HB2257 would replace Hawaii’s existing advance directive statutes with a new, consolidated chapter based on the Uniform Health-Care Decisions Act (2023), as modified. The bill is designed to unify and modernize the rules governing advance health care directives and advance mental health care directives, including powers of attorney for health care, health care instructions, default surrogates, and related court procedures. It expands the statutory framework for determining capacity, recognizes supported decision making and electronic records/signatures, and creates detailed rules for creating, revoking, and enforcing directives.
The bill also adds specific provisions for mental health planning, including advance mental health care directives and a limited “Ulysses clause” concept that can restrict revocation during a specified psychiatric or psychological event. It establishes model forms to be published by the Department of Health, sets duties for health care professionals and institutions, and provides immunity and civil remedies for good-faith compliance or intentional interference. The measure further updates related statutes on driver’s licenses and identification cards, emergency “comfort care only” documents, anatomical gifts, guardianship, Medicaid representation, and other health-care-related provisions to conform to the new chapter.
HB2257 would repeal chapters 327E and 327G of the Hawaii Revised Statutes and replace them with a new chapter governing health care decisions. It would change how advance directives are defined and executed, broaden who may serve as an agent or default surrogate, clarify when capacity exists or can be rebutted, and give legal effect to electronic records and copies. The bill also amends several cross-referenced statutes so that guardianship, emergency medical services, anatomical gift, insurance, syringe-sale, and identification-card provisions align with the new terminology and framework. Its effective date is July 1, 2027, giving time for transition to the new system.
The bill appears to be framed positively and administratively, with the stated goal of reducing confusion and conflicting provisions by consolidating and updating the law. The available context shows no recorded committee testimony or votes, so there is no documented public debate in the provided materials. Based on the text alone, the measure reflects a policy preference for modernization, clearer advance-planning rules, and broader recognition of patient autonomy in both physical and mental health care decisions.
The main areas likely to draw scrutiny are the mental health directive provisions, especially the Ulysses clause allowing a person to limit later revocation during a specified psychiatric event, and the expanded authority given to default surrogates and agents. The bill also raises potential concerns about when a surrogate may override or implement decisions, the role of health care institutions that may refuse care based on policy, religion, or standards, and the new civil liability provisions for interference with directives. Guardianship-related changes, including priority rules and restrictions on facility employees serving as guardians or surrogates, may also be points of concern for long-term care providers and family members.