Practice Agreement · PA
Physician Assistant Practice Agreement in Hawaii
Hawaii law does not require a Physician Assistant to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
No independent-practice pathway exists for PAs in Hawaii — physician supervision is required for as long as the PA practices (HRS § 453-5.3).
What a Physician Assistant practice agreement covers in Hawaii
Governed by the Hawaii Board of Medical Examiners and the Hawaii Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Physician Assistant ("PA") shall practice under the supervision of the Physician, as required by Haw. Rev. Stat. § 453-5.3. The Physician shall submit a Verification of Supervising Physician form to the Hawaii Board of Medical Examiners before the Physician Assistant begins practice; the Physician Assistant's license becomes inactive if no supervising physician is on file with the Board.
The Physician shall establish written guidelines for reviewing the Physician Assistant's medical records, and, if the Physician Assistant has fewer than one (1) year of experience, shall review at least fifty percent (50%) of the Physician Assistant's records within thirty (30) days of the encounter for the first six (6) months of supervision. A physician may not supervise more than two (2) Physician Assistants at one time, as provided under Haw. Admin. R. § 16-85-49, subject to any subsequent amendment of that rule.
- The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Haw. Rev. Stat. § 461-1statute
Defines 'collaborative agreement' and enumerates specific pharmacist functions performable under a Board-approved collaborative agreement (e.g., initiating emergency contraception drug therapy, dispensing an opioid antagonist).
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
Available remotely (no on-site requirement)
No codified mile/minute radius or on-site requirement; the board sets the 'degree of supervision' by rule (HRS § 453-5.3(a)) and the physician/PA jointly maintain written guidelines for chart review.
Supervision ratio
Not codified — no cap on file
Chart review
first 6 months of supervision: 50% of charts · Monthly (within 30 days of the patient visit)
Haw. Code R. § 17-1737 / HRS § 453-5.3 — supervising physician must review 50% of medical records within 30 days of the visit during the PA's first 6 months of supervision.
6 months to 1 year of supervision: 25% of charts (within 30 days of the patient visit)
Reduced from 50% following Hawaii S.B. 1406 (eff. July 1, 2019), which also repealed a prior 100%-review requirement.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
Prescriptive scope is set out in the written supervision guidelines required by HRS § 453-5.3; a Hawaii-specific controlled-substance schedule limit was not confirmed in this research pass.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under HRS § 415A-9 — shareholders must be licensed in the profession(s) the corporation practices. Hawaii's statute doesn't clearly define whether a PA may co-own a corporation with the supervising physician — treat as an open item.
Ownership is legally distinct from the clinical supervisory relationship above.
Legal sources for these rules (3)
About Hawaii's rules
Hawaii grants APRNs (NP/CRNA/CNM/CNS) full independent practice with no collaborative-agreement requirement (HRS § 457-8.5); prescriptive authority is a separate application, not automatic. Hawaii has no general corporate-practice-of-medicine statute — HRS § 415A-9 requires professional-corporation shareholders to be licensed, but doesn't clearly resolve multi-discipline (e.g. physician+APRN) ownership.
Other clinicians in Hawaii: see the state overview.