How to Nurse Hawaii Back to Good Health

by Keli’i Akina PhD, President/CEO Grassroot Institute, April 6, 2024

We must give credit where it’s due: Hawaii lawmakers seem to be getting serious about solving our healthcare shortages.

Problems such as Hawaii’s doctor and nursing shortages existed before the COVID-19 crisis, but facing such a healthcare emergency without enough healthcare workers made it clear that the issue couldn’t be ignored any longer.

State lawmakers took an important first step last year by passing legislation that allowed Hawaii to join the Interstate Medical Licensure Compact, which streamlines the licensure process for doctors to practice in Hawaii as long as they hold a license in good standing from another IMLC state.

I am proud to say that the Grassroot Institute of Hawaii, of which I am president, was instrumental in pushing for Hawaii to join the IMLC and other interstate licensure compacts for healthcare workers.

As we explained in our policy brief, “How changing Hawaii’s licensing laws could improve healthcare access,” there is a point at which local regulations on licensed out-of-state professionals become redundant and unnecessarily burdensome. Rather than protect the public, such provisions instead serve as barriers to medical professionals practicing here

I mean, let’s face it: You wouldn’t hesitate to accept care from any licensed doctor or nurse while visiting another state, so why should those same doctors and nurses have to jump through bureaucratic hoops in order to care for patients in Hawaii?

Fortunately, this common sense approach to bringing more medical professionals to Hawaii appears to have taken hold at the Legislature. After green-lighting the IMLC last year, state lawmakers now are are considering a bill, HB2415, that would allow Hawaii to also join the Nurse Licensure Compact.

The NLC allows nurses to apply for a multi-state license, which means that nurses who hold a multi-state license can practice in other NLC states and territories without having to obtain another license. It’s basically like a driver’s license for nursing.

Admittedly, joining the NLC probably wouldn’t end Hawaii’s nursing shortage — according to a report from the Hawaii State Center for Nursing, we need 300 to 400 additional nurses in order to meet demand. It would, however, remove barriers for some out-of-state nurses to practice in Hawaii, regardless of whether they want to work here temporarily or permanently.

Joining the NLC would also make it easier for nurses who are military spouses to work at Hawaii facilities, which is why the U.S. Department of Defense testified in support of HB2415.

The compact model has become an effective way for states to streamline cross-state medical licensure, and Hawaii cannot afford to be left behind. There are currently 41 states and territories participating in the NLC, with Hawaii and eight other states having introduced bills to also join.

So what’s next for the Nurse Licensure Compact bill?

Lawmakers might still need to hash out some of the details, but if that process goes well, it will head to the governor's desk.

If you want to add your voice to the many others who are urging Hawaii lawmakers to bring more nurses to our state, you can reach out to your legislators through the Grassroot Institute’s “Take Action” portal.

Enacting this bill would be another step toward improving our healthcare access in Hawaii, but there's still much more to do.

In the coming year, my colleagues and I at Grassroot will be urging policymakers to keep up the momentum by also reforming the state’s medical certificate-of-need laws, improving telehealth access and eliminating the general excise tax on all medical services.

For now, we should applaud our Legislature for embracing the Nurse Licensure Compact.

And let's encourage them to improve our healthcare access even further by passing more laws that will attract healthcare workers to Hawaii.

E hana kākou! (Let's work together!)