HB 1244 Summary

• Establishes minimum registered nurse-to-patient staffing ratios for Hawaii hospitals, varying by unit type (e.g., 1:1 for operating rooms, 1:4 for medical-surgical units, 1:2 for ICUs depending on patient stability).

• Requires hospitals to establish registered nurse staffing committees by September 1, 2025, with majority nurse membership, and develop annual staffing plans by July 1, 2026.

• Authorizes the Department of Labor and Industrial Relations to grant variances from minimum staffing standards upon finding of good cause, with 15-day decision timeline and opportunity for affected employees and unions to be heard.

• Imposes civil penalties of $5,000 per day ($100 per day for small/critical access hospitals) for violations including failure to establish committees, submit plans, or comply with staffing ratios, with escalating penalties for repeated violations.

• Appropriates funding to the Department of Labor and Industrial Relations for fiscal years 2025-2026 and 2026-2027 to implement and enforce these requirements.