Interstate licensure compacts would assist appeal to extra medical staff

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The next testimony was offered Feb. 1, 2023, by the Grassroot Institute of Hawaii to the Home Committee on Well being & Homelessness.

To: Home Committee on Well being & Homelessness
Rep. Della Au Belatti, Chair
Rep. Jenna Takenouchi, Vice Chair


From: Grassroot Institute of Hawaii
Jonathan Helton, Coverage Researcher


Feedback Solely

Expensive Chair and Committee Members:

The Grassroot Institute of Hawaii want to supply its feedback on HB666, which might enter Hawaii into the Interstate Medical Licensure Compact.

If this invoice is enacted, the Legislature will take an necessary step towards addressing Hawaii’s physician scarcity, an issue that has existed for years and has turn into a critical impediment to healthcare entry in our state.

It’s properly established that Hawaii is affected by a doctor scarcity. In line with the newest report from the Hawaii Doctor Workforce Evaluation Undertaking, the state is at present brief by roughly 776 full-time equal physicians.[1] Whereas the best space of want is main care physicians, the dearth of specialists — particularly in rural areas — can be extreme

Furthermore, that scarcity doesn’t apply to solely docs. Throughout the state, and particularly in rural areas, Hawaii is going through shortages of skilled well being professionals, from main care suppliers to nurses, specialists and workers.

Fixing the issue requires a multipronged technique that may deal with all the things from Hawaii’s excessive price of residing to the state’s regulatory scheme for healthcare amenities. Maybe most necessary, nevertheless, is the necessity to reform licensing rules for healthcare professionals.

One-fourth of all licensed staff within the U.S. work in healthcare.[2] These licenses could be troublesome to acquire, are costly and carry geographic or “scope of follow” limitations.

In gentle of Hawaii’s shortages of healthcare professionals, restrictions on healthcare staff who already maintain licenses in different U.S. states appear redundant and self-defeating. Because the Federal Commerce Fee famous in a report on occupational licensing portability:

There’s little justification for the burdensome, expensive, and redundant licensing processes that many states impose on certified, licensed, out-of-state candidates. Such necessities seemingly inhibit multistate follow and delay and even stop licensees from working of their occupations upon relocation to a brand new state. Certainly, for occupations that haven’t carried out any type of license portability, the hurt to competitors from suppressed mobility could far outweigh any believable client safety profit from the failure to supply for license portability.[3]

In different phrases, although medical licensing is meant to guard the general public, there’s a level at which the extent of regulation reduces the variety of folks in follow with out an considerable public profit.

One examine of licensing amongst medical professionals discovered that, “licensing is related to restricted labor provide, an elevated wage of the licensed occupation, rents, elevated output costs, and no measurable impact on output high quality.”[4]

That is the place we will profit from the teachings of the coronavirus scenario. The governor’s emergency modification to state licensing legal guidelines demonstrated a have to embrace license portability, making it a easy matter for a physician licensed in one other state to follow in Hawaii.

The interstate compact method outlined on this invoice would streamline licensing for physicians, making it simpler for docs from collaborating states to follow in Hawaii with out going through time-consuming, expensive and redundant regulatory hurdles.

The state would retain its management over Hawaii licensure necessities, however would concurrently improve the pool of docs capable of follow in Hawaii and shorten the time it might take for them to start working right here.

At current, the Interstate Medical Licensure Compact contains 37 states, the District of Columbia and Guam. 5 further states have launched laws to hitch as properly. Years of profitable implementation testify to the security and effectiveness of this method to license reciprocity.

In line with the IMLC, its goal is to function “an administrative clearinghouse of licensing and disciplinary info amongst collaborating member states and territories. The Fee doesn’t have regulatory management over physicians or the follow of medication. It neither points nor revokes licenses. Its solely goal is to facilitate interstate cooperation and the switch of data between member states and territories.”

Becoming a member of the IMLC can be an necessary step towards attracting extra docs to our state, thereby addressing our doctor scarcity and bettering healthcare entry for all.

Thanks for the chance to submit our feedback.


Jonathan Helton
Coverage Researcher,
Grassroot Institute of Hawaii

[1] “Annual Report on Findings from the Hawai’i Doctor Workforce Evaluation Undertaking: Report back to the 2023 Legislature,” College of Hawaii, December 2022, p.1

[2] Ryann Nunn, “Enhancing Well being Care By way of Occupational Licensing Reform,” RealClear Markets, Aug. 28, 2018

[3] Karen Goldman, “Choices to Improve Occupational License Portability,” Federal Commerce Fee, September 2018, p. 25.

[4] Sean Nicholson and Carol Propper, “Chapter Fourteen — Medical Workforce,” “Handbook of Well being Economics,” Vol. 2, Elsevier, B.V., 2012, p. 885, cited additionally within the beforehand talked about FTC examine, footnote #9, p3.