SB 3192: DOH; Emergency; Healthcare; Licenses; Waivers; Reports

A BILL FOR AN ACT

RELATING TO EMERGENCY HEALTHCARE LICENSURE WAIVERS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that the State faces escalating threats from natural disasters, including wildfires, hurricanes, flooding, and public health emergencies necessitating the rapid deployment of healthcare professionals for medical and behavioral health needs.  Past reliance on gubernatorial proclamations for out-of-state license waivers has proven effective but has caused delays and hampered coordination with partners, including the military and the American Red Cross.

     The purpose of this Act is to codify streamlined emergency licensure flexibilities to enable the swift mobilization of qualified healthcare professionals, thereby enhancing the State's disaster response capabilities.

     SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

     "§321-     Emergency healthcare licensure flexibility.  (a)  Notwithstanding any law to the contrary, during a state of emergency or local state of emergency declared by the governor or a county mayor pursuant to chapter 127A, the following  professionals may engage in the practice of their respective professions in the State without a Hawaii-issued license, subject to the conditions in this section:

     (1)  Physicians and osteopathic physicians;

     (2)  Physician assistants;

     (3)  Registered nurses, licensed practical nurses, and advanced practice registered nurses, including those with prescriptive authority;

     (4)  Emergency medical service personnel;

     (5)  Pharmacists;

     (6)  Mental health counselors; and

     (7)  Other healthcare professionals as designated by the department of health in consultation with the department of commerce and consumer affairs.

     (b)  To qualify to practice under this section, individuals shall:

     (1)  Hold a current and active license in good standing in another state, territory, or the District of Columbia, or have previously held a license in good standing in Hawaii that was not revoked or surrendered under discipline;

     (2)  Have no history of license revocation, suspension, or voluntary surrender due to disciplinary action in any jurisdiction;

     (3)  Be affiliated with a state or county government agency, hospital, licensed healthcare facility, federally qualified health center, or nationally recognized emergency response organization, including the American Red Cross, Federal Emergency Management Agency, or any military medical unit; and

     (4)  Comply with the scope of practice, standards of care, and prescribing authority of the person's home jurisdiction, not exceeding the State's standards.

     (c)  Telehealth services may be provided by eligible out‑of-state practitioners without requiring an in‑person consultation or existing provider-patient relationship; provided that the services comply with the provider's home jurisdiction's laws and standards of care, and federal privacy laws.  All patient records shall be transferred to a Hawaii-licensed provider upon request or during a transition of care.

     (d)  The department of health shall:

     (1)  Establish and publicly maintain an online registry of professionals practicing under this section, including verification of credentials and affiliation;

     (2)  Require self-registration via a secure portal within twenty-four hours of the deployment in the State of a professional pursuant to this section, with expedited department verification within forty-eight hours;

     (3)  Coordinate with the department of commerce and consumer affairs for license checks; and

     (4)  Adopt administrative rules under chapter 91 to implement this section, including reporting on utilization and outcomes.

     (e)  Authorization under this section shall expire upon termination of the emergency declaration or sixty days after activation, whichever is sooner, unless extended by the governor.  The department of health may immediately revoke authorization for violations, malpractice, or criminal conduct, with notice to the practitioner's home jurisdiction.

     (f)  No civil liability shall attach to the State, counties, or facilitating entities for good-faith actions under this section.  Practitioners shall remain subject to the State's malpractice laws and insurance requirements.

     (g)  The department of health shall submit a report to the legislature no later than twenty days prior to the convening of each regular session on program usage, which shall include the number of professionals authorized to practice, services provided, recommendations for improvements, and any proposed legislation."

     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.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect on July 1, 2050.

Report Title:

DOH; Emergency; Healthcare; Licenses; Waivers; Reports

Description:

Authorizes the waiver of certain healthcare worker licensure requirements during emergencies.  Requires the Department of Health to submit an annual report to the Legislature.  Effective 7/1/2050.  (SD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

relating to emergency healthcare LICENSURE waivers.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that Hawaii faces escalating threats from natural disasters, including wildfires, hurricanes, flooding, and public health emergencies necessitating the rapid deployment of healthcare professionals for medical and behavioral health needs.  Past reliance on gubernatorial proclamations for out-of-state license waivers has proven effective but has caused delays and hampered coordination with partners, including the military and the American Red Cross.

     The purpose of this Act is to codify streamlined emergency licensure flexibilities to enable the swift mobilization of qualified healthcare professionals, thereby enhancing Hawaii's disaster response capabilities.

     SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

     "§321-     Emergency healthcare licensure flexibility.  (a)  Notwithstanding any law to the contrary, during a state of emergency or local state of emergency declared by the governor or a county mayor pursuant to chapter 127A, the following  professionals may engage in the practice of their respective professions in the State without a Hawaii-issued license, subject to the conditions in this section:

     (1)  Physicians and osteopathic physicians;

     (2)  Physician assistants;

     (3)  Registered nurses, licensed practical nurses, and advanced practice registered nurses, including those with prescriptive authority;

     (4)  Emergency medical service personnel;

     (5)  Pharmacists;

     (6)  Mental health counselors; and

     (7)  Other healthcare professionals as designated by the department of health in consultation with the department of commerce and consumer affairs.

     (b)  To qualify to practice under this section, individuals shall:

     (1)  Hold a current and active license in good standing in another state, territory, or the District of Columbia, or have previously held a license in good standing in Hawaii that was not revoked or surrendered under discipline;

     (2)  Have no history of license revocation, suspension, or voluntary surrender due to disciplinary action in any jurisdiction;

     (3)  Be affiliated with a state or county government agency, hospital, licensed healthcare facility, federally qualified health center, or nationally recognized emergency response organization, including the American Red Cross, Federal Emergency Management Agency, or any military medical unit; and

     (4)  Comply with the scope of practice, standards of care, and prescribing authority of the person's home jurisdiction, not exceeding Hawaii's standards.

     (c)  Telehealth services may be provided by eligible out‑of-state practitioners without requiring an in‑person consultation or existing provider-patient relationship; provided that the services comply with the provider's home jurisdiction's laws and standards of care, and federal privacy laws.  All patient records shall be transferred to a Hawaii-licensed provider upon request or during a transition of care.

     (d)  The department of health shall:

     (1)  Establish and publicly maintain an online registry of professionals practicing under this section, including verification of credentials and affiliation;

     (2)  Require self-registration via a secure portal within twenty-four hours of the deployment in Hawaii of a professional pursuant to this section, with expedited department verification within forty-eight hours;

     (3)  Coordinate with the department of commerce and consumer affairs for license checks; and

     (4)  Adopt administrative rules under chapter 91 to implement this section, including reporting on utilization and outcomes.

     (e)  Authorization under this section shall expire upon termination of the emergency declaration or sixty days after activation, whichever is sooner, unless extended by the governor.  The department of health may immediately revoke authorization for violations, malpractice, or criminal conduct, with notice to the practitioner's home jurisdiction.

     (f)  No civil liability shall attach to the State, counties, or facilitating entities for good-faith actions under this section.  Practitioners remain subject to Hawaii malpractice laws and insurance requirements.

     (g)  The department of health shall submit a report to the legislature no later than twenty days prior to the convening of each regular session on program usage, which shall include the number of professionals authorized to practice, services provided, recommendations for improvements, and any proposed legislation."

     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.  New statutory material is underscored.

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

Report Title:

DOH; Emergency; Healthcare; Licenses; Waivers; Reports

Description:

Authorizes the waiver of certain healthcare worker licensure requirements during emergencies.  Requires an annual report to the legislature.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

STAND. COM. REP. NO. 2588

Honolulu, Hawaii

RE:     S.B. No. 3192

        S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Sir:

     Your Committee on Public Safety and Military Affairs, to which was referred S.B. No. 3192 entitled:

"A BILL FOR AN ACT RELATING TO EMERGENCY HEALTHCARE LICENSURE WAIVERS,"

begs leave to report as follows:

     The purpose of this measure is to:

     (1)  Authorize the waiver of certain healthcare worker licensure requirements during emergencies; and

     (2)  Require an annual report to the Legislature.

     Your Committee received testimony in support of this measure from ATA Action, Hawaiʻi-American Nurses Association, American Red Cross, AlohaCare, Waianae Coast Comprehensive Health Center, and eight individuals.

     Your Committee received comments on this measure from the Healthcare Association of Hawaii.

     Your Committee finds that natural disasters and health care emergencies, such as epidemics and pandemics, place significant strain on health care systems.  This strain often results in widespread workforce shortages for health care professionals, which in turn interrupt access to health services. Your Committee further finds that polices allowing waivers to health care professionals under certain conditions are increasingly common.  Over twenty other states have recognized the challenges that natural disasters and emergencies present and have adopted similar legislation to maintain access to health care services for their residents.  Given the State's geographic isolation, maintaining health care access during disasters and emergencies can be exceptionally challenging, making waivers even more important than in other jurisdictions.  By granting waivers to volunteer health care professionals under emergency conditions, this measure will promote the health and safety of the State's residents.

     Your Committee has amended this measure by:

     (1)  Inserting an effective date of July 1, 2050, to encourage further discussion; and

     (2)  Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

     As affirmed by the record of votes of the members of your Committee on Public Safety and Military Affairs that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 3192, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 3192, S.D. 1, and be referred to your Committees on Commerce and Consumer Protection and Judiciary.

Respectfully submitted on behalf of the members of the Committee on Public Safety and Military Affairs,