STAND. COM. REP. NO.486
Honolulu, Hawaii
, 2001
RE: H.B. No. 238
H.D. 1
Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twenty-First State Legislature
Regular Session of 2001
State of Hawaii
Sir:
Your Committee on Health, to which was referred H.B. No. 238 entitled:
"A BILL FOR AN ACT RELATING TO NURSES,"
begs leave to report as follows:
The purpose of this bill is to:
(1) Transfer the regulation of prescriptive authority of advanced practice registered nurses from the Department of Commerce and Consumer Affairs to the Board of Nursing;
(2) Transfer the responsibility of formulary designation to the Board of Nursing rather than the Board of Medical Examiners; and
(3) Delete outdated language regarding the interim report of 1994 on drug formularies.
This measure received supporting testimony from the Board of Nursing of the Department of Commerce and Consumer Affairs, the Hawaii Nurses Association, the Hawaii Government Employees Association, and a number or advanced practice registered nurses.
Opposition to this bill was received from the Hawaii Medical Association and the Hawaii Psychiatric Medical Association. Both organizations felt that physicians were the only medical professionals, due to their extensive education and clinical training in pharmacology, qualified to provide appropriate oversight of the drug formularies and prescriptive authority of the nurses.
Your Committee understands that the Board of Nursing has expertise in the area of nursing and that this board knows the boundaries of the Advanced Practice Registered Nurse scope of practice. Moreover, your Committee realizes that by having the Advanced Practice Registered Nurses regulated by the Board of Nursing, prescriptive authority granted by the Department of Commerce and Consumer Affairs, and a drug formulary regulated by the Board of Medical Examiners, confusion and, at times, an unclear line of authority may exist.
At the same time, your Committee understands the concerns of the Hawaii Medical Association and the Hawaii Psychiatric Medical Association regarding the medical expertise required to determine prescriptive rights when dealing with an ever changing medical field.
Thus, your Committee has decided to amend the measure by:
(1) Adding language requiring the Board of Medical Examiners to designate the requirements for advanced nursing practice, prescriptive authority, and applicable formularies on an annual basis;
(2) Adding language requiring the Board of Medical Examiners to submit an annual report on any updated requirements and formularies to the Legislature no later than twenty days prior to the convening of each regular session;
(3) Adding language creating an advisory board made up of advanced practice registered nurses, physicians who work with these nursing specialties, pharmacists, and other health related fields to advise the board on formulary matters.
(4) Making technical, nonsubstantive amendments for the purposes of clarity and style.
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. 238, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 238, 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,
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____________________________ DENNIS A. ARAKAKI, Chair |
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