RELATING TO HEALTH CARE.

SB3202

THE SENATE

S.B. NO.

3202

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to health care
.

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

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SECTION
1.
�
The legislature finds that there is a
shortage of health care providers in the State, including primary care
providers and specialty providers, which will be exacerbated by the projected
retirement of existing physicians, advanced practice registered nurses,
pharmacists, and other health care workers.
�

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 the State and the limited supply of expert
clinicians who volunteer as qualified preceptors.
�
One way to encourage the participation of
preceptors is to offer an income tax credit for health care professionals who
serve as preceptors.

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The
purpose of the existing healthcare preceptor income tax credit is to
incentivize volunteer preceptors to offer professional instruction, training,
and supervision to students and residents seeking careers as health care
providers in the State.
�
The legislature
finds that although many providers have trained eligible students,
modifications to the existing program will amplify the success of the program.

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The
legislature further finds that the preceptor tax credit program has been
successful in facilitating the growth of the preceptor program.
�
The five-year evaluation of the program found
a seventy-seven per cent increase in active preceptors who taught at least one
rotation, and seventy-six providers started precepting during this five-year
period.
�
The evaluation also recommended
that, to improve the function of the program, additional health care provider
professions that have established graduate schools in Hawaii should be added to
the tax credit eligibility, the primary care specialty requirement for
preceptors should be removed, and the requirement that the preceptor credit
should be only for precepting students enrolled in a primary care program should
be removed.

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The
legislature recognizes that removing the primary care specialty provision
expands the program to specialty areas and also elevates the training
opportunities in primary care.
�
Programs
training future health care providers in primary care benefit by exposing
students to technical training in focused specialty areas like cardiology,
pulmonology, and behavioral health.
�
The
legislature further recognizes that the health care workforce has shortages in
professions beyond those included in the tax credit and whose workforce
expansion is also limited by available preceptors, including social workers,
physician assistants, and licensed dietitians, as well as workers in
high-demand specialties, such as behavioral health.
�
Furthermore, the advanced training
environments, such as residencies, provide an extended safety net for
new-career health care professionals and rely on preceptors for mentorship and
clinical advancement of the residents.
�

As such, the healthcare preceptor tax credit should not be limited to medical,
advanced practice registered nurse, and pharmacy students.
�
Rather, the program should expand to apply to
physician assistants, licensed dieticians, and social workers and include
qualified residency programs for eligible professions.

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Finally,
the legislature finds that the definition of "volunteer-based supervised
clinical training rotation" should be clarified to facilitate the
preceptor credit assurance committee's implementation of the tax credit.

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Accordingly,
the purpose of this Act is to:

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(1)
�
Amend the healthcare preceptor tax credit to
improve accessibility and further promote the education of health care
professionals by:

���������
(A)
�
Removing language limiting access to only
those in primary care;

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(B)
�
Adding physician assistants, licensed
dietitians, and social workers as eligible preceptors and students; and

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(C)
�
Expanding eligibility to residency and
fellowship programs; and

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(2)
�
Revise the membership of the preceptor credit
assurance committee to include the director of health and representatives of
residency programs with eligible students.

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SECTION
2
.
�
Section
235-110.25, Hawaii Revised Statutes, is as follows:

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1.
�

By amending subsection (e) to read:

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"
(e)
�
If in any taxable year the annual amount of
certified credits for all taxpayers reaches $1,500,000 in the aggregate, the
preceptor credit assurance committee shall immediately discontinue certifying
credits and notify the department of taxation.
�

In no instance shall the preceptor credit assurance committee certify a
total amount of credits exceeding $1,500,000 per taxable year.
�
To comply with this restriction, the
preceptor credit assurance committee shall certify or deny credits in the order
submitted for certification; provided that credits shall not be submitted for
certification [
prior to
]
before
the
volunteer-based

supervised clinical training rotation being performed."

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2.
�

By amending subsection (g) to read:

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"
(g)
�
For the purposes of this section:

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

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

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

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"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.
�
"Advanced practice
registered nurse student" includes a graduate from a nationally accredited
academic program who has continued their training in the role of resident or
fellow.

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"Dietetics student" means an
individual participating in an academic program that is nationally accredited
for the training of individuals to become registered dietitians pursuant to
chapter 448B.
�
"Dietetics
student" includes students enrolled in
�

nationally accredited academic programs that require supervised practice
hours.

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

pharmacist, pursuant to chapter 461[
.
]
; or a social worker, pursuant
to chapter 467E.

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"Eligible student" means
an advanced practice registered nurse student,
dietetics student,

medical student, [
or
] pharmacy student
, physician assistant student,
or social work student, or resident,
who is enrolled in an
eligible

academic program[
.
]
, residency program, or fellowship.

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"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
]

a graduate
from
a
nationally accredited academic [
programs
]

program
who [
have
]
has
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.

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"Nationally accredited"
means holding an institutional accreditation by name to offer post-secondary
medical [
primary care
] education.
�

Accreditation [
for medical students
] shall be offered
as
follows:

����
(1)
�
For medical
students,
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
]
, or any
other accreditation body recognized by the preceptor credit assurance
committee;

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(2)
�
For advanced
practice registered nurse students,
by the Commission on Collegiate Nursing
Education[
.
]
or any other accreditation body recognized by the
preceptor credit assurance committee;

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(3)
�
For nursing
residency programs, by the Commission on Collegiate Nursing Education, American
Nurses Credentialing Center, Consortium for Advanced Practice Providers, or any
other accreditation body recognized by the preceptor credit assurance
committee;

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(4)
�
For pharmacy
students, by the Accreditation Council for Pharmacy Education or any other
accreditation body recognized by the preceptor credit assurance committee;

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(5)
�
For pharmacy
residency programs, by the American Society of Health-System Pharmacists;

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(6)
�
For physician
assistant students, by the Accreditation Review Commission on Education for the
Physician Assistant;

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(7)
�
For physician
assistant residency programs, by the Consortium for Advanced Practice
Providers, Accreditation Review Commission on Education for the Physician
Assistant, or any other accreditation body recognized by the preceptor credit
assurance committee;

����
(8)
�
For dietetics
students, by the Accreditation Council for Education in Nutrition and Dietetics
or any other accreditation body recognized by the preceptor credit assurance
committee; and

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(9)
�
For social work
students, by the Council on Social Work Education or any other accreditation
body recognized by the preceptor credit assurance committee.

New or additional accreditation bodies may be
eligible; provided that they are recognized by the preceptor credit assurance
committee.

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"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.
�
"Pharmacy
student" includes a graduate from a nationally accredited academic program
who has continued their training in the role of resident or fellow.

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"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.
�
"Physician assistant student"
includes a graduate from a nationally accredited academic program who has
continued their training in the role of resident or fellow.

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"Preceptor" means
a
licensed dietitian, licensed pursuant to chapter 448B;
a physician [
or
]
osteopathic physician,
or physician assistant,
licensed pursuant to
chapter 453[
,
]
;
an advanced practice registered nurse, licensed
pursuant to chapter 457[
, or
]
;
a
registered
pharmacist,
licensed pursuant to chapter 461[
,
]
; or a social worker, licensed
pursuant to chapter 467E,
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 for clinical health care practice.

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[
"Primary care" means
the principal point of continuing care for patients provided by a healthcare
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.
]

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"Residency program"
means a residency or fellowship program that provides continuing training for
eligible professions, in the role of resident or fellow, to obtain the
additional qualifications that support professional practice.
�
"Residency program" includes a program
offered through academic programs or employers; provided that the program is
nationally accredited and holds either its principal accreditation or a
physical location in the State.

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"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.
�
"Social
work student" includes a graduate from a nationally accredited academic
program who has continued their training in the role of resident or fellow.

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"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[
.
]
; provided that, while
a preceptor may be compensated for providing standard clinical services, the
preceptor shall be uncompensated for:

����
(1)
�
Clinical training
above or beyond clinical salary or reimbursements for clinical services; and

����
(2)
�
Provision of
clinical training services from tuition funds or from state general funds.
"

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

����
1.
�

By amending subsections (a) and (b) to read:

����
"(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 days following the close of each calendar year;
and

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(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;

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

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(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
uncompensated for:

��������������
(i)
�
Clinical
training above or beyond clinical salary or reimbursements for clinical
services; and

�������������
(ii)
�
Provision
of clinical training services from tuition funds or from state general funds;
and

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(D)
�
Other information deemed
necessary by the committee.

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

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

����
(2)
�
Representatives
of:

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[
(1)
]

(A)
�
The Hawaii/Pacific basin area health education
center;

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[
(2)
]

(B)
�
The center for nursing; [
and
]

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[
(3)
]

(C)
�
Academic programs with eligible students[
.
]
;
and

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(D)
�
Residency programs with eligible students.
"

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2.
�
By amending subsection (e) to read:

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

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

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SECTION 5.
�
This Act shall take effect upon its approval;
provided that section 2 shall apply to taxable years beginning after December
31, 2026.

INTRODUCED BY:

_____________________________

Report Title:

Healthcare
Preceptor Tax Credit; Licensed Dietitians; Physician Assistants; Social
Workers; Residency Programs; Preceptor Credit Assurance Committee

Description:

Amends
the Healthcare Preceptor Tax Credit to remove language limiting access only to
those practicing in primary care, to add licensed dietitians, physician
assistants, and social workers as eligible preceptors and students, and to
include residency and followship programs.
�

Adds the Director of Health and a representative of residency programs
with eligible students to the Preceptor Credit Assurance Committee.
�
Applies to taxable years beginning after
12/31/2026.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.