HOUSE OF REPRESENTATIVES
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO EMPLOYEE BENEFITS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that in 2020, one in ten babies, or ten per cent of live births, was born preterm in the State, meaning that those births occurred before thirty-seven completed weeks of gestation. The legislature also finds that approximately 1.6 per cent of live births in the State are "very preterm", denoting that the babies were born before thirty-two completed weeks of gestation.
The legislature further finds that these preterm and very preterm babies spend weeks or months in neonatal intensive care units (NICU), requiring their parents to also spend weeks or months at the NICU in support of their babies' care. Research published in 2015 in the medical journal Pediatrics shows that parental "kangaroo care", meaning continual skin-to-skin contact, reduces infant mortality by thirty-six per cent, lowers risk of sepsis or major infection by forty-seven per cent, and reduces the length of stay in the NICU by up to one week. Additional benefits include better neurological development of the baby, reduced depression for the mother, and a fifty per cent increase in the likelihood of exclusive breastfeeding after discharge, which itself has well-known and unique benefits for child health and development. For babies in the NICU, it is vitally important that mothers continually express breast milk for them, which requires up to an hour of pumping every few hours throughout the day and night.
The legislature also finds that `Oahu has the only high‑risk NICU in the State, resulting in parents from other islands being forced to relocate at significant disruption and expense for an extended period of time. Even for parents on `Oahu, it is nearly impossible to maintain full time employment when they are constantly caring for their babies in the NICU. Added to this time, expense, and stress, parents caring for their NICU child may not necessarily qualify for financial assistance through temporary disability insurance or protection from job loss under the federal Family and Medical Leave Act. When parents do qualify, they often use a large proportion of their family leave while their baby is in the NICU, and often feel financial pressure to return to work when their babies are still very young, which deprives the babies and parents of early bonding that is an important factor in child development and long-term outcomes. Some parents return to work while their babies are still in the NICU to preserve and use their family leave upon their babies' discharge. Furthermore, many parents are advised not to enroll their babies in childcare upon discharge from the NICU due to concerns of infection, which further interferes with their planned return to work.
The legislature additionally finds that according to the State Health Planning and Development Agency's 2020 Health Care Utilization Report, the cost of an average NICU stay is between $7,700 to $8,500 per day in Hawai`i. Thus, the cost of a twelve‑week NICU stay could easily exceed $650,000. Reducing a NICU stay by one week could save an average of $57,000 per baby. Furthermore, the cost of temporary disability insurance for twelve weeks for two parents is less than $40,000.
Accordingly, the purpose of this Act is to extend, under certain conditions, the family leave period for employees who are unable to perform their employment duties due to the birth of a child who is required to stay in a neonatal intensive care unit for up to eight weeks.
SECTION 2. Section 398-3, Hawaii Revised Statutes, is amended to read as follows:
"§398-3 Family leave requirement. (a) An employee shall be entitled to a total of four weeks of family leave during any calendar year:
(1) Upon the birth of a child of the employee or the adoption of a child; or
(2) To care for the employee's child,
spouse, reciprocal beneficiary, sibling, grandchild, or parent with a serious
provided that any employee who suffers from a total inability to perform the duties of the employee's employment resulting from the birth of a child who is required to stay in a neonatal intensive care unit, shall be entitled to additional family leave equivalent to the duration the child is in a neonatal intensive care unit, for up to eight weeks, starting from the date the child is discharged from the neonatal intensive care unit; provided further that during the additional period of family leave, the employee provides kangaroo care to the child or expresses breast milk for the child.
During each calendar year, the leave]
Leave pursuant to this section may be taken intermittently[ .]
during each calendar year.
(c) Leave pursuant to this section shall
not be cumulative[
.] from one calendar year to another.
(d) If unpaid leave under this chapter conflicts with the unreduced compensation requirement for exempt employees under the federal Fair Labor Standards Act, an employer may require the employee to make up for the leave taken within the same pay period.
(e) Nothing in this chapter shall entitle an
employee to more than a total of four weeks of leave in any twelve-month
.]; except as provided in subsection (a) for any
employee who suffers from a total inability to perform the duties of the
employee's employment resulting from the birth of a child who is required to
stay in a neonatal intensive care unit for up to eight weeks.
(f) For purposes of this section, "kangaroo care" means a technique of newborn care where the baby is kept chest-to-chest and skin-to-skin with a parent."
SECTION 3. Section 398-4, Hawaii Revised Statutes, is amended by amending subsections (a) and (b) to read as follows:
Pursuant to section 398-3, an employee
shall be entitled to four weeks of family leave. The family leave shall] Nothing in
this chapter shall be construed to require an employer to provide its employees
with paid family leave. If an employer
provides its employees with paid family leave, family leave taken by an
employee pursuant to section 398-3 may consist of unpaid leave, paid leave,
or a combination of paid and unpaid leave.
If an employer provides paid family leave for fewer than [ four weeks,
the additional period of leave added to attain the four-week total] the
family leave period to which an employee is entitled pursuant to section 398-3,
leave taken by the employee beyond the period of paid family leave provided by
the employer may be unpaid.
(b) Except as otherwise provided in subsection
(c), an employee may elect to substitute any part of family leave to which
the employee is entitled pursuant to section 398-3, with any of the
employee's accrued paid leaves, including [
but not limited to] vacation[ ,]
or personal[ , or family leave for any part of the four-week period in
subsection (a).] leave."
SECTION 4. The civil rights commission shall amend its administrative rules to ensure that neonatal care is included as a "related medical condition" wherever the phrase "pregnancy, childbirth, or related medical condition" or any similar phrase is used.
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect on June 30, 2032.
Family Leave; Childbirth; Neonatal Intensive Care Unit; Kangaroo Care; Breast Milk Expression
Extends under certain conditions, the family leave period for up to eight weeks for employees who are unable to perform their employment duties due to the birth of a child who is required to stay in a neonatal intensive care unit. Requires the Civil Rights Commission to amend its rules to include neonatal care as a related medical condition wherever the phrase "pregnancy, childbirth, or other related condition" or any similar phrase is used. Effective 6/30/2032. (SD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.