Preceptor Law, Act 43

A letter to the editor from Laura Reichhardt

Working on healthcare workforce issues is complex. One of the hardest tasks is making sure the efforts align. Do we have the enough highly qualified students applying to needed healthcare educational programs? Do we have education programs, locally, to create the needed types and numbers of future health care professionals? Are there an adequate number of experienced health care professionals to oversee, mentor, and teach students in clinical settings? Do we have employers who are willing and able to hire these students who just graduated? Do we have people working in these areas with experience and expertise to balance out the influx of new professionals, mentor them in their new careers, or both?

In this game of chutes and ladders, if one wrung is out of alignment, these efforts bottleneck. Last summer, healthcare provider education programs realized the state is experiencing a shortage in preceptors, or experienced healthcare professionals who volunteer to teach nursing, medicine, and pharmacy students, and others, in clinical settings. As a result, it was becoming increasingly difficult to secure the needed clinical experiences a student must complete before the student may graduate, take national certification exams, or become licensed, and so schools were beginning to reduce their class sizes. This is a problem. In Hawai‘i, we depend on our local healthcare schools to educate our future healthcare workers. We also are continuously growing in our healthcare demands as our population size, and population average age, grows. If our schools decrease class sizes, we won’t be able to meet these demands.

Action was needed. Using models successfully passed in Georgia, Maryland and Colorado, Senator Rosalyn Baker introduced a bill proposing that the state create tax credits for primary care health care providers who volunteer their time to provide students clinical experiences. Act 43 was signed into law on June 13, 2018. Our legislators demonstrated understanding that supporting the clinical placement environment for students can directly impact the number of future healthcare professionals in our state. Further, this act recognizes our current primary care healthcare professionals who are doing above and beyond their call of duty by volunteering their time and expertise to educate the next generation of healthcare professionals. With high levels of burnout, and our very high needs for primary care providers, particularly on neighbor islands and rural communities, this recognition of primary care providers is important.

Starting in January 2019, primary care advanced practice registered nurses, like nurse practitioners, physicians, and pharmacists who precept, or provide clinical experience education to students enrolled in our in-state schools of advanced practice nursing, medicine, and pharmacy will be eligible to apply for these tax credits. The $1,000 personal income tax credit applies per student, up to five students a year. Through this effort, we hope to build the number of preceptors on all islands. In doing so, we hope that students who learn from these healthcare professionals gain employment where they learn, on all islands, and therefore increase access to timely, high quality care in all corners of our state. This effort aims to address multiple rungs in our game of healthcare chutes and ladders.