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GM 1238

Informing the Legislature that on June 24, 2026, the Governor signed the following bill into law: HB1858 HD2 SD1 (ACT 137).

2026 Regular Session

The act requires mandatory fetal-death reporting and certificates for 20+ weeks (or 350g+), streamlines data collection, and aligns Hawaii’s system with national practices to impro

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Bill Summary · GM 1238

Summary of HB1858, SD1 (Act 137), Hawaii, 2026

Purpose and intent

  • This act amends Hawaii’s vital statistics framework to improve the reporting and data quality surrounding fetal deaths and miscarriages.
  • It aims to address high fetal-death rates among Native Hawaiians and other Pacific Islanders by clarifying reporting requirements, reducing administrative burdens, and aligning state law with federal and national reporting practices.
  • The overarching goal is to enable better prevention, education, and targeted interventions to reduce fetal death rates and mitigate the societal and psychological impact on families.

Key provisions and changes

  • Adds five new statutory sections to Chapter 338 (vital statistics) dealing with fetal deaths and related processes.
  • Establishes compulsory registration for certain fetal deaths:
    • A certificate of fetal death must be filed for fetuses of 20 weeks gestation or more (or weight-based if gestational age is unknown, with a threshold of at least 350 grams) within 14 days of fetal death.
    • Filing is required before interment or disposition, with specific exceptions for very early gestations or certain terminated pregnancies.
  • Regulates filing and preparation of the certificate:
    • The person in charge of disposition files the certificate within 14 days, with exemptions similar to the above.
    • Requires proper collection of personal data and medical data, and certification by a physician, physician assistant, advanced practice registered nurse, or coroner’s physician.
  • Documents for miscarriages less than 20 weeks:
    • Allows the attending clinician to issue documentation of fetal death to a birthing parent upon request, including a signed physician statement or medical-record copy.
    • Such documentation is not a prima facie government record or evidence of the facts.
  • Late determination of cause:
    • If the cause cannot be determined within 14 days (for fetal deaths) or 3 days (for deaths), certification may be filed later, with the attending clinician notifying the local department agent for disposition permits.
  • Permits for removal, burial, or disposition:
    • A written permit is generally required before removal/disposition, except in specific early gestation scenarios or certain intentional terminations.
    • The Act clarifies when permits are not required and outlines conditions for disposition after permits.
  • Definitions added:
    • Advanced practice registered nurse (as licensed under Hawaii law), physician assistant (as licensed under Hawaii law), and Department of Health are defined within the context of these provisions.
  • Department and process updates:
    • Revisions to duties and terminology to align with modern reporting practices.
    • Requires the state’s health statistics system to be properly equipped for data collection and conservation of records.

Who and what is affected

  • Health care providers, birthing parents, and funeral/disposition professionals:
    • Involved in reporting fetal deaths, preparing and filing certificates, and obtaining necessary permits.
  • Hawaii Department of Health (DOH):
    • Responsible for receiving, processing, and maintaining fetal death data; implementing new reporting rules; and ensuring data quality.
  • Public health statistics program:
    • Expanded to support the new reporting framework and improve data integrity for analysis and prevention efforts.
  • Death and fetal death reporting system:
    • Updated to reflect new thresholds, timelines, and documentation requirements.

Procedural and timeline aspects

  • Effective date: Upon approval (Act takes effect immediately after its approval).
  • Filing deadlines:
    • Certificates of fetal death: within 14 days of fetal death.
    • Standard death certificates: still governed by existing three-day filing rules for deaths; fetal deaths have separate deadlines under the new framework.
  • Late determinations:
    • If cause of fetal death is not determinable within 14 days, filing may occur later with written notice to the local health district agent.
  • Disposition permits:
    • Generally required before disposition, with specific exceptions for very early gestations (less than 20 weeks) or certain termination scenarios.
  • Data handling:
    • Emphasizes accurate collection of data and certification by qualified medical professionals.
    • Documentation for miscarriages provided to birthing parents is limited in legal standing as a government record.

Notable policy implications

  • Improves data quality and consistency for fetal death reporting, enabling better surveillance and prevention programs.
  • Reduces administrative burden in cases where fetal deaths are less than 20 weeks or where prenatal termination occurred under allowed circumstances.
  • Aligns Hawaii's reporting framework with federal recommendations and national practices, facilitating comparability and research.

If you’d like, I can provide a line-by-line comparison of pre- vs. post-Act provisions or highlight any potential implementation considerations for the Department of Health.

Compiled from official sources — confirm details with the bill’s official record.

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