SB3074

SECTION 1. The legislature finds that Hawaii is facing a critical physician shortage. The University of Hawaii's most recent physician workforce assessment found that Oahu needs three hundred eighty-one physicians, the Big Island is short one hundred ninety-six physicians, Maui county has a deficit of one hundred thirty-nine physicians and Kauai needs fifty-three physicians. Physician assistants, like nurse practitioners, can help fill this need.

The legislature further finds that physician assistants undergo rigorous medical training. They must take a test in general medicine in order to be licensed and certified, and they must graduate from an accredited physician assistant program and pass a certification exam. Like physicians and nurse practitioners, physician assistants must complete extensive continuing medical education throughout their careers. Studies have shown that when physician assistants practice to the full extent of their abilities and training, hospital readmission rates and lengths of stay decrease and infection rates go down. A Harris poll found extremely high satisfaction rates among Americans who interact with physician assistants. The survey found that ninety-three per cent of respondents regard physician assistants as trusted healthcare providers, ninety-two per cent of respondents said that having a physician assistant makes it easier to get a medical appointment, and ninety-one per cent of respondents believe that physician assistants improve the quality of healthcare.

The legislature further finds that current requirements for the license renewal of physician assistants is overly burdensome and discourages individuals from entering the profession. Hawaii is one of a minority of states that mandate both continuing education requirements and certification by the National Commission of Certification of Physician Assistants for the renewal of a physician assistant license. More than thirty states allow physician assistants to renew their licenses by meeting continuing education requirements only.

The legislature believes that Hawaii's licensing standard for physician assistants should be aligned with the majority of states and the growth of the physician assistant profession should be encouraged.

The purpose of this Act is to allow physician assistants to renew their licenses by meeting continuing education requirements only.

SECTION 2. Section 453-5.3, Hawaii Revised Statutes, is amended to read as follows:

"§453-5.3 Physician assistant; licensure required. (a) The Hawaii medical board shall require each person practicing medicine under the supervision of a physician or osteopathic physician, other than a person licensed under section 453-3, to be licensed as a physician assistant. A person who is trained to do only a very limited number of diagnostic or therapeutic procedures under the direction of a physician or osteopathic physician shall not be deemed a practitioner of medicine or osteopathy and therefore does not require licensure under this section.

(b) The board shall establish medical educational and training standards with which a person applying for licensure as a physician assistant shall comply. The standards shall be at least equal to recognized national education and training standards for physician assistants.

(c) Upon satisfactory proof of compliance with the required medical educational and training standards, the board may grant state licensure to a person who has been granted certification based upon passage of a national certifying examination and who holds a current certificate from the national certifying entity approved by the board.

(d) The board shall approve temporary licensure of an applicant under this section. The applicant shall have graduated from a board approved training program within twelve months of the date of application and never taken a national certifying examination approved by the board but otherwise meets the requirements of this section. The applicant shall file a complete application with the board and pay all required fees. If the applicant fails to apply for, or to take, the first examination scheduled by the board following the issuance of the temporary license, fails to pass the examination, or fails to receive licensure, all privileges under this section shall automatically cease upon written notification sent to the applicant by the board. A temporary license shall be issued only once to each person.

(e) Prior to practicing under temporary licensure, holders of temporary licenses shall notify the board in writing of any and all supervising physicians or osteopathic physicians under whom they will be performing services.

(f) The board shall establish the degree of supervision required by the supervising physician or osteopathic physician when a physician assistant performs a service within the practice of medicine. A physician or osteopathic physician who does not supervise a physician assistant's services at the degree required by the board shall be deemed to have engaged in professional misconduct.

(g) Any license of a physician assistant may be denied, not renewed, revoked, limited, or suspended under section 453-8.

(h) The board shall establish the application procedure, medical educational and training standards, examination requirement, if any, and degrees of supervision by rule.

(i) Every person holding a license under this section shall apply for renewal with the board no later than January 31 of each even-numbered year and pay a renewal fee. Failure to apply for renewal shall constitute a forfeiture of the license that may only be restored upon written application for restoration and payment to the board of a restoration fee.

(j) Prior to each license renewal, a person holding a license under this section shall furnish the board with proof of completion during the time period subsequent to the person's previous license renewal of continuing education as required by the board; provided that the board shall not require a physician assistant to maintain or receive certification by the National Commission of Certification of Physician Assistants to satisfy the continuing education requirement or for license renewal.

[~~(j)~~] (k) A license that has been forfeited for one renewal term shall be automatically terminated and cannot be restored. A new application for licensure shall be required."

SECTION 3. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 5. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	3074
TWENTY-NINTH LEGISLATURE, 2018
STATE OF HAWAII