HI HB1865

Requires each Hawaii hospital to establish a registered nurse staffing committee by September 1, 2026, with a majority of members being nonsupervisory nurses providing direct patient care.

Mandates annual adoption of hospital-wide staffing plans by July 1, 2027, incorporating minimum nurse-to-patient ratios based on professional specialty organization recommendations.

Establishes daily penalties for hospitals failing to adopt staffing plans: $100/day for critical access and small hospitals, $5,000/day for all other hospitals.

Creates an enforcement framework through the Department of Labor and Industrial Relations, including complaint investigations, administrative appeals, and civil penalties for violations.

Prohibits retaliation against registered nurses, patients, or others who report staffing concerns or participate in enforcement proceedings.