Requires Oahu regional system board approval to privatize, sell or change services at all Oahu regional health care system facilities. Amends the membership of the Hawaii Health Systems Corporation board. Requires the Oahu regional system board to create a 5-year sustainability plan in consultation with other government stakeholders and report to the Legislature. Creates a right of first refusal for the Director of Health, Governor’s Coordinator on Homelessness, and Mayor of the City and County of Honolulu if the Hawaii Health Systems Corporation board fully or partially privatizes Leahi or Maluhia Hospital. Sunsets the Oahu regional health care system on 7/1/2024 and integrates it into the Hawaii Health Systems Corporation Board.