REPORT TITLE:
Health Care Professionals


DESCRIPTION:
Establishes a Scope of Practice Investigative Panel in DCCA that
analyzes, and presents findings and recommendations on
legislation that proposes to expand the scope of practice of a
health care professional. (HB2279 HD1)


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        2279
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO HEALTH CARE PROFESSIONALS.



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

 1      SECTION 1.  The legislature finds that over the last few
 
 2 years, various groups of health care professionals have sought to
 
 3 expand the scope of practice of their own practice or limit the
 
 4 scope of practice of other health care professionals.  Each time
 
 5 a new measure is considered to expand the scope of practice of a
 
 6 health profession, the legislature is at a disadvantage because
 
 7 there has been no objective review and analysis conducted on its
 
 8 behalf, which could assist the legislature in its deliberations
 
 9 on such measures.  Often times, the legislature becomes the
 
10 referee between those groups whose practices potentially overlap
 
11 and who have a great deal to win or lose in the outcome.
 
12      The legislature finds, however, that in making decisions on
 
13 measures of expanded scope of practice, it is necessary to have
 
14 an objective review and analysis conducted prior to consideration
 
15 and enactment of such measures.  Most, if not all, licensed
 
16 health care professions are within the regulatory authority or
 
17 jurisdiction of the department of commerce and commerce affairs.
 
18 The legislature therefore finds it is appropriate for the
 
19 department of commerce and consumer affairs to analyze and report
 

 
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 1 to the legislature on whether new measures to expand the scope of
 
 2 practice of health care professionals should be enacted.
 
 3      Accordingly, the purpose of this Act is to establish a scope
 
 4 of practice investigative panel to analyze and present findings
 
 5 and recommendations on measures that proposes to expand the scope
 
 6 of practice of a health care professional.  The legislature
 
 7 believes that this approach will provide a thoughtful, reasoned
 
 8 approach to a discussion of the issues involved.
 
 9      SECTION 2.  Chapter 451D, Hawaii Revised Statutes, is
 
10 amended by adding two new sections to be appropriately designated
 
11 and to read as follows:
 
12      "§451D-A  Health care professionals; expansion in scope of
 
13 practice; analysis by the department.  (a)  New measures being
 
14 considered for enactment that, if enacted, would expand the scope
 
15 of practice of a health care professional shall be referred for
 
16 analysis to the department.  Referral shall be by concurrent
 
17 resolution that identifies a specific legislative bill to be
 
18 analyzed; provided that prior to the referral:
 
19      (1)  A petition is signed, including facsimile signatures,
 
20           by sixty per cent of those currently licensed in the
 
21           profession seeking the expanded scope of practice, all
 
22           of whom pledge support for the new measure to expand
 

 
 
 
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 1           their scope of practice; provided further that the
 
 2           petition is submitted to the speaker of the house of
 
 3           representatives and president of the senate prior to
 
 4           the first legislative hearing on the new measure; and
 
 5      (2)  The department, upon its review of the new measure,
 
 6           determines that the substance of the measure defines
 
 7           the area of expanded scope of practice, qualifications
 
 8           for and any limitations to be placed on the expanded
 
 9           scope of practice, and that the measure can be
 
10           understood in order to conduct the analysis required
 
11           under subsection (b).
 
12      (b)  The analysis required by this section shall include but
 
13 not be limited to the following:
 
14      (1)  An assessment that the licensee, by reason of current
 
15           qualifications for licensure or proposed advanced
 
16           qualifications in education or experience, is competent
 
17           to practice the expanded scope;
 
18      (2)  A survey of all states that have enacted laws allowing
 
19           for the expanded scope of practice in question to
 
20           include:
 
21           (A)  Testimony from the state regulator who is of
 
22                comparable position to this State's director of
 
23                the department or the person's designee, on
 

 
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 1                whether there is any evidence that the expanded
 
 2                scope of practice in question has jeopardized, by
 
 3                nature of the expanded service offered by the
 
 4                licensee, the health, safety, or welfare of the
 
 5                consumer, and whether there is evidence of abuses
 
 6                by licensees; and
 
 7           (B)  Information on substantiated complaints and final
 
 8                orders of discipline by the licensing authority,
 
 9                if public disclosure is allowed, regarding
 
10                competency and practice issues related to the
 
11                expanded scope of practice;
 
12      (3)  A survey of federal agencies who have recognized and
 
13           allowed the licensed health care professional to
 
14           practice under the expanded scope in question and
 
15           whether there have been evidence of jeopardizing the
 
16           health, safety, or welfare of consumers, or abuses by
 
17           licensees; and
 
18      (4)  A determination whether the expanded scope of practice
 
19           will benefit the consumer.
 
20      (c)  For the purposes of this section, "expanded scope of
 
21 practice" means inclusion of a new field of practice for a
 
22 licensed health care professional, and not changing an already
 
23 authorized field of practice to include variations or additions.
 

 
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 1      (d)  The department shall implement section 451D-B upon
 
 2 receipt of the concurrent resolution adopted in accordance with
 
 3 subsection (a).  The department may impose a special assessment,
 
 4 not subject to chapter 91, on all current licensees of the
 
 5 profession seeking the expanded scope of practice.  The special
 
 6 assessment shall yield revenues that will support the
 
 7 implementation of section 451D-B.
 
 8      (e)  The department may terminate proceedings under section
 
 9 451D-B when there is evidence that subsection (a)(1) have not
 
10 been met.
 
11      (f)  The department shall submit a report to the legislature
 
12 no later than twenty days before the convening of the next
 
13 regular session of the legislature, unless otherwise stated in
 
14 the concurrent resolution, of:
 
15      (1)  The analysis, findings, and recommendations of the
 
16           scope of practice investigative panel convened pursuant
 
17           to section 451D-B; and
 
18      (2)  A summary of the revenues and expenditures associated
 
19           with implementing section 451D-B.
 
20      (g)  This section and section 451D-B shall not be applicable
 
21 in instances where a similar measure of expanded scope of
 
22 practice has undergone the processes of said sections and the
 
23 department has submitted a report to the legislature within a
 
24 period of two years.
 

 
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 1      (h)  Health care professionals subject to this section
 
 2 include those defined within section 451D-2, and:
 
 3      (1)  Dental hygienists licensed pursuant to chapter 447;
 
 4      (2)  Marriage and family therapists licensed pursuant to
 
 5           chapter 451J;
 
 6      (3)  Dispensing opticians licensed pursuant to chapter 458;
 
 7      (4)  Optometrists licensed pursuant to chapter 459;
 
 8      (5)  Physical therapists licensed pursuant to chapter 461J;
 
 9      (6)  Social workers licensed pursuant to chapter 467E; and
 
10      (7)  Speech pathologists and audiologists licensed pursuant
 
11           to chapter 468E.
 
12      This section shall include only those health care
 
13 professions within the regulatory authority or jurisdiction of
 
14 the department, and any new health care profession that comes
 
15 under the regulatory authority or jurisdiction of the department
 
16 after the effective date of this section.
 
17      (i)  Notwithstanding this section, nothing shall preclude
 
18 the legislature from consideration and enactment of a measure
 
19 that would expand the scope of practice of a health care
 
20 profession.
 
21      §451D-B  Scope of practice investigative panel.  (a)  The
 
22 director of commerce and consumer affairs shall establish and
 
23 convene one or more scope of practice investigative panels within
 

 
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 1 the department for the purpose of conducting the analysis and
 
 2 reporting required under section 451D-A.  The director shall:
 
 3      (1)  Appoint one member from each respective health care
 
 4           profession substantially affected by the measure in
 
 5           question;
 
 6      (2)  Include representatives from government agencies
 
 7           substantially affected by the measure in question; and
 
 8      (3)  Appoint other public persons with no affiliation to any
 
 9           of the health care professionals substantially affected
 
10           by the measure.
 
11      (b)  The term of members and size of the scope of practice
 
12 investigative panel shall be left to the discretion of the
 
13 director of commerce and consumer affairs; provided that the
 
14 panel shall always be, in total, an odd number, and public
 
15 persons shall be at least one more in number than the total
 
16 members of health care professionals substantially affected by
 
17 the measure.  Members of the scope of practice investigative
 
18 panel shall serve without compensation, but shall be reimbursed
 
19 for travel expenses necessary for the performance of their
 
20 duties.
 
21      (c)  On behalf of the department, the scope of practice
 
22 investigative panel shall:
 

 
 
 
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 1      (1)  Conduct the analysis required under section 451D-A(b);
 
 2      (2)  Prepare findings; and
 
 3      (3)  Include a recommendation whether the new measure to
 
 4           expand the scope of practice should be enacted, or
 
 5           whether any amendments to the measure should be
 
 6           considered prior to enactment.
 
 7      Any recommendation made by the scope of practice
 
 8 investigative panel shall be by two-thirds vote of the members to
 
 9 which the panel is entitled.
 
10      (d)  Chapter 92 shall not apply to meetings of the scope of
 
11 practice investigative panel, and any analysis, findings, and
 
12 recommendations of the panel shall be open to the extent required
 
13 under chapter 92F after the director submits the report required
 
14 under 451D-A, to the legislature.
 
15      (e)  The director shall provide for a facilitator who shall
 
16 lead and direct the scope of practice investigative panel to
 
17 accomplish the purposes of section 451D-A."
 
18      SECTION 3.  The department of commerce and consumer affairs
 
19 may establish and fill an administrative assistant and secretary
 
20 position, not subject to chapters 76 and 77, to assist with the
 
21 implementation of section 451D-B, Hawaii Revised Statutes.
 
22      SECTION 4.  In codifying the new sections added to chapter
 
23 451D, Hawaii Revised Statutes, by section 2 of this Act, the
 

 
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 1 revisor of statutes shall substitute appropriate section numbers
 
 2 for letters used in the designation of new sections.
 
 3      SECTION 5.  New statutory material is underscored.
 
 4      SECTION 6.  This Act shall take effect upon its approval.