SB321 SD1: Authorize study of licensing compact for nurses

The following testimony was submitted by the Grassroot Institute of Hawaii for consideration by the Senate Committee on Commerce and Consumer Protection, and the Senate Committee on Ways and Means on March 1, 2023.

March 1, 2023
9:30 a.m.
Conference Room 211

To: Senate Committee on Commerce and Consumer Protection
       Sen. Jarrett Keohokalole, Chair
       Sen. Carol Fukunaga, Vice Chair

      Senate Committee on Ways and Means
      Sen. Donovan Dela Cruz, Chair
      Sen. Gilbert Keith-Agaran, Vice Chair

From: Grassroot Institute of Hawaii
           Ted Kefalas, Director of Strategic Campaigns


Comments Only

Dear Chair and Committee Members:

The Grassroot Institute of Hawaii would like to offer its comments on SB321 SD1, which would create a working group to review the feasibility and possible consequences of Hawaii joining the Advanced Practice Registered Nurse Compact.

It is well established that Hawaii is suffering from a shortage of vital healthcare workers, especially nurses. A 2021 report from the Hawaii State Center for Nursing estimated that the state has 300 to 400 fewer nurses than needed to meet demand.[1] Since 2021, we have seen research indicating that nearly one-fourth of Hawaii’s nurses have been considering leaving the workforce, largely due to the stresses caused by the pandemic.[2]

As we discuss in a new policy brief How changing Hawaii’s licensing laws could improve healthcare access, licensing compacts are one reform that might make it easier for Hawaii to attract and retain healthcare professionals.[3]

“Joining multiple interstate compacts could be the simplest route to address the difficulties medical professionals face in moving to Hawaii.

“Most important, the compact approach has support from within the medical community,” the report states.

Numerous other states have adopted this compact and others, and the various compact commissions are more than happy to assist state regulators in the implementation phase.

Even though this bill does not outright adopt the APRN Compact, we hope that the working group will examine the costs and benefits of joining the compact and that the Legislature might consider it again next session.

Thank you for the opportunity to submit our comments.


Ted Kefalas
Director of Strategic Campaigns,
Grassroot Institute of Hawaii

[1] Carrie M. Oliveira, Ph.D., “2021 Hawai’i Nursing Workforce Supply: Statewide Report,” Hawai’i State Center for Nursing, 2021.

[2] Holly B. Fontenot, Ph.D., et al., “Impact of the COVID-19 Pandemic on the Hawai‘i Nursing Workforce: A Cross-sectional Survey,” Hawaii Journal of Health and Social Welfare, May 2022.

[3] Malia Hill, “How changing Hawaii’s licensing laws could improve healthcare access,” Grassroot Institute of Hawaii, Feb. 2023.

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