Managing Healthcare Compliance in Hawaii

Sarah Jones
Outline of Hawaii over healthcare photo

There are specific healthcare regulations and requirements that apply to each individual state in the United States, and Hawaii is no exception. All healthcare organizations, along with their providers and compliance officers, must understand the requirements of each regulatory state agency that provides oversight. For example, the Office of Health Care Assurance (OHCA) is one governing body that healthcare professionals need to understand in order to manage organizational licensure and healthcare compliance in Hawaii effectively.

Robust, flexible, and reliable compliance programs must be developed to maintain compliance in Hawaii. While staying up to date with regulatory changes may not be easy, it’s essential to maintaining compliance and avoiding legal or financial consequences for non-compliance. This article offers a summary of essential aspects of healthcare compliance specific to Hawaii.

Hawaii Healthcare Compliance Resources

Let’s start with the important state government agencies you’ll need to work with:

  • The Hawaii Department of Health (DOH) is a state agency responsible for overseeing public health and environmental protection initiatives across the Hawaiian Islands.
  • The Healthcare Association of Hawaii (HAH) represents and advocates for Hawaii’s hospitals and health systems, focusing on enhancing healthcare quality and accessibility for the state’s residents.
  • The Med-QUEST Division administers Hawaii’s Medicaid program, providing essential healthcare services to low-income individuals and families across the state.
  • The Hawaii Medical Board is responsible for licensing and regulating physicians and surgeons in Hawaii, ensuring that they meet professional standards for safe and ethical practice.
  • Hawaii’s Mental Health Counselor Licensing Program within the Department of Commerce and Consumer Affairs in Hawaii is a regulatory framework that ensures mental health counselors meet stringent professional standards and qualifications to provide quality mental health care in the state.

These agencies help maintain the integrity and quality of healthcare services in Hawaii, protecting the public and promoting patient safety. The resources provided by these Hawaii state agencies are essential for promoting public health, ensuring access to healthcare, supporting healthcare professionals, and enhancing overall health outcomes for the residents of Hawaii.

Regulations Unique to Hawaii

To meet the standards of healthcare compliance in Hawaii, there are a few additional regulations. 

Facility Licensing, Regulation, and Surveys

The Office of Health Care Assurance (OHCA) in Hawaii plays a crucial role in the oversight and regulation of healthcare facilities and providers in the state. Compliance officers need to have a deep understanding of OHCA’s role in the licensing of healthcare facilities, agencies, and organizations. OHCA ensures organizations adhere to both state and federal standards by conducting on-site surveys and Medicare certification surveys on behalf of the Centers for Medicare and Medicaid Services (CMS). Additionally, OHCA oversees regulatory requirements for Clinical Laboratory Improvement Amendments (CLIA) laboratories​​​​. Compliance officers must stay current with OHCA’s regulations and guidelines to ensure compliance with both state and federal requirements.

Certificate of Need Required

Healthcare executives and compliance professionals in Hawaii must navigate the Certificate of Need (CON) program, overseen by the State Health Planning and Development Agency (SHPDA). The program evaluates CON applications based on criteria like need, quality, cost, and impact on the existing healthcare system. Applications are subject to either standard or administrative reviews. While standard reviews involve recommendations from three advisory councils or panels, administrative reviews cater to specific scenarios like minor service changes, cost-effective acquisitions, ownership transitions, or expansions of existing services. Understanding the dynamics of Hawaii’s CON program is key for healthcare leaders involved with their organization’s planning and development.

Tips To Manage Healthcare Compliance in Hawaii

Effectively managing healthcare compliance in Hawaii is a critical responsibility for healthcare organizations, as it ensures the delivery of high-quality care while adhering to legal and regulatory requirements. Here are some key strategies to help healthcare organizations manage compliance effectively:

  • Conduct State-Specific Training: Provide ongoing training and education to staff that is customized to your state’s regulations as well as your facility. If using a learning management system, ensure the vendor offers Hawaii-approved training.
  • Organize Policies By Requirement: Including “HI” in every document that is required by the state will make it much easier for you to find these documents in an online system when a surveyor is onsite. It is also best practice to include the standard you are meeting for additional clarity.
  • Establish a System for Monitoring Risk: Being able to identify compliance risks before they become incidents or violations can save the entire organization time and money. Identifying trends and consistently reviewing reports can signal issues, such as training not being completed or a large number of incidents in one location.
  • Use Compliance Management Software: Accreditation surveyors say organizations that use compliance software are more prepared for onsite visits and surveys. The software helps to keep documents and policies organized, ensures training content is up to date, and makes reporting easy.

By implementing these strategies and fostering a culture of compliance within your healthcare organization, you can effectively manage healthcare compliance, reduce risks, and provide the best possible care to your patients while staying within legal boundaries.

Credentialing Compliance in Hawaii

In Hawaii, the Medical Board oversees credentialing for healthcare providers, a necessary process for those seeking to practice in the state. Similar to other states, credentialing in Hawaii entails verifying qualifications and professional history, including educational background, residency training, licensure exams, work history, and any disciplinary actions. 

One feature not shared by all states is Hawaii’s participation in the Interstate Medical Licensure Compact (IMLP). The goal of this plan is to streamline licensure for qualified physicians in multiple states, improving access to healthcare for Hawaiian residents and reducing the administrative burden for providers who want to expand their practice. As with any inter-state provider pact, physicians are required to meet the licensing requirements of the pact.

Meet Hawaii Compliance Requirements With MedTrainer 

While the path may be complex, healthcare providers who prioritize compliance will not only avoid legal troubles but also enhance the quality of care they provide to their patients in Hawaii

MedTrainer’s all-in-one compliance platform can streamline management of Hawaii healthcare compliance. MedTrainer seamlessly consolidates your organization’s policies, incident reports, safety plans, HR documents, contracts, and more. This centralized repository ensures all employees have easy access to essential information. The course library is curated to align with regulatory and accreditation requirements, and courses are regularly added and updated to ensure the most current information. Learn more about MedTrainer today!