TITLE 19

TITLE 19. HEALTH

Chapter

321 Department of Health

321C Office of Language Access

321D Interdepartmental Cluster for Services to Children

321E Dispersal Review Council--Repealed

321F Office of the Aloha Health Corps--Repealed

321G California-Hawaii Cooperative Commission--Repealed

321H Neurotrauma

322 Nuisances; Sanitary Regulations

322H Hawaii Health Authority

323 Hospitals and Medical Facilities

323B Health Care Privacy Harmonization Act

323C Privacy of Health Care Information--Repealed

323D Health Planning and Resources Development and

Health Care Cost Control

323F Hawaii Health Systems Corporation

323G Hospital Discharge Planning--Designation of a Caregiver

324 Medical Research; Morbidity and Mortality

Information

325 Infectious and Communicable Diseases

326 Hansen's Disease

327 Medical and Research Use of Bodies

327C Death

327D Medical Treatment Decisions--Repealed

327E Uniform Health-Care Decisions Act (Modified)

327F Medical Treatment Decisions for Psychotic Disorders--

Repealed

327G Advance Mental Health Care Directives

327H Pain Patient's Bill of Rights

327K Provider Orders for Life-Sustaining Treatment

327L Our Care, Our Choice Act

327N Hydrolysis Facilities

328 Food, Drugs, and Cosmetics

328A Water, Furnishing Potable--Repealed

328B Return-for-Credit-and-Reuse of Prescription Drugs--

Repealed

328C Donation of Pharmaceuticals and Health Care Supplies

328D Bottled Water

328E Intoxicating Compounds

328G Hemp Processors

328J Smoking

328K Smoking--Repealed

328L Hawaii Tobacco Settlement Moneys

329 Uniform Controlled Substances Act

329B Substance Abuse Testing

329C Imitation Controlled Substances Act

329D Medical Cannabis Dispensary System

329E Overdose Prevention and Emergency Response Act

330 Poisons, Sale of

330C Hawaii Poison Prevention Packaging Act

331 Radium for Medical and Surgical Purposes--Repealed

332 Mattresses, Manufacture, Etc., and Sale of

332D Polybrominated Diphenyl Ethers

333 Mental Retardation--Repealed

333E Developmental Disabilities

333F Services for Persons with Developmental or

Intellectual Disabilities

334 Mental Health, Mental Illness, Drug Addiction,

and Alcoholism

334B Utilization Review and Managed Care of Mental Health,

Alcohol, or Drug Abuse Treatment

334D Diversion Program for Chemically Dependent Nurses

334E Rights of Recipients of Mental Health Services

335 Interstate Compact on Mental Health

336 Deportation and Transfer of Alien and Nonresident

Public Charges

337 Uniform Act for the Extradition of Persons of Unsound

Mind

338 Vital Statistics

339 Litter Control

339D Electronic Device Recycling and Recovery Act

339K Northwest Interstate Compact on Low-Level Radioactive

Waste Management

340 Hawaii Waste Management--Repealed

340A Solid Waste

340B Wastewater Treatment Personnel

340E Safe Drinking Water

340F Hawaii Law for Mandatory Certification of Public

Water System Operators

341 Environmental Advisory Council

342 Environmental Quality--Repealed

342B Air Pollution Control

342C Ozone Layer Protection

342D Water Pollution

342E Nonpoint Source Pollution Management and Control

342F Noise Pollution

342G Integrated Solid Waste Management

342H Solid Waste Pollution

342I Special Wastes Recycling

342J Hazardous Waste

342L Underground Storage Tanks

342N Used Oil Transport, Recycling, and Disposal--Repealed

342P Asbestos and Lead

343 Environmental Impact Statements

343D Hawaii Environmental Disclosure Law--Repealed

344 State Environmental Policy

Note

Pacific-Asia institute for resilience and sustainability. L 2014, c 229.

CHAPTER 321

DEPARTMENT OF HEALTH

Part I. General and Administrative Provisions

Section

321-1 General powers and duties of the department

321-1.1 Development of environmental goals and

objectives

321-1.3 Domestic violence and sexual assault special fund

321-1.4 Office of health care assurance special fund;

deposits; expenditures

321-1.5 Primary health care incentive program;

establishment

321-1.6 Additional duties of the director

321-1.65 Community health centers special fund

321-1.7 Public health nursing services program

321-1.8 Inspections; public notice

321-1.9 Inspections; visits; state-licensed or state-certified

care facilities

321-2 General office

321-2.5 Volunteer medical assistance personnel

321-2.7 Preceptor credit assurance committee

321-3 Repealed

321-4 Agents and inspectors

321-4.3 Epidemiologists

321-4.5 Inspection of food establishments

321-4.6 Advisory council on food protection practices;

created

321-4.7 Producers of hand-pounded poi; exemption

321-5 Contract for exchange of Hawaii personnel

321-6 Repealed

321-6.5 Clinical laboratory test results

321-7 Disbursement of moneys

321-8 Repealed

321-9 Seal, rules and regulations

321-10 Rules, adoption, effect

321-10.5 Agricultural processing facilities; permits;

priority

321-11 Subjects of health rules, generally

321-11.1 Medically accurate sexuality health education

321-11.2 Adult foster homes

321-11.3 Repealed

321-11.4 Fees for electronic applications and payments

321-11.5 Establishment of fees

321-11.51 Sanitation permits; transfer

321-11.6 Genetically modified organisms

321-11.7 Repealed

321-11.8 Care homes; liability insurance; coverage

321-11.9 Dental health facilities; health care facilities; use

of latex gloves

321-12 Barbers, hairdressers, cosmeticians,

cosmetologists, and beauticians

321-12.2 Tanning facilities; minors; penalties

321-12.5 Certified forensic examination fees

321-13 Regulation of certain other occupations

321-13.5 Certified nurse aides; investigations of abuse

and neglect

321-14 License to practice certain occupations

321-14.5 Hospitals; licensing

321-14.8 Home care agencies; licensing

321-15 Biennial registration; fees, failure to register;

denial, suspension, or revocation of a license

321-15.1 Definitions

321-15.2 Background checks

321-15.3 Criminal history disclosure of prospective

care home resident

321-15.5 Repealed

321-15.6 Adult residential care homes; licensing

321-15.61 Adult residential care homes expanded admissions

321-15.62 Expanded adult residential care homes; licensing

321-15.63 Hospice services

321-15.7 Penalty

321-15.8 Repealed

321-15.9 Developmental disabilities residential services

321-16, 16.1 Repealed

321-16.5 Special treatment facilities

321-16.6 Therapeutic living programs

321-17 Vessels to carry diseased persons; penalty

321-18 Penalty

321-19 Delegation to counties

321-20 Remedies

321-21 Infectious wastes; management and disposal

321-22 Long term care service development fund established

321-22.5 Trauma system special fund

321-23 Catastrophic and traumatic emergency response

program established

321-23.3 Volunteer emergency medical disaster response

personnel

321-23.6 Rapid identification documents

321-24 to 26 Repealed

321-26.5 Environmentally-sensitive cleaning and maintenance

products for use in public schools; approved list

of products

321-27 Sanitation and environmental health special fund

321-27.5 Audit of sanitation branch

321-28 Traumatic brain injury advisory board

321-29 Epidemiologic investigations

321-29.5 Testing laboratory; diseases; air and water quality

321-30 Human placenta

321-30.1 Medical cannabis registry and regulation special

fund; established

321-30.2 Civil monetary penalty special fund

321-30.3 Default beverages offered with children's meals

321-30.4 Cosmetics; animal testing; prohibition

321-30.5 Prohibition of plastic microbeads; personal care

products; non-prescription drugs

Part II. Preventive Medicine

321-31 Functions of the department

321-31.5 Public health standing orders; screening

321-32 Epidemiological specialists

321-33 Shaken baby syndrome

321-34 Cytomegalovirus public education

321-35 Department of education student physical examination

follow-up assistance and consultations

Part IIA. Child Abuse and Neglect Prevention

321-36 Definitions

321-37 Child abuse and neglect secondary prevention

programs

321-38 Hawaii children's trust fund advisory committee

Part III. Cancer Control

321-41 Educational program

321-42 Tumor clinics

321-43 Statistical activities

321-44 Repealed

321-45 Cancer examination

321-46 Breast density mammography results; report and

notification

Part IV. Children with Special Health Needs

321-51 Department to administer part

321-52 Powers, duties, and activities of the department

321-52.5 Repealed

321-53 Funds

321-54 Application of part

Part V. Dental Health

321-61 Dental health

321-62 General duties of department

321-63 Director's specific duties and powers

Part VI. Industrial Hygiene

321-71 Industrial hygiene

321-72 Sources of ionizing radiation; federal-state

agreements

Part VII. Nutrition

321-81 Nutrition

321-82 Field nutritionist, rural Oahu

Part VIII. Home Health Services

321-91 Program of home health services

321-92 Fees for services

321-93 Home health services; source of funds; disposition

of receipts

Part IX. Hearing and Vision Program

321-101 Hearing and vision program

Part IXA. Prevention of Blindness

321-106 Prevention of blindness at childbirth

Part X. Sexually Transmitted Diseases

321-111 Sexually transmitted disease prevention program

321-112 to 114 Repealed

321-115 Prophylactics

Part XI. Chronic Renal Disease--Repealed

321-121 to 123 Repealed

Part XII. Safety Glazing of Glass--Repealed

321-131 to 137 Repealed

Part XIII. Emergency services--Repealed

321-151 Repealed

Part XIV. Blood Alcohol

321-161 Chemical testing for alcohol concentration or drug

content

Part XV. Mental Health Services for Children

and Youth

321-171 Children's mental health services; department

responsibility

321-171.5 Employees of the department of health, its providers

and subcontractors; background checks

321-172 Children's mental health services branch

321-173 Community mental health services for children and

youth

321-174 Coordination of services with department of

education

321-175 Statewide children's mental health services plan

321-176 Biennial review of progress

321-177 Rules

Part XVI. Substance Abuse

321-191 Definitions

321-192 Substance abuse program

321-192.5 Substance abuse treatment monitoring program

321-193 Duties and responsibilities of department

321-193.5 Interagency coordination

321-193.7 Clean and sober homes registry

321-194 State advisory commission

321-195 Annual report to the legislature

321-196 Rules

321-197 Personnel

321-198 State funding of substance abuse agencies

Part XVII. Smoking in Public Places--Repealed

321-201 to 206 Repealed

Part XVIIA. Tobacco Products

321-211 Definitions

321-212 Tobacco products; possession or consumption

prohibited

321-213 Exemptions

321-214 Enforcement; rules

Part XVIII. State Emergency Medical Services System

321-221 Findings and purpose

321-222 Definitions

321-223 State emergency medical services system, establishment

321-224 Department of health, functions, duties

321-224.2 Enhanced and expanded emergency medical services; fees

321-224.4 Community paramedicine program; established

321-225 The state emergency medical services advisory

committee

321-225.5 Fall prevention and early detection coordinator

321-226 Emergency medical services and systems, standards

321-227 Regulation of ambulances

321-228 Emergency medical services; counties

321-228.5 Renumbered

321-228.6 Renumbered

321-229 Emergency medical services personnel, training

programs

321-229.2 First responder personnel; dementia training

321-229.5 Renumbered

321-230 Technical assistance, data collection, evaluation

321-231 Grants

321-232 Revenues; deposit into state general fund

321-233 Rules

321-234 Emergency medical services special fund

321-235 Immunity and limitation on liability for emergency

aeromedical services

321-236 Emergency medical services; use of latex gloves

prohibited

321-237 Retention of relevant documentation

Part XIX. School Health Services Program--Repealed

321-241 to 246 Repealed

Part XX. Agent Orange--Repealed

321-261 to 271 Repealed

Part XXI. Hemophilia

321-281 Financial assistance fund for hemophilia

321-282 General duties of the department

Part XXII. Newborn Metabolic Screening

321-291 Tests for phenylketonuria, hypothyroidism, and other

metabolic diseases

Part XXIIA. Newborn Pulse Oximetry Screening

321-296 Newborn pulse oximetry screening

Part XXIII. Health Education

321-301 Bilingual health education aide program;

establishment

Part XXIV. Environmentally-Related Illness and Injury

321-311 Environmentally-related illness and injury

surveillance

321-311.5 Renumbered

321-312 Definition of environmentally-related illness or

injury

321-313 Definition of health care professional

321-314 Reports to the department

321-315 Confidentiality

321-316 Immunity from liability

321-317 Rules

Part XXV. Maternal and Child Health Program

321-321 Purpose

321-322 Administration of programs

321-323 Definitions

321-324 Powers of the department

321-325 Agreements

321-326 Rules

321-327 Hawaii home visiting program; established

Part XXVI. Prenatal Health Care

321-331 Prenatal health care; authority

Part XXVII. Child Death Review

321-341 Multidisciplinary and multiagency reviews

321-342 Definitions

321-343 Access to information; use of child death review

information; protections

321-344 Exception

321-345 Repealed

321-345.5 Child death reviews; reports

321-346 Immunity from liability

Part XXVIII. Infants and Toddlers

321-351 Definitions

321-352 Early intervention services for infants and toddlers

with special needs

321-352.2 Early language services for children who are deaf,

hard of hearing, or deaf-blind

321-353 Hawaii early intervention coordinating council;

establishment

321-354 Rules

321-355 Early intervention special fund

321-356 Repealed

321-357 Early intervention special fund; purpose and use

Part XXIX. Statewide Newborn Hearing Screening

Program

321-361 Definitions

321-362 Duties

321-362.5 Hearing screening, diagnostic audiologic evaluation,

and intervention

321-363 Rules

Part XXX. Tattoo Artists

321-371 Purpose

321-372 Definitions

321-373 Regulation of tattoo artists

321-373.5 Permit; required for tattoo shop and temporary

locations

321-374 License required; exemptions

321-375 Examination, fees required

321-376 Repealed

321-377 Suspension or revocation of permit or license

321-378 Repealed

321-379 Enforcement; penalties

321-380 Repealed

321-381 Biennial renewal; failure to renew

321-382 Fees

321-383 Repealed

Part XXXI. Midwives--Repealed

321-391 to 398 Repealed

Part XXXII. Food Safety Consultative and Education

Program

321-401 Findings and purpose

321-402 Food safety consultative and education program

321-403 Food safety control system

321-404 Public information monitoring system

321-405 Confidentiality of information

Part XXXIII. Indoor Air Quality

321-411 Definitions

321-412 Indoor air quality program

321-413 General functions, powers, and duties of the

department

Part XXXIV. Birth Defects Program

321-421 Definitions

321-422 Birth defects program

321-423 Confidentiality of data

321-424 Rules

321-425 Requests for information

321-426 Birth defects special fund

Part XXXV. Case Management Services for Medically

Fragile Children

321-431 Definitions

321-432 Case management services for medically fragile

children

Part XXXVI. Emergency Response Stockpile

321-441 Definitions

321-442 Exemption from certain laws and rules

Part XXXVII. Domestic Violence Fatality Review

321-471 Definitions

321-472 Multidisciplinary and multiagency reviews

321-473 Access to information

321-474 Exception

321-475 Use of domestic violence fatality review information

and records

321-476 Immunity from liability

Part XXXVIII. Home and Community-Based Case

Management Agencies and Community Care

Foster Family Homes

321-481 Definitions

321-482 Home and community-based case management agency,

authority over and evaluation of

321-483 Community care foster family home, authority over

and evaluation of

321-484 Repealed

321-485 Penalty

Part XXXVIIIA. Uncertified or Unlicensed Care

Facilities

321-486 Investigations

321-486.1 Action upon investigation

321-486.2 Right of entry

321-486.3 Repealed

321-487 Referral or transfers to uncertified or unlicensed

care facility; penalty

321-488 Repealed

Part XXXIX. Services to Adults

321-491 Purpose

321-492 Definitions

321-493 Day care centers for disabled and aged persons

321-494 Purchase of service

321-495 Penalty

321-496 Repealed

Part XL. Mortality Review of Deaths of Persons with

Developmental or Intellectual Disabilities

321-501 Multidisciplinary and multiagency mortality reviews

321-502 Definitions

321-503 Access to information

321-504 Exception

321-505 Use of information and records from mortality

reviews of deaths of persons with developmental

or intellectual disabilities

321-506 Immunity from liability

Part XLI. Compassionate Care for Sexual Assault

Victims

321-511 Definitions

321-512 Compassionate care

321-513 Enforcement; administrative penalties

321-514 Rules

Part XLII. Stroke Care

321-531 Definitions

321-532 Stroke system of care; department duties

321-533 Stroke database

321-534 Confidential information

Part XLIII. Durable Medical Equipment Supplier

License Program

321-541 Title

321-542 Definitions

321-543 Licensing

321-544 License fee

321-545 Exemptions

321-546 Rules

321-547 Severability

Part XLIV. Miscellaneous Provisions

321-561 Limited service pregnancy centers; notice of

reproductive health services

321-562 Limited service pregnancy centers; enforcement;

private right of action

321-563 Seizure first aid; information

Part XLV. Skilled Nursing Facilities

321-571 Skilled nursing facilities

Part XLVI. Leahi Hospital and Maluhia

321-581 Authority of the department of health

321-582 Consultation with the University of Hawaii required

321-583 Reduction or elimination of direct patient care

services

Part XLVII. Perfluoroalkyl and Polyfluoroalkyl

Substances Prohibited

321-601 Definitions

321-602 Food packaging; prohibited items

321-603 Class B firefighting foam; prohibited items

321-604 Manufacturers of class B firefighting foam;

prohibitions; certificate of compliance; penalty

321-605 Rules

Note

Cesspool compliance pilot grant project; report to 2024 legislature (repealed on June 30, 2028). L 2022, c 153, §2.

Child and adolescent crisis mobile outreach team pilot program; report to 2025 legislature (ends on December 31, 2025). L 2023, c 89, §2.

Concussion educational program under department of education. L 2012, c 197; L 2016, c 262.

Continuum of dental care; community-based dental health clinics. L 2006, c 199.

Dark night skies protection strategy; advisory committee (dissolved on June 30, 2027); report to 2018-2021 legislature. L 2017, c 185, §§2, 3.

Department of health may require the department of education to report on coronavirus disease 2019 potential outbreaks or other public health emergencies. L Sp 2021, c 4; L 2024, c 105, §1.

Department of health to request funding for the permanent position that facilitates the licensing of home care agencies as part of its annual budget request, beginning with fiscal year 2015-2016. L 2014, c 125, §4.

Food and Drug Administration-approved, Centers for Disease Control and Prevention-recommended test for tuberculosis infection as alternative to Mantoux tuberculin skin test. L 2017, c 94.

Hawaii hemp task force; report to 2025 legislature (dissolved on August 30, 2024). L 2023, c 263, §13.

Three-year pilot program to implement a co-management system of care for persons with a fetal alcohol spectrum disorder. L 2023, c 192, §3.

Trauma-informed care task force; reports to 2024-2025 legislature (ceases to exist on June 30, 2025). L 2021, c 209, §2; L 2023, c 87, §1. (This Note supersedes the Note in the main volume.)

Working group to develop, evaluate, and implement any additional steps necessary to complete the transition of the Oahu regional health care system into the department of health; report to 2022 and 2025 legislatures (dissolved on December 31, 2025, or upon completion of the transition, whichever is sooner). L 2021, c 212, §9; L 2022, c 150, §2.

Cross References

Regulatory licensing of certain health related professions or occupations, see title 25.

Coordination and development of caregiver support services, see §349-15.

Drug demand reduction assessments; special fund, see §706-650.

Hawaii health authority, see chapter 322H.

Hawaii health corps, see chapter 309H.

Health and dental insurance data; mandatory reporting for certain insurers, see §323D-18.5.

Health care-associated infection reporting, see §325-2.5.

Hospital sustainability program, see chapter 346G.

Kahuku medical center; designation as a rural hospital, see §346-53.8.

Long-term care financing, see chapter 346C.

Medicaid contracts; nonprofit and for-profit reporting requirements, see §103F-107.

Medical cannabis; economic and other data; collection, see §201-13.9.

Medical cannabis testing and research programs, see §304A-1865.

Nursing facility sustainability program, see chapter 346F.

Safe place for newborns, see chapter 587D.

Sale of sterile syringes for the prevention of disease, see §325-21.

Sex offender treatment program, see chapter 353E.

State health insurance program, see chapter 431N.

Law Journals and Reviews

Long-Term Care in Hawaii. 18 HBJ, no. 13, at 59 (2015).

Hounds at the Hospital, Cats at the Clinic: Challenges Associated with Service Animals and Animal-Assisted Interventions in Healthcare Facilities. 40 UH L. Rev. 53 (2018).