STAND. COM. REP. NO. 431-00

                                 Honolulu, Hawaii
                                                   , 2000

                                 RE: H.B. No. 2279
                                     H.D. 1




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Sir:

     Your Committee on Health, to which was referred H.B. No.
2279 entitled: 

     "A BILL FOR AN ACT RELATING TO HEALTH CARE PROFESSIONALS,"

begs leave to report as follows:

     The purpose of this bill, as received by your Committee, is
to provide a thoughtful, reasoned approach when changing the
scope of practice of a health care professional by requiring the
Director of Commerce and Consumer Affairs to establish a review
panel to analyze legislation seeking to change a profession's
scope of practice.

     The National Association of Social Workers supported this
measure with reservations.  The Hawaii Nurses' Association, the
Hawaii Chapter of the American Physical Therapy Association, and
an individual testified in support of the intent of this measure.
The Hawaii Psychiatric Medical Association, the Hawaii
Psychological Association, the Hawaii Dental Hygienists'
Association, and several individuals opposed this measure.  The
Departments of Health and Commerce and Consumer Affairs (DCCA),
the Hawaii Medical Association, and an individual submitted
comments noting several concerns with the bill.

     Your Committee finds that over the past several years,
various groups of health care professionals have sought to extend
the scope of their own practice or limit the scope of practice of
other health care professionals.  Each time the scope of practice
of a health care professional is modified, however, the

 
 
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                                 Page 2

 
Legislature often becomes the referee between those groups whose
practices potentially overlap, and who have a great deal to win
or lose in the final outcome.

     While this measure is an innovative approach to addressing
scope of practice differences, your Committee finds that it
raises questions of feasibility, implementation, staffing, and
funding.  Additionally, the creation of a review and
recommendation process, as written, appears duplicative of
functions and responsibilities of other governmental entities.

     After much consideration, your Committee has amended this
measure by deleting its substance and inserting similar language:

     (1)  Preserving the basic intent of the measure; and

     (2)  Clarifying the type of legislation that would trigger
          the DCCA review.

     As amended, the purpose of this bill is to establish a Scope
of Practice Investigatory 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.  It draws the line at legislation where the
practitioner does not have current authority to expand the
practitioner's scope, and legislation that tweaks the
practitioner's already expanded scope of practice.

     As affirmed by the record of votes of the members of your
Committee on Health that is attached to this report, your
Committee is in accord with the intent and purpose of H.B. No.
2279, as amended herein, and recommends that it pass Second
Reading in the form attached hereto as H.B. No. 2279, H.D. 1, and
be referred to the Committee on Consumer Protection and Commerce.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health,



                                   ______________________________
                                   ALEXANDER C. SANTIAGO, Chair