New report urges licensure reform to boost ranks of medical workers

The Grassroot Institute of Hawaii says making it easier for qualified medical professionals to practice here would improve healthcare access

News release from Grassroot Institute, Feb 22, 2023

HONOLULU, Feb. 22, 2023 >> The Grassroot Institute of Hawaii released a new policy brief today recommending that state lawmakers enact legislation to permanently accept out-of-state medical licenses as a way to improve healthcare access in Hawaii.

The brief, “How changing Hawaii’s licensing laws could improve healthcare access,” makes the point that Hawaii’s occupational licensing laws have made it difficult for out-of-state medical personnel to work in the islands, thereby contributing to the state’s documented shortage of healthcare workers.

As Keli‘i Akina, Grassroot Institute president and CEO, explains in the brief's introduction, “Authoritative estimates suggest Hawaii needs nearly 800 full-time doctors and hundreds more nurses and other medical professionals to ensure that Hawaii residents receive the healthcare they need, when they need it."

He continues: “Considering Hawaii’s reputation as a virtual natural paradise, you might think medical professionals from the mainland would be clamoring to move here and take up the slack. Unfortunately, Hawaii can be a hostile place for such professionals to practice, due to its high cost of living, absence of affordable housing, lack of opportunities and other economic disincentives.

“But making it even harder has been the state’s medical licensure laws, which require medical professionals who hold valid, unencumbered licenses in other U.S. states to endure expensive and time-consuming Hawaii bureaucratic hurdles in order to practice here.

“This serves no public interest," Akina says. "It only discourages them from coming to our state, depriving Hawaii residents of capable healthcare providers. That is why Hawaii should embrace licensure reform."

Malia Hill, Institute policy director and author of the report, notes that during the COVID-19 crisis, then-Gov. David Ige joined many other state governors in using his emergency powers to temporarily create a streamlined licensing recognition program for medical professionals.

Now that Ige's emergency orders have been lifted, Hill says, “Hawaii lawmakers should consider expanding Ige's temporary measures in favor of licensure reform that will help address our state’s healthcare crisis while better preparing us for future emergencies.”

The brief outlines three policies the Legislature could adopt to help fill the ranks of Hawaii’s doctors, nurses and other medical workers. They are:

>> Interstate compacts, which streamline licensing among participating states to allow qualified applicants to practice more easily across state lines. 

For example, 37 states already participate in the Interstate Medical Licensing Compact for doctors, and 23 states have joined the Audiology & Speech-Language Pathology Interstate Compact for hearing and speech pathologists.

>> Licensing recognition, by which Hawaii would recognize a license issued by another state — any other state, whether in a compact or not — as valid to work in Hawaii.

>> Licensing reciprocity, which focuses on a single state’s acceptance of out-of-state licenses and, like interstate compacts, is an agreement between specific states governing mutual acceptance of a valid professional license.

In the 2023 Legislature, there are numerous bills already being considered that would adopt some form of medical licensure reform, including SB63, relating to nurses; SB674 and HB666, relating to physicians; SB317, relating to hearing and speech specialists; SB322, relating to professional counselors; SB323, relating to occupational therapists; and SB668, relating to physical therapists.

Akina says in his introduction that “whether through interstate compacts or carefully tailored recognition or reciprocity laws, … our lawmakers have the power to attract more healthcare workers to Hawaii, without jeopardizing public health and safety or adding to the government’s administrative burden."

He said licensure reform would not be a cure-all, "but if we fail to lift the licensing barriers that discourage doctors, nurses and other medical professionals from coming here, all other efforts to attract and retain healthcare workers will be stymied.”

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The Grassroot Institute of Hawaii is a nonpartisan, nonprofit research and educational institute devoted to promoting individual liberty, economic freedom and accountable government. Its goal is to improve the quality of life in Hawaii by lowering the cost of living and expanding opportunities for all.