HI HB2257

Adopts a modified version of the Uniform Health-Care Decisions Act (2023), consolidating Hawaii's existing advance directive laws from chapters 327E and 327G into a single unified statutory framework

Establishes clear standards for determining mental capacity, requiring individuals to understand the nature and consequences of their health care decisions and be able to communicate those decisions with appropriate support

Allows individuals to create advance mental health care directives that include "Ulysses clauses," which prevent the individual from revoking the directive during specified psychiatric or psychological events

Expands who can make capacity determinations to include physicians, psychologists, and advanced practice registered nurses with psychiatric specialization, while prohibiting family members, cohabitants, or surrogates from making such findings

Creates a hierarchy of surrogates including appointed agents, default surrogates, and guardians authorized to make health care decisions, with provisions for judicial review of capacity findings by family court