PA · Hawaii
Supervision Agreement for Physician Assistants in Hawaii
Yes, a written supervising-physician agreement is required. Hawaii does not name a specific instrument.
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 the supervision must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
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 July 1, 2019), which also repealed a prior 100%-review requirement.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)
What a supervising physician costs here
Typical monthly cost in Hawaii
$500 – $700
Estimate for one Physician Assistant. Standard-tier state.
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.