Hawaii Medical Education Council (HMEC)

• January 31, 2022: Agenda / Minutes
• April 25, 2022: Agenda / Minutes
• July 25, 2022: Agenda / Minutes
• October 24, 2022: Agenda / Minutes

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The University of Hawaiʻi System (UH) and its John A. Burns School of Medicine (JABSOM) administer two (2) statutes related to graduate medical education (GME) and addressing the severe physician shortage needs in Hawaiʻi. See excerpted text of statutes in the Appendix A.

1. [HRS § 304A-1702] – Graduate Medical Education (GME) Program, was established to formally encompass the administration of UH JABSOM’s institutional graduate medical education (GME) program.
2. [HRS §§304A-1703, 1704, 1705] – Medical Education Council, was created within UH JABSOM and called “The Hawaiʻi Medical Education Council” (HMEC). HMEC was given the administrative duties and powers to:
   • Analyze the State healthcare workforce for the present and future, focusing in particular on the State’s need for physicians;
   • Assess the State’s healthcare training programs, focusing on UH JABSOM’s institutional GME enterprise to determine its ability to meet the workforce needs identified by HMEC;
   • Recommend to the Legislature and UH Board of Regents (BOR) ways in which identified GME and other healthcare training programs can improve and change in order to effectively meet the HMEC assessment;
   • (4) Work with other entities and state agencies, and in consultation with the Legislature and BOR, develop and implement a Plan to ensure the adequate funding of healthcare training programs in the State, with an emphasis on UH JABSOM GME programs;
   • (5) Seek funding to implement the Plan from all public (county, state and federal government) and private sources;
   • (6) Monitor and continue to improve the funding Plan; and,
   • (7) Submit an annual report to the Legislature no later than twenty days before the convening of each regular Legislative session.

Part I. System Structure Section
Part IV. Divisions, Departments, and Programs

J. Medical Education Council
304A-1701 Definitions
304A-1702 Graduate medical education program
304A-1703 Medical education council
304A-1704 Council duties
304A-1705 Council powers

J. MEDICAL EDUCATION COUNCIL[§304A-1701] Definitions. As used in this subpart:
“Centers for Medicaid and Medicare Services” means the Centers for Medicaid and Medicare Services within the United States Department of Health and Human Services.
“Council” means the medical education council created under section [304A-1703].
“Graduate medical education” means that period of clinical training of a physician following receipt of the medical doctor degree and prior to the beginning of an independent practice of medicine.
“Graduate medical education program” means a graduate medical education training program accredited by the American Council on Graduate Medical Education.
“Healthcare training program” means a healthcare training program that is accredited by a nationally-recognized accrediting body. [L 2006, c 75, pt of §2] [§304A-1702] Graduate medical education program.

(a) There is created a graduate medical education program to be administered by the medical education council in cooperation with the department of health.
(b) The program shall be funded with moneys received for graduate medical education and deposited into the Hawaiʻi medical education special fund established under section [304A-2164].
(c) All funding for the graduate medical education program shall be nonlapsing.
(d) Program moneys shall only be expended if:

(1) Approved by the medical education council; and
(2) Used for graduate medical education in accordance with sections [304A-1704] and [304A-1705]. [L 2006, c 75, pt of §2] [§304A-1703] Medical education council.

(a) There is established within the University of Hawaiʻi, the medical education council consisting of the following thirteen members:

(b) Except as provided in subsection (a)(1), (2), (3), and (4), no two council members may be employed by or affiliated with the same:

(1) Institution of higher education;
(2) State agency outside of higher education; or
(3) Private entity.

(c) Terms of office of council members shall be as follows:

(1) Except as provided in paragraph (2), the dean of the school of medicine, dean of the school of nursing and dental hygiene, vice dean for academic affairs of the school of medicine at the University of Hawaiʻi, and the director of health, or the director’s designated representative, shall be permanent ex officio members of the council, and the remaining nonpermanent council members shall be appointed to four-year terms of office;
(2) Notwithstanding paragraph (1), the governor at the time of the initial appointment shall reduce the terms of four nonpermanent council members to two years to ensure that approximately half of the nonpermanent council members are appointed every two years; and
(3) If a vacancy occurs in the membership for any reason, the replacement shall be appointed by the governor for the unexpired term in the same manner as the original appointment was made.

(d) The dean of the school of medicine at the University of Hawaiʻi shall chair the council. The council shall annually elect a vice chair from among the members of the council.
(e) All council members shall have voting rights. A majority of the council members shall constitute a quorum. The action of a majority of a quorum shall be the action of the council.
(f) Per diem and expenses incurred in the performance of official duties may be paid to a council member who:

(1) Is not a government employee; or
(2) Is a government employee, but does not receive salary, per diem, or expenses from the council member’s employing unit for service to the council.

A council member may decline to receive per diem and expenses for service to the council. [L 2006, c 75, pt of §2] [§304A-1704] Council duties. The medical education council shall:

(1) Conduct a comprehensive analysis of the healthcare workforce requirements of the State for the present and the future, focusing in particular on the State’s need for physicians;
(2) Conduct a comprehensive assessment of the State’s healthcare training programs, focusing in particular on graduate medical education programs and their role in and ability to meet the healthcare workforce requirements identified by the council;
(3) Recommend to the legislature and the board of regents changes in or additions to the healthcare training programs in the State identified by the council’s assessment;
(4) Work with other entities and state agencies as necessary, develop a plan to ensure the adequate funding of healthcare training programs in the State, with an emphasis on graduate medical education programs, and after consultation with the legislature and the board of regents, implement the plan. The plan shall specify the funding sources for healthcare training programs and establish the methodology for funding disbursement. Funds shall be expended for the types of costs normally associated with healthcare training programs, including but not limited to physician salaries and other operating and administrative costs. The plan may include the submission of an application in accordance with federal law for a demonstration project to the Centers for Medicaid and Medicare Services, for the purpose of receiving and disbursing federal funds for direct and indirect graduate medical education expenses;
(5) Seek funding from public sources, including state and federal government, and private sources to support the plan required in paragraph (4);
(6) Monitor the implementation and effectiveness of the plan required in paragraph (4), making such modifications as may be required by future developments and changing needs and after consulting with the legislature and the board of regents, as appropriate; and
(7) Submit a summary report to the legislature no later than twenty days before the convening of each regular session, of the expenditures of program moneys authorized by the council under this subpart. [L 2006, c 75, pt of §2] [§304A-1705] Council powers. The medical education council may:

(1) Conduct surveys, with the assistance of the department of health and the department of commerce and consumer affairs, to assess and meet changing market and education needs;
(2) Appoint advisory committees of broad representation on interdisciplinary clinical education, workforce mix planning and projections, funding mechanisms, and other topics as is necessary;
(3) Use federal moneys for necessary administrative expenses to carry out its duties and powers as permitted by federal law;
(4) Distribute program moneys in accordance with this subpart; provided that any expenditures authorized shall be for a public purpose and shall not be subject to chapters 42F, 103, 103D, and 103F;
(5) Hire employees not subject to chapters 76 and 89 necessary to carry out its duties under this subpart; and
(6) Adopt rules in accordance with chapter 91, necessary to carry out the purposes of this subpart. [L 2006, c 75, pt of §2]