Hawaii Medical Board – February 9, 2023

Date:

Thursday, 02/09/2023

Start Time:

01:00 PM

Place:

Queen Liliuokalani Conference Room

Agenda

HAWAII MEDICAL BOARD

Professional and Vocational Licensing Division

Department of Commerce and Consumer Affairs

State of Hawaii

AGENDA

Date: February 9, 2023

Time: 1:00 p.m.

In-Person Queen Liliuokalani Conference Room

Meeting HRH King Kalakaua Building

Location: 335 Merchant Street, First Floor

Honolulu, Hawaii 96813

Agenda: The agenda was posted to the State electronic calendar as required by Hawaii Revised Statutes (“HRS”) section 92-7(b).

Virtual

Participation: Virtual Videoconference Meeting – Zoom Webinar (use link below)

https://dcca-hawaii-gov.zoom.us/j/98452925250

Phone: (669) 900-6833

Meeting ID: 984 5292 5250

If you wish to submit written testimony on any agenda item, please email your testimony to medical@dcca.hawaii.gov or by hard copy mail to: Attn: Hawaii Medical Board, P.O. Box 3469, Honolulu, HI 96801. We request submission of testimony at least 24 hours prior to the meeting to ensure that it can be distributed to the Board members.

INTERNET ACCESS:

To view the meeting and provide live oral testimony, please use the link at the top of the agenda. You will be asked to enter your name. The Board requests that you enter your full name, but you may use a pseudonym or other identifier if you wish to remain anonymous. You will also be asked for an email address. You may fill in this field with any entry in an email format, e.g., *****@***mail.com.

Your microphone will be automatically muted. When the Chairperson asks for public testimony, you may click the Raise Hand button found on your Zoom screen to indicate that you wish to testify about that agenda item. The Chairperson will individually enable each testifier to unmute their microphone. When recognized by the Chairperson, please unmute your microphone before speaking and mute your microphone after you finish speaking.

PHONE ACCESS:

Hawaii Medical Board Agenda

February 9, 2023

Page 2

If you cannot get internet access, you may get audio-only access by calling the Zoom Phone Number listed at the top on the agenda.

Upon dialing the number, you will be prompted to enter the Meeting ID which is also listed at the top of the agenda. After entering the Meeting ID, you will be asked to either enter your panelist number or wait to be admitted into the meeting. You will not have a panelist number. So, please wait until you are admitted into the meeting.

When the Chairperson asks for public testimony, you may indicate you want to testify by entering “*” and then “9” on your phone’s keypad. After entering “*” and then “9”, a voice prompt will let you know that the host of the meeting has been notified. When recognized by the Chairperson, you may unmute yourself by pressing “*” and then “6” on your phone. A voice prompt will let you know that you are unmuted. Once you are finished speaking, please enter “*” and then “6” again to mute yourself.

For both internet and phone access, when testifying, you will be asked to identify yourself and the organization, if any, that you represent. Each testifier will be limited to five minutes of testimony per agenda item.

If connection to the meeting is lost for more than 30 minutes, the meeting will be continued on a specified date and time. This information will be provided on the Board’s website at http://cca.hawaii.gov/pvl/boards/medical/board-meeting-schedule/.

Instructions to attend State of Hawaii virtual board meetings may be found online at https://cca.hawaii.gov/pvl/files/2020/08/State-of-Hawaii-Virtual-Board-Attendee-Instructions.pdf

1. Call to Order

2. Approval of the Open Session and Executive Session Minutes of the January 19, 2023, Meeting

The Board may enter into Executive Session to consult with the Board’s attorney on questions and issues pertaining to the Board’s powers, duties, privileges, immunities, and liabilities in accordance with HRS section 92-5(a)(4) to review the executive session minutes.

3. Chapter 91, HRS, Adjudicatory Matter:

A. In the Matter of the Physician’s License to Practice Medicine of Ryan D. McCracken, M.D.; MED-2021-65-L; Hearings Officer’s Findings of Fact, Conclusions of Law, and Recommended Order.

B. In the Matter of the Physician’s License of Patrick D. Kavanagh, M.D.; MED 2022-224-L; MED 2022-251-L; MED 2023-3-L; Settlement Agreement Prior to Filing of Petition for Disciplinary Action and Board’s Final Order.

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February 9, 2023

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4. Applications for License/Certification:

The Board will enter into Executive Session pursuant to Hawaii Revised Statutes §§ 92-5(a)(1) and 92-5(a)(4) to consider and evaluate personal information relating to individuals applying for professional or vocational licenses cited in section 26-9 or both and to consult with the board’s attorney on questions and issues pertaining to the board’s powers, duties, privileges, immunities, and liabilities.

A. Applications:

(i) Physician (Permanent/Non-Endorsement):

a. Mark A. Pithan, M.D.

b. David Leffers, M.D.

c. Hager Ahmed Mohammed, M.D.

B. Ratification List (See attached lists)

(i) February 9, 2023 Ratification List

5. 2023 Legislation:

A. S.B. 61 RELATING TO ASSOCIATE PHYSICIANS

Creates a new category of professional licensure for associate physicians, which are recent medical school graduates who have passed certain medical exams but have not been placed into a residency program and who work under the supervision of a licensed physician to provide primary care in medically underserved areas. Prescribes the scope of practice of associate physicians. Creates requirements for collaborative practice agreements between associate physicians and collaborating physicians. Authorizes associate physicians to prescribe certain controlled substances.

B. S.C.R. 4 REQUESTING THE AUDITOR TO CONDUCT A SUNRISE REVIEW OF THE REGULATION AND LICENSURE OF ASSOCIATE PHYSICIANS

C. H.B. 482 / S.B. 955 RELATING TO MEDICAL CARE FOR MINORS

Authorizes licensed osteopathic physicians and physician assistants, in addition to physicians and advance practice registered nurses, to provide minor-initiated medical care and services. Requires the licensed health care provider to ensure that the covered entity has been notified that minor-initiated medical care and services should not be disclosed. Requires the covered entity to have policies and procedures established to maintain nondisclosure of the minor-initiated medical care and services to the minor’s parent or legal guardian. Authorizes the licensed health care provider to submit a claim to the covered entity for the provision of minor-initiated medical care and services.

D. H.B. 510 RELATING TO CHILDREN

Hawaii Medical Board Agenda

February 9, 2023

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Ensures the protection and promotion of the health and wellbeing of all infants born alive in the State. Mandates medically appropriate and reasonable lifesaving and life sustaining medical care and treatment to all born alive infants. Establishes civil and criminal penalties.

E. H.B. 516 RELATING TO HEALTH

Authorizes naturopathic physicians to provide written certification to qualifying patients for the medical use of cannabis. Clarifies provisions regarding the establishment of bona fide physician-patient, naturopathic physician-patient, and advanced practice registered nurse-patient relationships via telehealth.

F. H.B. 518 / S.B. 17

Requires the Hawaii Medical Board to establish standards for health care providers to ensure that a patient’s consent to treatment is an informed consent. Requires that informed consent for a proposed medical or surgical treatment or a diagnostic or therapeutic procedure shall be obtained prior to the day of that treatment or procedure. Specifies that if the treatment or procedure is to occur on the same day it is scheduled, the informed consent shall be obtained at the time the decision is made to schedule that treatment or procedure.

G. H.B. 664 / S.B. 599 RELATING TO HEALTH

Expands the class of health care providers under whom respiratory therapists may practice respiratory care to include physician assistants and advanced practice registered nurses.

H. H.B. 666 / S.B. 674 RELATING TO THE INTERSTATE MEDICLA LICENSURE COMPACT

Adopts the Interstate Medical Licensure Compact to create a comprehensive process that complements the existing licensing and regulatory authority of state medical boards and provides a streamlined process that allows physicians to become licensed in multiple states, thereby enhancing the portability of a medical license and ensuring the safety of patients.

I. H.B. 685 RELATING TO ABORTION

Prohibits the abortion of a fetus that contains a fetal heartbeat. Provides certain exceptions. Establishes penalties

J. H.B. 884 RELATING TO TRAVELING TEAM PHYSICIANS

Adopts model legislation to allow traveling team physicians to temporarily practice medicine in the State for the traveling team members and coaches.

K. H.B. 1275 RELATING TO PROHIBITING CHEMICAL ABORTIONS

Hawaii Medical Board Agenda

February 9, 2023

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Relating to abortions; prohibiting chemical abortion drugs for abortions as specified; providing exceptions; providing a criminal penalty for violating the prohibition on use of chemical abortion drugs for abortions; providing definitions; specifying exceptions; making conforming amendments.

L. H.B. 1332 RELATING TO THE TERMINATION OF PREGNANCY

Prohibits the abortion of a fetus that is capable of feeling pain. Prohibits abortions by dismemberment. Provides certain exceptions. Establishes penalties.

M. H.B. 1427 / S.B. 896

Prohibits a covered entity from disclosing communication or information relating to reproductive health care services. Prohibits the issuance of a subpoena in connection with an out-of-state proceeding relating to reproductive health care services legally performed in the State. Prohibits agencies from providing information or expending resources in the furtherance of interstate investigations or proceedings relating to reproductive health care services. Prohibits the State from penalizing, prosecuting, or otherwise taking adverse action based on pregnancy outcomes or aiding or assisting a pregnant individual with accessing reproductive health care services. Requires the governor to deny any demand for surrender of a person charged with a crime involving reproductive health care services unless the conduct constitutes a crime in the State. Enumerates laws contrary to public policy and prohibits their application as rules of decision in the courts. Prohibits the issuance of a summons for persons to testify in another state with regard to lawful reproductive health care services. Clarifies under various licensing statutes that the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services related to the human reproductive system cannot form a basis for disciplinary action. Prohibits the enforcement of a judgment or order arising from a foreign penal civil action or other penal law with respect to reproductive health care services.

N. H.B. 1428 RELATING HEALTH CARE

Prohibits the State from denying or interfering with a patient’s right to choose to obtain an abortion or to terminate a pregnancy if the termination is necessary to protect the life or health of the patient. Repeals a criminal penalty for violations of certain abortion provisions. Clarifies that advanced practice registered nurses may provide abortion care. Clarifies that physicians, osteopathic physicians, and advanced practice registered nurses may administer a medication abortion via telehealth for a patient residing in the State.

O. H.B. 1441 / S.B. 1526 RELATING TO REPRODUCTIVE HEALTH CARE

Explicitly provides that a patient has a right to choose to obtain an abortion, or terminate a pregnancy if the termination is necessary to protect the patient’s life or health. Repeals criminal penalties for violations of certain abortion provisions. Clarifies which health care providers may provide abortion care.

P. S.B. 1 RELATING TO HEALTH CARE

Hawaii Medical Board Agenda

February 9, 2023

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Authorizes licensed physician assistants to perform certain abortions. Declares a law of another state that authorizes a person to bring a civil action against a person who: terminates or seeks to terminate a pregnancy; performs or induces the termination of a pregnancy; knowingly engages in conduct that aids or abets the performance or inducement of the termination of a pregnancy; or attempts or intends to engage in the conduct, as contrary to the public policy of this State and shall not be enforceable in any court of the State and shall not afford any basis for the granting if legal or equitable relief by any court of the State. Prohibits the State from engaging in certain actions with regard to civil and criminal actions from another state.

Q. S.B. 17 RELATING TO MEDICAL INFORMED CONSENT

Requires the Hawaii Medical Board to establish standards for health care providers to ensure that a patient’s consent to treatment is an informed consent. Requires that informed consent for a proposed medical or surgical treatment or a diagnostic or therapeutic procedure shall be obtained prior to the day of that treatment or procedure. Specifies that if the treatment or procedure is to occur on the same day it is scheduled, the informed consent shall be obtained at the time the decision is made to schedule that treatment or procedure.

R. S.B. 60 RELATING TO HEALTH

Authorizes state-licensed and credentialed physicians, advanced practice registered nurses, and physician assistants, who are not physically in the State, to issue prescriptions for certain controlled substances under a limited circumstance. Authorizes pharmacies to dispense the prescriptions.

S. S.B. 254 RELATING TO THE TERMINATION OF PREGNANCY

Prohibits the abortion of a fetus that is capable of feeling pain. Prohibits abortions by dismemberment. Provides certain exceptions. Establishes penalties.

T. S.B. 266 RELATING TO CHILDREN

Requires medically appropriate and reasonable life-saving and life-sustaining medical care and treatment for all born alive infants. Establishes civil and criminal penalties.

U. S.B. 604 RELATING TO HEALTH

Prohibits state and county employees and officers from providing reproductive health care services patient information or expending state resources in furtherance of another state’s investigation or proceeding that seeks to impose civil, criminal, or professional liability upon a person or entity related to reproductive health care services. Prohibits any person from being compelled to provide reproductive health care services patient information. Prohibits any persons from being disqualified from licensure or subject to discipline by a Hawaiʻi board of professional licensure for providing reproductive health care services.

Hawaii Medical Board Agenda

February 9, 2023

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V. S.B. 870 RELATING TO HEALTH CARE PROVIDERS

Prohibits hospitals and health care facilities to permit or require health care providers to provide services for any period after the health care provider has been on duty for sixteen consecutive hours or an aggregate of eighty hours during any period of seven consecutive days, until the health care provider takes at least ten consecutive hours of time off-duty. Clarifies that the terms and conditions of a collective bargaining agreement will prevail, if in conflict with this prohibition. Defines health care facility, health care provider, and hospital.

W. S.B. 890 RELATING TO HEALTH CARE

Prohibits the State from denying or interfering with a patient’s right to choose to obtain an abortion or to terminate a pregnancy if the termination is necessary to protect the life or health of the patient. Repeals a criminal penalty for violations of certain abortion provisions. Clarifies that advanced practice registered nurses may provide abortion care. Clarifies that physicians, osteopathic physicians, and advanced practice registered nurses may administer a medication abortion via telehealth for a patient residing in the State.

X. S.B. 1167 PROPOSING AN AMENDMENT TO THE HAWAII STATE CONSTITUTION TO PROTECT INDIVIDUAL REPRODUCTIVE RIGHTS

Proposes a constitutional amendment to protect an individual’s reproductive freedom in their most intimate decisions, including the right to abortion and contraceptives.

Y. S.B. 1503 RELATING TO HEALTH CARE

Prohibits certain boards from taking adverse action against individuals possessing or applying for a license to practice medicine and surgery or nursing for providing abortion care services or gender affirming treatments in the State in compliance with the laws of the State, or being disciplined by another state for providing abortion care services or gender affirming treatments. Prohibits certain insurers from taking adverse actions against reproductive health care providers for providing abortion care services or gender affirming treatments. Prohibits court clerks from issuing subpoenas in connection with out-of-state subpoenas related to abortion care services or gender affirming treatments that are provided in compliance with the laws of the State. Prohibits the Department of Law Enforcement and the county police departments from participating in another state’s investigations concerning abortion-related conduct, gender affirming treatments, or other reproductive health care or services that are lawful in the State. Requires the Attorney General to routinely submit to the Legislature and Governor reports of these requests for participation. Establishes additional protections for patient health information related to reproductive health services or gender affirming treatments. Establishes protections for certain information related to reproductive health services or gender affirming treatments that does not qualify as patient health information. Prohibits the State from penalizing individuals based on the individual’s pregnancy outcomes or gender affirming treatments received or for aiding or assisting in a third party’s abortion or gender affirming treatment.

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February 9, 2023

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Z. S.B. 1528 PROPOSING A CONSTITUTIONAL AMENDMENT TO PROTECT THE RIGHT TO REPRODUCTIVE FREEDOM

Amends the Hawaii State Constitution to prohibit the State from denying or interfering with an individual’s reproductive freedom, including the right to choose or obtain an abortion or to choose to obtain or use contraceptives

6. Legislative Liaison

The Board will delegate a member(s) to act as its legislative liaison for the 2023 legislative session.

7. Federation of State Medical Boards, Inc. (FSMB):

a. FSMB Special Committee on Strategic Planning

The Board will consider the FSMB’s Report on Strategic Plan Recommendations, 2023

8. Next Meeting: March 9, 2023

Virtual Videoconference Meeting – Zoom Webinar

and

In-Person Queen Liliuokalani Conference Room, First Floor

Meeting HRH King Kalakaua Building

Location: 335 Merchant Street

Honolulu, HI 96813

9. Adjournment

If you need an auxiliary aid/service or other accommodation due to a disability, contact Ahlani Quiogue at (808) 586-2699 or medical@dcca.hawaii.gov as soon as possible, preferably within two (2) business days prior to the meeting. If a response is received after that date, we will try to obtain the auxiliary aid/service or accommodation, but we cannot guarantee that the request will be fulfilled. Upon request this notice is available in alternate formats such as large print, Braille, or electronic copy.

01/30/2023