed authority to act as a default surrogate is not willing or
able to comply with a duty under section
-17 or fails to comply with the duty in a timely manner, the responsible
health care professional may request interested persons to choose another
default surrogate.
(h)
A health care decision made by a default surrogate shall be effective
without judicial approval.
(i)
As used in this section, unless the context clearly requires otherwise,
"interested persons" means any of the individual's family members or
any adult who has exhibited special care and concern for the individual and who
is familiar with the individual's personal values.
§
-13 Disqualification to act as
default surrogate. (a) An individual for whom a health care decision
would be made may disqualify a person from acting as default surrogate for the
individual by expressing the wish to disqualify that person. The disqualification shall be in a record
signed by the individual or communicated verbally or nonverbally by the
individual to the person being disqualified, another person, or a responsible
health care professional. If the
individual has expressed that the individual did not want a particular person
to make health care decisions for the individual, that person shall be
disqualified from being a default surrogate.
Disqualification under this subsection shall be effective even if made
by an individual who is found under section
-4(b) or by a court to lack capacity to make a health care decision if
the individual clearly communicates a desire that the person being disqualified
not make health care decisions for the individual.
(1) A
court finds that the potential default surrogate poses a danger to the
individual's well-being, even if the court does not issue a restraining order
or injunction against the potential default surrogate;
(2) The
potential default surrogate is an owner, operator, employee, or contractor of a
nursing home or other residential care facility in which the individual is
residing or receiving care unless the owner, operator, employee, or contractor
is a family member of the individual, the cohabitant of the individual, or a
family member of the cohabitant;
(3) The
potential default surrogate refuses to provide a timely declaration under
section -12(f) upon the request by a
responsible health care professional; or
(4) The
potential default surrogate is the individual's spouse or civil union partner,
and:
(A) A
petition for annulment, divorce, or dissolution of marriage, legal separation,
or termination has been filed and not dismissed or withdrawn;
(B) A
decree of annulment, divorce, or dissolution of marriage, legal separation, or
termination has been issued;
(C) The
individual and the spouse or civil union partner have agreed in a record to a
legal separation; or
(D) The
spouse or civil union partner has abandoned or deserted the individual for more
than one year.
(c)
Notwithstanding subsection (b)(4), a spouse or civil union partner shall
not be disqualified if the individual has retained capacity under section -3(a)(1) and (2)(C) and expresses the wish
not to disqualify the spouse or civil union partner as a default surrogate.
§
-14 Revocation. (a) An
individual may revoke the appointment of an agent, the designation of a default
surrogate, or a health care instruction in whole or in part, unless:
(1) A
court finds the individual lacks capacity to do so;
(2) The
individual is found under section
-4(b) to lack capacity to do so; or
(3) The
individual created an advance mental health care directive that includes the
provision under section -9(d) and the individual is
experiencing the psychiatric or psychological event specified in the directive.
(b)
Revocation under subsection (a) may be by any act of the individual that
clearly indicates that the individual revokes the appointment, designation, or
instruction, including an oral statement to a health care professional.
(c)
Except as provided in section
-10, an advance health care directive of an individual that conflicts
with another advance health care directive of the individual shall revoke the
earlier directive to the extent of the conflict.
(d)
Unless otherwise provided in an individual's advance health care
directive appointing an agent, the appointment of a spouse or civil union
partner of an individual as agent for the individual shall be revoked if:
(1) A
petition for annulment, divorce, legal separation, or termination has been
filed and not dismissed or withdrawn;
(2) A
decree of annulment, divorce, legal separation, or termination has been issued;
(3) The
individual and the spouse or civil union partner have agreed in a record to a
legal separation; or
(4) The
spouse or civil union partner has abandoned or deserted the individual for more
than one year.
§
-15 Withdrawal of agent. An agent may withdraw by giving notice to the
individual for whom the agent is acting, if the individual has capacity at the
time. If the individual is found under
section -4(b) or by a court to lack
capacity, the agent may withdraw by giving notice to a responsible health care
professional.
§
-16 Validity of advance health
care directive; conflict with other law.
(a) An advance health care
directive created outside this State shall be valid if it complies with:
(1) The
law of the state specified in the directive or, if a state is not specified,
the state in which the individual created the directive; or
(2) This
chapter.
(b)
A person may assume without inquiry that an advance health care
directive is genuine, valid, and still in effect, and may implement and rely on
it, unless the person has good cause to believe the directive is invalid or has
been revoked.
(c)
An advance health care directive, revocation of a directive, or a
signature on a directive or revocation shall not be denied legal effect or
enforceability solely because it is in electronic form.
(d)
Evidence relating to an advance health care directive, revocation of a
directive, or a signature on a directive or revocation shall not be excluded in
a proceeding solely because the evidence is in electronic form.
(e)
This chapter shall not affect the validity of an electronic record or
signature that is valid under chapter 489E.
(f)
If this chapter conflicts with other laws of this State relating to the
creation, execution, implementation, or revocation of an advance health care
directive, this chapter shall prevail.
§
-17 Duties of agent and default
surrogate. (a) An agent or default surrogate shall have a
fiduciary duty to the individual for whom the agent or default surrogate is
acting when exercising or purporting to exercise a power under section ‑18.
(b)
An agent or a default surrogate shall make a health care decision in
accordance with the direction of the individual in an advance health care
directive and other goals, preferences, and wishes of the individual to the
extent known or reasonably ascertainable by the agent or default surrogate.
(c)
If there is not a direction in an advance health care directive and the
goals, preferences, and wishes of the individual regarding a health care
decision are not known or reasonably ascertainable by the agent or default
surrogate, the agent or default surrogate shall make the decision in accordance
with the agent's or default surrogate's determination of the individual's best
interest.
(d)
In determining the individual's best interest under subsection (c), the
agent or default surrogate shall:
(1) Give
primary consideration to the individual's contemporaneous communications,
including verbal and nonverbal expressions;
(2) Consider
the individual's values to the extent known or reasonably ascertainable by the
agent or default surrogate; and
(3) Consider
the risks and benefits of the potential health care decision.
(e)
As soon as reasonably feasible, an agent or a default surrogate who is
informed of a revocation of an advance health care directive or
disqualification of the agent or default surrogate shall communicate the revocation
or disqualification to a responsible health care professional.
§
-18 Powers of agent and default
surrogate. (a) Except as provided in subsection (c), the
power of an agent or a default surrogate shall commence when the individual is found under section
-4(b) or by a court to lack capacity to make a health care
decision. The power shall cease if the
individual is later found to have capacity to make a health care decision.
(b)
An agent or a default surrogate may request, receive, examine, copy, and
consent to the disclosure of medical and other health care information about
the individual if the individual would have the right to request, receive,
examine, copy, or consent to the disclosure of the information.
(c)
A power of attorney for health care may provide that the power of an
agent under subsection (b) commences on appointment.
(d)
If no other person is authorized to do so, an agent or a default
surrogate may apply for private health insurance and benefits on behalf of the
individual. An agent or a default
surrogate who may apply for insurance and benefits shall not, solely by reason
of the power, have a duty to apply for the insurance or benefits.
A default surrogate may act as a medicaid
authorized representative, pursuant to federal and state medicaid laws relating
to authorized representatives, on the individual's behalf for the purposes of
medicaid, including assisting with, submitting, and executing a medicaid
application, redetermination of eligibility, or other ongoing medicaid-related
communications with the department of human services. For the purposes of medicaid, the default
surrogate may access medicaid records of the individual on whose behalf the
default surrogate is designated to act.
For a default surrogate to be able to act under this subsection, the
default surrogate shall agree to be legally bound by the federal and state
authorities related to authorized representatives, including maintaining the
confidentiality of any information provided by the department of human
services, in compliance with all federal and state confidentiality laws.
(e)
An agent or a default surrogate shall not consent to voluntary admission
of the individual to a facility for mental health treatment unless:
(1) Voluntary
admission is specifically authorized by the individual in an advance health
care directive in a record; and
(2) The
admission is for not more than the maximum of the number of days specified in
the directive or thirty days, whichever is less.
(f) An
agent or a default surrogate may consent to placement of the individual in a
nursing home without specific authorization by the individual; provided that if
the placement is intended to be for more than one hundred days, an agent or a
default surrogate shall not consent to placement of the individual in a nursing
home if:
(1) An
alternative living arrangement is reasonably feasible;
(2) The
individual objects to the placement; or
(3) The
individual is not terminally ill.
Nothing in this subsection shall prevent an
agent or a default surrogate from consenting to placement of the individual in
a nursing home for more than one hundred days if the individual specifically
authorizes the agent or default surrogate to do so in an advance health care
directive in a record.
§
-19 Limitation on powers. If an individual has a long-term disability
requiring routine treatment by artificial nutrition, hydration, or mechanical
ventilation and a history of using the treatment without objection, an agent or
default surrogate shall not consent to withhold or withdraw the treatment
unless:
(1) The
treatment is not necessary to sustain the individual's life or maintain the
individual's well‑being;
(2) The
individual has expressly authorized the withholding or withdrawal in a health
care instruction that has not been revoked; or
(3) The
individual has experienced a major reduction in health or functional ability
from which the individual is not expected to recover, even with other
appropriate treatment, and the individual has not:
(A) Given
a direction inconsistent with withholding or withdrawal; or
(B) Communicated
by verbal or nonverbal expression a desire for artificial nutrition, hydration,
or mechanical ventilation.
§
-20 Co-agents; alternate agent. (a) An
individual may appoint multiple individuals as co-agents in a power of attorney
for health care. Unless the power of
attorney for health care provides otherwise, each co-agent may exercise
independent authority.
(b)
An individual in a power of attorney for health care may appoint one or
more individuals to act as alternate agents if a predecessor agent withdraws,
dies, becomes disqualified, is not reasonably available, or otherwise is
unwilling or unable to act as agent.
(c)
Unless the power of attorney for health care provides otherwise, an
alternate agent shall have the same authority as the original agent:
(1) At
any time the original agent is not reasonably available or is otherwise
unwilling or unable to act, for the duration of the unavailability,
unwillingness, or inability to act; or
(2) If
the original agent and all other predecessor agents have withdrawn, died, or
are disqualified from acting as agent.
§
-21 Duties of health care
professional, responsible health care professional, and health care
institution. (a) A responsible health care professional who is
aware that an individual has been found under section -4(b) or by a court to lack capacity to
make a health care decision shall make a reasonable effort to determine if the
individual has a surrogate.
(b)
If possible before implementing a health care decision made by a
surrogate, a responsible health care professional as soon as reasonably
feasible shall communicate to the individual the decision made and the identity
of the surrogate.
(c)
A responsible health care professional who makes or is informed of a
finding that an individual lacks capacity to make a health care decision or no
longer lacks capacity, or that other circumstances exist that affect a health
care instruction or the authority of a surrogate, as soon as reasonably
feasible, shall:
(1) Document
the finding or circumstance in the individual's medical record; and
(2) If
possible, communicate the finding or circumstance to the individual and the
individual's surrogate.
(d)
A responsible health care professional who is informed that an
individual has created or revoked an advance health care directive, or that a
surrogate for an individual has been appointed, designated, or disqualified, or
has withdrawn, shall:
(1) Document
the information as soon as reasonably feasible in the individual's medical
record; and
(2) If
evidence of the directive, revocation, appointment, designation,
disqualification, or withdrawal is in a record, request a copy and, on receipt,
cause the copy to be included in the individual's medical record.
(e)
Except as provided in subsections (f) and (g), a health care
professional or health care institution providing health care to an individual
shall comply with:
(1) A
health care instruction given by the individual regarding the individual's
health care;
(2) A
reasonable interpretation by the individual's surrogate of an instruction given
by the individual; and
(3) A
health care decision for the individual made by the individual's default
surrogate in accordance with sections -17
and -18 to the same extent as if the
decision had been made by the individual at a time when the individual had
capacity.
(f)
A health care professional or a health care institution may refuse to
provide health care consistent with a health care instruction or health care
decision if:
(1) The
instruction or decision is contrary to a policy of the health care institution
providing care to the individual and the policy was timely communicated to the
individual with capacity or to the individual's surrogate;
(2) The
care would require health care that is not available to the health care
professional or health care institution; or
(3) Compliance
with the instruction or decision would:
(A) Require
the health care professional to provide care that is contrary to the health
care professional's religious belief or moral conviction and if other law
permits the health care professional to refuse to provide care for that reason;
(B) Require
the health care professional or health care institution to provide care that is
contrary to generally accepted health care standards applicable to the health
care professional or health care institution; or
(C) Violate
a court order or other law.
(g)
A health care professional or health care institution that refuses to
provide care under subsection (f) shall:
(1) As
soon as reasonably feasible, inform the individual, if possible, and the
individual's surrogate of the refusal; and
(2) Immediately
make a reasonable effort to transfer the individual to another health care
professional or health care institution that is willing to comply with the
instruction or decision and provide life-sustaining care and care needed
to keep or make the individual comfortable, consistent with accepted medical
standards to the extent feasible, until a transfer is made.
§
-22 Decision by guardian. (a) A
guardian may refuse to comply with or revoke the individual's advance health
care directive only if the court appointing the guardian expressly orders the
noncompliance or revocation.
(b)
Unless a court orders otherwise, a health care decision made by an agent
appointed by an individual subject to guardianship prevails over a decision of
the guardian appointed for the individual.
§
-23 Immunity. (a) A
health care professional or health care institution acting in good faith shall
not be subject to civil or criminal liability or to discipline for
unprofessional conduct for:
(1) Complying
with a health care decision made for an individual by another person if
compliance is based on a reasonable belief that the person has authority to
make the decision, including a decision to withhold or withdraw health care;
(2) Refusing
to comply with a health care decision made for an individual by another person
if the refusal is based on a reasonable belief that the person lacked authority
or capacity to make the decision;
(3) Complying
with an advance health care directive based on a reasonable belief that the
directive is valid;
(5) Determining
that a person who otherwise might be authorized to act as an agent or default
surrogate is not reasonably available; or
(6) Complying
with an individual's direction under section ‑9(d).
(b)
An agent, default surrogate, or person with a reasonable belief that the
person is an agent or a default surrogate shall not be subject to civil or
criminal liability or to discipline for unprofessional conduct for a health
care decision made in a good faith effort to comply with section ‑17.
§
-24 Prohibited conduct; damages. (a) A
person shall not:
(1) Intentionally
falsify, in whole or in part, an advance health care directive;
(2) For
the purpose of frustrating the intent of the individual who created an advance
health care directive or with knowledge that doing so is likely to frustrate
the intent:
(A) Intentionally
conceal, deface, obliterate, or delete the directive or a revocation of the
directive without consent of the individual who created or revoked the
directive; or
(B) Intentionally
withhold knowledge of the existence or revocation of the directive from a
responsible health care professional or health care institution providing
health care to the individual who created or revoked the directive;
(3) Coerce
or fraudulently induce an individual to create, revoke, or refrain from
creating or revoking an advance health care directive or a part of a directive;
or
(4) Require
or prohibit the creation or revocation of an advance health care directive as a
condition for providing health care.
(b)
An individual who is the subject of conduct prohibited under subsection
(a), or the individual's estate, shall have a cause of action against a person
that violates subsection (a) for statutory damages of $25,000 or actual damages
resulting from the violation, whichever is greater.
(c)
Subject to subsection (d), an individual who makes a health care
instruction, or the individual's estate, shall have a cause of action against a
health care professional or health care institution that intentionally violates
section -21 for statutory damages of
$5,000 or actual damages resulting from the violation, whichever is greater.
(d)
An emergency department of a health care institution or health care
professional who is an emergency medical services personnel or first responder
personnel shall not be liable under subsection (c) for a violation of
section -21(e) if:
(1) The
violation occurs in the course of providing care to an individual experiencing
a health condition for which the professional reasonably believes the care is
appropriate to avoid imminent loss of life or serious harm to the individual or
providing care;
(2) The
failure to comply is consistent with accepted standards of the profession of
the professional; and
(3) The
provision of care does not begin in a health care institution in which the
individual resides or was receiving care.
(e)
In an action under this section, a prevailing plaintiff may recover
reasonable attorneys' fees, court costs, and other reasonable litigation
expenses.
(f)
A cause of action or remedy under this section shall be in addition to
any cause of action or remedy under other law.
§
-25 Effect of copy; certified
physical copy. (a) A physical or electronic copy of an advance
health care directive, revocation of an advance health care directive, or
appointment, designation, or disqualification of a surrogate shall have the
same effect as the original.
(b)
An individual may create a certified physical copy of an advance health
care directive or revocation of an advance health care directive that is in
electronic form by affirming under penalty of law that the physical copy is a
complete and accurate copy of the directive or revocation.
§
-26 Judicial relief. (a) On
petition of an individual, the individual's surrogate, a health care
professional or health care institution providing health care to the
individual, or a person interested in the welfare of the individual, the family
court may:
(1) Enjoin
implementation of a health care decision made by an agent or default surrogate
on behalf of the individual, on a finding that the decision is inconsistent
with section -17 or -18;
(2) Enjoin
an agent from making a health care decision for the individual, on a finding
that the individual's appointment of the agent has been revoked or the agent:
(A) Is
disqualified under section -8(b);
(B) Is
unwilling or unable to comply with section ‑17; or
(C) Poses
a danger to the individual's well-being;
(3) Enjoin
another person from acting as a default surrogate, on a finding that the other
person acting as a default surrogate did not comply with section -12
or the other person:
(A) Is
disqualified under section -13;
(B) Is
unwilling or unable to comply with section -17; or
(C) Poses
a danger to the well-being of the individual for whom the person is acting as a
default surrogate; or
(4) Order
the implementation of a health care decision made:
(A) By
and for the individual; or
(B) By
an agent or default surrogate who is acting in compliance with the powers and
duties of the agent or default surrogate.
(b)
In this chapter, advocacy for the withholding or withdrawal of health
care or mental health care from an individual shall not by itself be evidence
that an agent or default surrogate, or a potential agent or default surrogate,
poses a danger to the individual's well-being.
(c)
A petition filed under this section shall include notice of the
existence of an advance health care directive, if applicable, and a copy of the
directive shall be provided to the court.
(d)
A proceeding under this section shall be expedited on motion by any
party.
§
-27 Construction. (a)
Nothing in this chapter shall be construed to authorize mercy killing,
assisted suicide, or euthanasia.
(b)
This chapter shall not affect any other laws of this State governing
treatment for mental illness of an individual involuntarily committed, or an
individual who is the subject of an assisted community treatment order, under
chapter 334.
(c)
Death of an individual caused by withholding or withdrawing health care
in accordance with this chapter shall not constitute a suicide or homicide or
legally impair or invalidate a policy of insurance or an annuity providing a
death benefit, notwithstanding any term of the policy or annuity.
(d)
Nothing in this chapter shall create a presumption concerning the
intention of an individual who has not created an advance health care
directive.
(e)
An advance health care directive created before, on, or after January 1,
2026, shall be interpreted in accordance with all other laws of this State,
excluding the State's choice-of-law rules, at the time the directive is
implemented.
§
-28 Uniformity of application and
construction. In applying and
construing this chapter, a court may consider the promotion of uniformity of
the law among jurisdictions that enact it.
§
-29 Saving provisions. (a) An
advance health care directive created before January 1, 2026, shall be valid on
January 1, 2026, if it complies with this chapter or complied at the time of
creation with the law of the state in which it was created.
(b)
This chapter shall not affect the validity or effect of an act done
before January 1, 2026.
(c)
A person who assumed authority to act as default surrogate before
January 1, 2026, may continue to act as default surrogate until the individual
for whom the default surrogate is acting regains capacity to make health care
decisions or the default surrogate is disqualified, whichever occurs first.
§
-30 Transitional provision. This chapter shall apply to an advance health
care directive created before, on, or after January 1, 2026."
SECTION 3.
Section 286-109.4, Hawaii Revised Statutes, is amended to read as
follows:
"[[]§286-109.4[]] Designation of advance [health-care] health
care directive. On the
application form for any driver's license or license renewal, the examiner of
drivers shall ask the applicant to designate whether the applicant has an
advance [health-care] health care directive. The examiner of drivers shall issue or renew
a license bearing the designation "advance [health-care] health
care directive", a symbol, or an abbreviation thereof, for those
applicants who have so indicated.
"Advance [health-care] health care directive"
means an individual instruction in writing, a living will, or a durable power
of attorney for health care decisions.
No specific medical treatment information shall be imprinted on the
driver's license."
SECTION 4.
Section 286-303, Hawaii Revised Statutes, is amended as follows:
1.
By amending subsection (d) to read:
"(d)
The application also shall state whether the applicant has an advance [health-care]
health care directive. If the
applicant has an advance [health-care] health care directive, the
identification card shall bear the designation "AHCD"."
2.
By amending subsection (g) to read:
"(g)
For the purpose of this section, "AHCD", which stands for
"advance [health-care] health care directive", means an
individual instruction in writing, a living will, or a durable power of
attorney for health care decisions."
SECTION 5.
Section 321-23.6, Hawaii Revised Statutes, is amended to read as
follows:
"§321-23.6 Rapid identification documents. (a)
The department shall adopt rules for emergency medical services that
shall include:
(1) Uniform
methods of rapidly identifying an [adult person] individual who is an
adult or emancipated minor who has certified, or for whom has been
certified, in a written "comfort care only" document that the [person]
individual or[, consistent with chapter 327E, the person's guardian,
agent, or] the individual's surrogate directs emergency medical
services personnel, first responder personnel, and health care providers not to
administer chest compressions, rescue breathing, electric shocks, or
medication, or all of these, given to restart the heart if the [person's]
individual's breathing or heart stops, and directs that the [person]
individual is to receive care for comfort only, including oxygen, airway
suctioning, splinting of fractures, pain medicine, and other measures required
for comfort;
(2) The
written document containing the certification shall be signed by the [patient]
individual or[, consistent with chapter 327E, the person's guardian,
agent, or] the individual's surrogate, and by any two other
adult persons who personally know the [patient;] individual; and
(3) The
original or copy of the document, which may be in an electronic form,
containing the certification and all three signatures shall be maintained by
the [patient,] individual, and if applicable, the [patient's:]
individual's:
(A) [Physician;]
Responsible health care professional;
(B) Attorney;
[(C) Guardian;
(D)] (C) Surrogate; or
[(E)] (D) Any other person
who may lawfully act on the [patient's] individual's behalf.
[Two copies of the document shall
be given to the patient, or the patient's guardian, agent, or surrogate.]
(b)
The rules shall provide for the following:
(1) The
[patient,] individual, or the [patient's guardian, agent, or]
individual's surrogate, may verbally revoke the "comfort care
only" document at any time, including during the emergency situation;
(2) An
anonymous tracking system shall be developed to assess the success or failure
of the procedures and to ensure that abuse is not occurring; and
(3) If
an emergency medical services [person,] personnel, first
responder[,] personnel, or any other health care [provider]
professional believes in good faith that the [provider's] professional's
safety, the safety of the family or immediate bystanders, or the [provider's]
professional's own conscience requires the [patient] individual
be resuscitated despite the presence of a "comfort care only"
document, then that [provider] professional may attempt to
resuscitate that [patient,] individual, and neither the [provider,
the ambulance service,] professional, the emergency medical services,
nor any other person or entity shall be liable for attempting to resuscitate
the [patient] individual against the [patient's will.] individual's
certification.
(c)
For the purposes of this section:
"Emergency medical services
personnel" has the same meaning as defined in section 321-222.
"First responder personnel"
has the same meaning as defined in section 321-222.
"Health care professional" has
the same meaning as defined in section
-2.
"Responsible health care
professional" has the same meaning as defined in section -2.
"Surrogate" has the same
meaning as defined in section ‑2."
SECTION 6.
Section 323G-3, Hawaii Revised Statutes, is amended to read as follows:
"[[]§323G-3[]] Noninterference with existing health care
directives. Nothing in this chapter
shall be construed to interfere with the rights of an agent operating under a
valid advance health care directive under [section 327E-3] chapter or confer upon the caregiver any authority
to make health care decisions on behalf of the patient unless the caregiver is
designated as an agent in [a] an advance health care directive
under [section 327E-3.] chapter
."
SECTION 7.
Section 325-21, Hawaii Revised Statutes, is amended by amending
subsection (a) to read as follows:
"(a)
The sale of sterile hypodermic syringes in a pharmacy, physician's
office, or health care institution for the purpose of preventing the
transmission of dangerous blood-borne diseases, may be made solely by:
(1) A
pharmacist licensed under chapter 461;
(2) A
physician as defined in section [327E-2;] -2;
(3) A
health care [provider] professional as defined in section [327E-2;]
-2; or
(4) An
authorized agent of a pharmacy, as defined in section 461-1, or of a health
care institution, as defined in section [327E-2,] -2, operating under the direction of a
licensed pharmacist or physician."
SECTION 8.
Section 327-21, Hawaii Revised Statutes, is amended to read as follows:
"[[]§327-21[]] Effect of anatomical gift on advance [health-care]
health care directive. (a) If a prospective donor has a declaration or
advance [health-care] health care directive, and the terms of the
declaration or directive and the express or implied terms of a potential
anatomical gift are in conflict with regard to the administration of measures
necessary to ensure the medical suitability of a body part for transplantation
or therapy, the prospective donor's attending physician and prospective donor
shall confer to resolve the conflict. If
the prospective donor is incapable of resolving the conflict, an agent acting
under the prospective donor's declaration or directive, or, if none or if the
agent is not reasonably available, another person authorized by law other than
this chapter to make [health-care] health care decisions on
behalf of the prospective donor, shall act for the donor to resolve the
conflict. The conflict shall be resolved
as expeditiously as possible.
Information relevant to the resolution of the conflict may be obtained
from the appropriate procurement organization and any other person authorized
to make an anatomical gift for the prospective donor under section 327−9. Before resolution of the conflict, measures
necessary to ensure the medical suitability of the body part may not be
withheld or withdrawn from the prospective donor if withholding or withdrawing
the measures is not contraindicated by appropriate end-of-life care.
(b)
As used in this section:
["Advance health-care
directive" means a record signed or authorized by a prospective donor
containing the prospective donor's direction concerning a health-care decision
for the prospective donor or a power of attorney for health care.]
"Advance health care
directive" has the same meaning as defined in section -2.
"Declaration" means a record
signed by a prospective donor specifying the circumstances under which a life
support system may be withheld or withdrawn.
["Health-care decision"] "Health
care decision" means any decision regarding the health care of the
prospective donor."
SECTION 9.
Section 327K-1, Hawaii Revised Statutes, is amended as follows:
1.
By amending the definition of "legally authorized
representative" to read:
""Legally authorized
representative" means an agent, guardian, or surrogate, as those terms are
defined in section [327E-2,] -2, or agent designated through a power
of attorney for health care, as defined in section [327E-2.] -2."
2.
By amending the definition of "provider orders for life-sustaining
treatment form" to read:
""Provider orders for
life-sustaining treatment form" means a form signed by a patient[,]
or, if incapacitated, by the patient's legally authorized representative
and the patient's provider, that records the patient's wishes and that directs
a health care provider regarding the provision of resuscitative and
life-sustaining measures. A provider
orders for life-sustaining treatment form is not an advance [health-care]
health care directive."
SECTION 10.
Section 432E-4, Hawaii Revised Statutes, is amended by amending
subsection (c) to read as follows:
"(c)
The provider shall discuss with the enrollee and the enrollee's
immediate family both [[]advance[] health-care] health care
directives, as provided for in [chapter 327E, and durable powers of attorney
in relation to medical treatment.] chapter ."
SECTION 11.
Section 560:5-304, Hawaii Revised Statutes, is amended by amending
subsection (b) to read as follows:
"(b)
The petition shall set forth the petitioner's name, residence, current
address if different, relationship to the respondent, and interest in the
appointment and, to the extent known, state or contain the following with
respect to the respondent and the relief requested:
(1) The
respondent's name, age, principal residence, current street address, and, if
different, the address of the dwelling in which it is proposed that the
respondent will reside if the appointment is made;
(2) The
name and address of the respondent's:
(A) Spouse
or reciprocal beneficiary, or if the respondent has none, an adult with whom
the respondent has resided for more than six months before the filing of the
petition; and
(B) Adult
children or, if the respondent has none, the respondent's parents and adult
siblings, or if the respondent has none, at least one of the adults nearest in
kinship to the respondent who can be found;
(3) The
name and address of any person responsible for care or custody of the
respondent;
(4) The
name and address of any legal representative of the respondent;
(5) The
name and address of any person nominated as guardian by the respondent[;],
including, if applicable, the nomination made in the respondent's advance
health care directive under section ‑7(a)(4);
(6) The
name and address of any agent appointed by the respondent under any [medical]
advance health care directive[, mental health care directive, or
health care power of attorney,] under section -8 or, if none, any [designated]
default surrogate under section [327E-5(f);] -12;
(7) The
name and address of any proposed guardian and the reason why the proposed
guardian should be selected;
(8) The
reason why guardianship is necessary, including a brief description of the
nature and extent of the respondent's alleged incapacity;
(9) If
an unlimited guardianship is requested, the reason why limited guardianship is
inappropriate and, if a limited guardianship is requested, the powers to be
granted to the limited guardian; and
(10) A
general statement of the respondent's property with an estimate of its value,
including any insurance or pension, and the source and amount of any other
anticipated income or receipts."
SECTION 12.
Section 560:5-310, Hawaii Revised Statutes, is amended as follows:
1.
By amending subsection (a) to read:
"(a)
Subject to subsection (c), the court in appointing a guardian shall
consider persons otherwise qualified in the following order of priority:
(1) A
guardian, other than a temporary or emergency guardian, currently acting for
the respondent in this State or elsewhere;
(2) A
person nominated as guardian by the respondent, including the respondent's most
recent nomination made in a durable power of attorney[,] or advance
health care directive if at the time of the nomination the respondent had
sufficient capacity to express a preference;
(3) An
agent appointed by the respondent under any [medical] advance health
care directive or health care power of attorney or, if none, any [designated]
default surrogate under section [327E-5(f);] -12;
(4) The
spouse or reciprocal beneficiary of the respondent or a person nominated by
will or other signed writing of a deceased spouse or reciprocal beneficiary;
(5) An
adult child of the respondent;
(6) A
parent of the respondent, or an individual nominated by will or other signed
writing of a parent; and
(7) An
adult with whom the respondent has resided for more than six months before the
filing of the petition."
2.
By amending subsection (c) to read:
"(c)
An owner, operator, [or] employee, or contractor of a
long-term care institution or other care settings at which the respondent is
receiving care [may] shall not be appointed as guardian unless [related
to the respondent by blood, marriage, or adoption,] the owner, operator,
employee, or contractor is a family member of the respondent, the cohabitant of
the respondent or a family member of the cohabitant, or otherwise ordered
by the court. As used in this
subsection, "cohabitant" and "family member" have the same
meanings as defined in section ‑2."
SECTION 13.
Section 560:5-316, Hawaii Revised Statutes, is amended by amending
subsections (c) and (d) to read as follows:
"(c)
A guardian, without authorization of the court, shall not:
(1) Revoke
any health care [directions] instructions set forth in any [medical]
advance health care directive or health care power of attorney of which
the ward is the principal; [provided that the appointment of a guardian
shall automatically terminate the authority of any agent designated in the
medical directive or health care power of attorney;] or
(2) Restrict
the personal communication rights of the ward, including the right to receive
visitors, telephone calls, and personal mail, unless deemed by the guardian to
pose a risk to the safety or well-being of the ward.
(d)
A guardian shall not initiate the commitment of a ward to a mental [health-care]
health care institution except in accordance with the ward's advance
health care directive or the State's procedure for involuntary civil
commitment."
SECTION 14.
Section 671-3, Hawaii Revised Statutes, is amended by amending
subsection (e) to read as follows:
"(e)
For the purposes of this section, "legal surrogate"
means [an agent designated in a power of attorney for health care or
surrogate designated or selected in accordance with chapter 327E.] an
agent or default surrogate, as defined in section ‑2."
SECTION 15.
Chapter 327E, Hawaii Revised Statutes, is repealed.
SECTION 16.
Chapter 327G, Hawaii Revised Statutes, is repealed.
SECTION 17.
Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 18.
This Act, upon its approval, shall take effect on July 1, 2027.
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INTRODUCED BY: |
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BY REQUEST |
Report Title:
Uniform Health Care Decisions Act (Modified); Advance Health Care Directives; Advance Mental Health Care Directives
Description:
Adopts the Uniform Health Care Decisions Act (2023), as modified, to replace existing chapters related to advance health care directives and advance mental health care directives.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.