This bill eliminates the certificate of need (CON) requirement for most health care facilities and services in Hawaii, with exceptions for nursing homes, hospices, intermediate care facilities for individuals with intellectual disabilities, and ambulance service providers. A certificate of need is a regulatory process that historically required state approval for healthcare providers to expand, construct, or significantly modify their facilities or services. The bill argues that CON programs are outdated, having originated from a 1974 federal mandate that was repealed in 1987, and contends that these programs restrict market competition, innovation, and consumer choice while failing to effectively control healthcare costs. The legislature believes that removing these regulatory barriers will allow healthcare providers to make more flexible decisions about facility development and potentially lower healthcare charges. The bill amends multiple sections of Hawaii Revised Statutes to remove references to the broad certificate of need requirements, narrowing the definition of facilities still subject to the program, and adjusting related administrative provisions. By January 1, 2026, the state health planning agency is required to update its state health services and facilities plan to align with these changes. The bill takes effect immediately upon approval.