Physician Assistants 

Establishes licensure of physician assistants in place of

THE SENATE                              S.B. NO.           40
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  Section 453-5.3, Hawaii Revised Statutes, is
 2 amended to read as follows:
 3      "453-5.3  Physician assistant; [certification] licensure
 4 required.(a)  The board of medical examiners shall require each
 5 person practicing medicine under the supervision of a physician,
 6 other than a person licensed under section 453-3, to be
 7 [certified] licensed as a physician assistant.  A person who is
 8 trained to do only a very limited number of diagnostic or
 9 therapeutic procedures under the direction of a physician shall
10 not be deemed a practitioner of medicine and therefore does not
11 require [certification] licensure under this section.
12      (b)  The board shall establish medical educational and
13 training standards with which a person applying for
14 [certification] licensure as a physician assistant shall comply.
15 The standards shall be at least equal to recognized national
16 education and training standards for physician assistants.
17      (c)  Upon satisfactory proof of compliance with the required
18 medical educational and training standards, the board may grant
19 state [certification] licensure to a person who has been granted

Page 2                                                     
                                     S.B. NO.           40

 1 certification based upon passage of a national certifying
 2 examination and who holds a current certificate from the national
 3 certifying entity approved by the board.
 4      (d)  The board shall approve temporary [certification]
 5 licensure of an applicant under this section.  The applicant
 6 shall have graduated from a board approved training program
 7 within twelve months of the date of application and never taken a
 8 national certifying examination approved by the board but
 9 otherwise meet the requirements of this section.  The applicant
10 shall file a complete application with the board and pay all
11 required fees.  If the applicant fails to [apply]:
12      (1)  Apply for[,] or [to] take[,] the first examination
13           scheduled by the board following the issuance of the
14           temporary [certificate, fails to pass] license; 
15      (2)  Pass the examination[, or fails to receive]; or 
16      (3)  Receive certification,
17 all privileges under this section shall automatically cease upon
18 written notification sent to the applicant by the board.  A
19 temporary [certificate] license shall be issued only once to each
20 person.
21      (e)  Prior to practicing under temporary [certification,]
22 licensure, holders of temporary [certificates] licenses shall
23 notify the board in writing of any and all supervising physicians

Page 3                                                     
                                     S.B. NO.           40

 1 under whom they will be performing services.
 2      (f)  The board shall establish the degree of supervision
 3 required by the supervising physician when a physician assistant
 4 performs a service within the practice of medicine.  A physician
 5 who does not supervise a physician assistant's services at the
 6 degree required by the board shall be deemed to have engaged in
 7 professional misconduct.
 8      (g)  Any [certification] licensure of a physician assistant
 9 may be denied, not [recertified,] renewed, revoked, limited, or
10 suspended under section 453-8.
11      (h)  The board shall establish the application procedure,
12 medical educational and training standards, examination
13 requirement, if any, and degrees of supervision by rule.
14      (i)  Every person holding a [certificate] license under this
15 section shall apply for [recertification] renewal with the board
16 no later than January 31 of each even-numbered year and pay a
17 renewal fee.  Failure to apply for [recertification] renewal
18 shall constitute a forfeiture of the [certificate] license which
19 [may] shall only be restored upon written application for
20 [recertification] restoration and payment to the board of a
21 restoration fee.
22      (j)  A [certificate] license that has been forfeited for one
23 renewal term shall be automatically terminated and cannot be

Page 4                                                     
                                     S.B. NO.           40

 1 restored.  A new application for [certification] licensure shall
 2 be required." 
 3      SECTION 2.  Section 453-5.4, Hawaii Revised Statutes, is
 4 amended to read as follows:
 5      "[[]453-5.4[]]  Physician assistant advisory committee.
 6 There shall be a physician assistant advisory committee under the
 7 board of medical examiners consisting solely of persons
 8 [certified] licensed under section 453-5.3.  The committee shall
 9 review all complaints and requests relating to physician
10 assistants, and review and recommend revisions of the physician
11 assistant regulations.
12      The chairperson of the committee shall be the representative
13 for the committee members to the board of medical examiners for
14 the purpose of providing input to the board from the physician
15 assistant's perspective on issues and concerns, including
16 complaints and requests, regarding physician assistants.  The
17 chairperson shall not be a member of the board of medical
18 examiners to avoid conflict of interests."
19      SECTION 3.  Statutory material to be repealed is bracketed.
20 New statutory material is underscored.
21      SECTION 4.  This Act shall take effect upon its approval.
23                           INTRODUCED BY:  _______________________