THE SENATE	S.B. NO.	2117
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII

A BILL FOR AN ACT

 

 

relating to health care preceptors.

 

 

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

 

     SECTION 1.  The legislature finds that there is a shortage of primary care providers in the State, which will be exacerbated by the projected retirements of current physicians, advanced practice registered nurses, pharmacists, and other health care workers.  Further, although students are interested in pursuing careers in Hawaii's health care service industry, in-state educational institutions are constrained by the lack of clinical education sites in Hawaii and limited supply of qualified preceptors.  One way to encourage the participation of preceptors is to offer an income tax credit for professionals who serve as preceptors.

     The purpose of the existing healthcare preceptor income tax credit established under section 235-110.25, Hawaii Revised Statutes, is to incentivize volunteer preceptors to offer professional instruction, training, and supervision to students and residents seeking careers as health care providers in Hawaii.  During the implementation of the tax credit, many providers trained eligible students, but only a small subset met the eligibility requirements due to the primary care qualifying criterion for the preceptor.

     Thus, the legislature recognizes that those programs training physicians, advanced practice registered nurses, pharmacists, and physician assistants in primary care also require training from specialty preceptors who support primary care, in addition to training from primary care providers.  The legislature further recognizes that the health care workforce has shortages that extend beyond the current professions included in the tax credit whose workforce expansion is also limited by available preceptors, including social workers, physician assistants, and registered dietitians.  The legislature also finds that the definition of "volunteer-based supervised clinical training rotation" may be clarified to facilitate the preceptor credit assurance committee's implementation of the tax credit.

     Therefore, the purpose of this Act is to:

     (1)  Amend the definition of "preceptor" to include physician assistants, registered dietitians, and social workers;

     (2)  Amend the definition of "volunteer-based supervised clinical training rotation" to clarify that preceptors may be compensated for the provision of standard clinical service during supervised clinical trainings;

     (3)  Amend the definition of "eligible student" to include physician assistant, registered dietitian, and social work student; and

     (4)  Include the director of health as a member of the preceptor credit assurance committee.

     SECTION 2.  Section 235-110.25, Hawaii Revised Statutes, is amended by amending subsection (g) to read as follows:

     "(g)  For the purposes of this section:

     "Academic program" means an academic degree granting program or graduate medical education program that:

     (1)  Holds either its principal accreditation or a physical location in Hawaii; and

     (2)  Provides education to students, of whom more than fifty per cent are residents of Hawaii.

     "Advanced practice registered nurse student" means an individual participating in a nationally accredited academic program that is for the education of advanced practice registered nurses and recognized by the state board of nursing pursuant to chapter 457.

     "Eligible professional degree or training certificate" means a degree or certificate that fulfills a requirement to be a physician, [or] osteopathic physician, or physician assistant, pursuant to chapter 453[,]; an advanced practice registered nurse, pursuant to chapter 457[, or]; a pharmacist, pursuant to chapter 461[.]; a registered dietitian, pursuant to chapter 448B; or a social worker, pursuant to chapter 467E.

     "Eligible student" means an advanced practice registered nurse student, medical student, [or] pharmacy student, physician assistant student, registered dietitian student, or social work student, who is enrolled in an academic program.

     "Medical student" means an individual participating in a nationally accredited academic program leading to the medical doctor or doctor of osteopathy degree.  "Medical student" includes graduates from nationally accredited academic programs who have continued their training, in the role of resident or fellow, to obtain the additional qualifications needed for medical licensure, pursuant to chapter 453, or specialty certification.

     "Nationally accredited" means holding an institutional accreditation by name to offer post-secondary medical primary care education.  Accreditation for medical students shall be offered by the Liaison Committee on Medical Education or American Osteopathic Association Commission on Osteopathic College Accreditation.  Accreditation for advanced practice registered nurse students shall be offered by the Commission on Collegiate Nursing Education.  Accreditation for pharmacy students shall be offered by the Accreditation Council for Pharmacy Education.  Accreditation for physician assistant students shall be offered by the Accreditation Review Commission on Education for the Physician Assistant, Inc.  Accreditation for social work students shall be offered by the Council on Social Work Education.  Accreditation for registered dietitian students shall be offered by the Accreditation Council for Education in Nutrition and Dietetics.

     "Pharmacy student" means an individual participating in an academic program that is nationally accredited for the training of individuals to become registered pharmacists pursuant to chapter 461.

     "Physician assistant student" means an individual participating in an academic program that is nationally accredited for the education of physician assistants to become a nationally certified and licensed physician assistant pursuant to section 453-5.3.

     "Preceptor" means a physician [or], osteopathic physician, or physician assistant, licensed pursuant to chapter 453[,]; an advanced practice registered nurse, licensed pursuant to chapter 457[,]; registered dietitian, licensed pursuant to chapter 448B; social worker, licensed pursuant to chapter 467E; or a pharmacist, licensed pursuant to chapter 461, who is a resident of Hawaii [and who], maintains a professional [primary care] practice in [this] the State[.], and whose specialty supports the development and training of an eligible student in primary care.

     "Primary care" means the principal point of continuing care for patients provided by a [healthcare] health care provider, including health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses, and coordination of other specialist care that the patient may need.

     "Registered dietitian student" means an individual participating in an academic program that is nationally accredited for the training of individuals to become licensed registered dietitians pursuant to chapter 448B.

     "Social work student" means an individual participating in an academic program that is nationally accredited for the training of individuals to become a social worker licensed pursuant to chapter 467E.

     "Volunteer-based supervised clinical training rotation" means [an uncompensated] a period of supervised clinical training [of] to an eligible student that totals at least eighty hours of supervisory time annually, in which a preceptor provides personalized instruction, training, and supervision to an eligible student to enable the eligible student to obtain an eligible professional degree or training certificate[.]; the preceptor may be compensated for providing standard clinical services; and the preceptor is:

     (1)  Uncompensated for the clinical training above or beyond clinical salary or reimbursements for clinical services; or

     (2)  Uncompensated for the provision of clinical training services from tuition funds or from state general funds."

     SECTION 3.  Section 321-2.7, Hawaii Revised Statutes, is amended to read as follows:

     "[[]§321-2.7[]]  Preceptor credit assurance committee.  (a)  There is established the preceptor credit assurance committee within the department of health.  The committee shall develop and implement a plan for certifying healthcare preceptor tax credits under section 235-110.25, including:

     (1)  Developing a process ensuring that requests for credit certification are reviewed and verifications are processed no later than [thirty] sixty days following the close of each calendar year; and

     (2)  Developing the documentation process for the committee to certify a preceptor for the tax credit; provided that the documentation to be collected shall include:

          (A)  The preceptor's name, address, place of practice, and Hawaii provider license number;

          (B)  Dates and hours of volunteer-based supervised clinical training rotation per eligible student;

          (C)  Attestation that the preceptor is uncompensated for the volunteer-based supervised clinical training rotation; [and] provided that, if the preceptor is compensated for providing standard clinical services, attestation that the preceptor is:

              (i)  Uncompensated for the clinical training above or beyond clinical salary or reimbursements for clinical services; or

             (ii)  Uncompensated for the provision of clinical training services from tuition funds or from state general funds;

          (D)  Itemized specialties that support the development and training of the eligible student in primary care; and

        [(D)]  (E)  Other information deemed necessary by the committee.

     (b)  The committee shall be composed of [representatives]:

     (1)  The director of health, or the director's designee; and

     (2)  Representatives of:

     [(1)] (A)  The Hawaii/Pacific basin area health education center;

     [(2)] (B)  The center for nursing; and

     [(3)] (C)  Academic programs with eligible students.

     (c)  Members of the committee shall be immune from civil liability for any official act, decision, or omission performed for the purpose for which the committee was established, except for any acts, decisions, or omissions that constitute gross negligence or wilful misconduct.

     (d)  The proceedings of the committee shall not be subject to part I of chapter 92.

     (e)  [As used in] For the purposes of this section, "academic program", "eligible student", "preceptor", "primary care", and "volunteer-based supervised clinical training rotation" shall have the same meanings as defined in section 235-110.25."

     SECTION 4.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect on July 1, 2024; provided that section 2 of this Act shall apply to taxable years beginning after December 31, 2023.

 

INTRODUCED BY:	_____________________________

 

 

 

Report Title:

Preceptors; Income Tax; Healthcare Preceptor Tax Credit; Preceptor Credit Assurance Committee

 

Description:

Amends the definition of "preceptor" to include physician assistants, registered dietitians, and social workers.  Amends the definition of "volunteer-based supervised clinical training rotation" to clarify that preceptors may be compensated for the provision of standard clinical services during supervised clinical trainings.  Amends the definition of "eligible student" to include physician assistants, registered dietitians, and social work students.  Includes the Director of Health as a member of the Preceptor Credit Assurance Committee.

 

 

 

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