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It has been estimated that Hawaii is nearly 1,000 nurses short of meeting its healthcare demands — a deficit that’s more than double what it was in 2019.

, the state’s doctor shortage clocks in at around .

In 2023, the Legislature moved to address Hawaii’s longstanding doctor shortage the state to join the Interstate Medical Licensure Compact, which streamlines the process for allowing doctors licensed in any member state or territory — — to practice in other IMLC member jurisdictions without enduring duplicative, costly and burdensome licensing requirements.

As a major force behind the state’s participation in the IMLC, the Grassroot Institute of Hawaii set out during the 2024 legislative session to also make it easier for out-of-state nurses to practice in Hawaii.

Like the IMLC, the national Nurse Licensure Compact streamlines interstate licensing procedures, in this case for nurses, and also has more than 40 members.

The nurse compact proposal faced opposition from various nurse trade groups, but lawmakers reached a compromise by revisiting and approving from the 2023 session.

When it takes effect in 2025, SB 63 will modify current temporary for out-of-state licensed nurses, primarily by simplifying the application process and extending the duration of the temporary licenses from three to six months.

More Change Needed

The new law also will require that the temporary permits be issued within 10 business days, versus no deadline previously; create a single condensed application and fee encompassing both temporary permits and permanent Hawaii licenses; and allow temporary nurses to practice in Hawaii for up to a year if they are waiting for their permanent licenses.

Other changes include a less rigorous and shorter verification process for temporary license applicants, and an exemption for licensed nurses not employed in Hawaii if they accompany an out-of-state patient for less than two weeks.

These changes will all help in the short run, but for the longer run, state lawmakers should still be considering permanent ways to ease Hawaii’s nursing shortage.

For example, is a process whereby states recognize and honor valid licenses issued by any other state. As Grassroot Policy Director Malia Hill explained in “How changing Hawaii’s licensing laws could improve healthcare access,” this is what Gov. David Ige in his COVID-19 emergency executive proclamations starting in April 2020.

Another option is , whereby individual states enter into agreements with other states on a case-by-case basis to mutually accept each other’s nursing licenses.

Either option would be more effective than current practices. But perhaps the simplest legislative decision would be for Hawaii to join the NLC.

Rather than a Band-Aid approach, reintroducing and passing the NLC legislation could have the longest lasting impact on the state’s healthcare shortage by opening up our healthcare facilities to nurses from more than 40 other states and territories.

With Hawaii being more attractive to out-of-state nurses looking for contracted jobs, healthcare access and quality would improve — and then we could look to see which should be the next group of licensed medical professionals to be considered for interstate licensure compact status.