HR97 HD1

HOUSE OF REPRESENTATIVES	H.R. NO.	97
THIRTY-THIRD LEGISLATURE, 2026		H.D. 1
STATE OF HAWAII

HOUSE RESOLUTION

REQUESTING THE HAWAII STATE CENTER FOR NURSING TO COMPILE A COMPREHENSIVE LIST OF RECOMMENDED SAFE PATIENT STAFFING RATIOS FOR ALL NURSING SPECIALTIES AND SUBSPECIALITIES ACROSS ALL HEALTH CARE SETTINGS, AND TO MAINTAIN A REPOSITORY FOR THIS INFORMATION.

WHEREAS, the issue of safe staffing in hospitals has escalated into a growing public health concern in Hawaii and other states across the nation and can no longer be defined as strictly a collective bargaining issue; and

WHEREAS, the nursing community is the largest segment of Hawaii's health care workforce and is indispensable to the health, safety, and well-being of the residents of the State; and

WHEREAS, as more care is delivered in outpatient or home and community-based settings, the acuity of patients who are admitted to hospitals has intensified, requiring significantly more attention, complex monitoring, and clinical intervention by frontline nurses; and

WHEREAS, the Legislature commissioned the Legislative Reference Bureau to conduct a comprehensive study on nurse staffing pursuant to House Concurrent Resolution No. 187 (2024); and

WHEREAS, the Legislative Reference Bureau submitted its 2025 report, Time for Triage: A Summary of Best Practices, State Requirements, and Successful Efforts to Reduce Nurse Staffing Shortages, which cited several studies demonstrating that patient outcomes improve with higher nurse staffing ratios, or nurse-to-patient ratios, through results such as shorter hospital stays, fewer complications, fewer readmissions, less risk of death, reduced hospital-acquired infections, increased patient satisfaction, improved patient compliance with treatment plans, improved pain management, and fewer medication errors, and that nurse staffing ratios may be especially important for patients of color; and

WHEREAS, The Joint Commission, the nation's leading health care accrediting body, has established National Performance Goal 12, effective January 1, 2026, which formally recognizes that hospital staffing levels and competencies must align with patient needs as a critical component of clinical quality and patient safety; and

WHEREAS, data from the 2025 Hawaii Nursing Workforce Supply Statewide Report and the 2026 Informational Brief on The State of Hawaii's LPN and RN Workforces by the Hawaii State Center for Nursing show there is an adequate number of registered nurses in the islands to meet existing demand, indicating the number of registered nurses statewide is not a barrier to safe staffing; and

WHEREAS, the Hawaii State Center for Nursing reports findings from a 2023 Nursing Wellbeing, Recruitment, and Retention Strategic Initiative Working Group literature review that Hawaii registered nurses felt so stressed at work that they considered leaving the nursing profession, and that nurses increasingly indicated physical and mental health as leading contributors to their desire to leave the workforce; and

WHEREAS, creating supportive work environments with safe staffing levels is essential to attracting the next generation of nurses to Hawaii's workforce and retaining the experienced nurses currently practicing in Hawaii's health care facilities; and

WHEREAS, establishing a central repository of safe staffing standards as adopted by other states or recommended by industry professionals will allow for better-informed decision-making by health care providers, policymakers, and the public; now, therefore,

BE IT RESOLVED by the House of Representatives of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2026, that the Hawaii State Center for Nursing is requested to compile a comprehensive list of recommended safe patient staffing ratios for all nursing specialties and subspecialities across all health care settings, and to maintain a repository for this information; and

BE IT FURTHER RESOLVED that the Hawaii State Center for Nursing is requested to make the repository of recommended safe staffing ratios publicly available no later than twenty days prior to the convening of the Regular Session of 2027; and

BE IT FURTHER RESOLVED that this body urges Hawaii's health care facilities to use every effort to implement safe patient staffing ratios that reflect the standards compiled by the Hawaii State Center for Nursing; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Health, who in turn is requested to submit copies of this measure to the Chief Executive Officers of each hospital and health care facility licensed in the State; and Executive Director of the Hawaii State Center for Nursing.