Honorable Robert Bunda

President of the Senate

Twenty-First State Legislature

Regular Session of 2002

State of Hawaii

Sir:

Your Committees on Commerce, Consumer Protection and Housing and Health and Human Services, to which was referred H.B. No. 2065, H.D. 1, entitled:

beg leave to report as follows:

The purpose of this measure is to transfer responsibilities for the oversight of prescriptive authority for advanced practice registered nurses (APRNs) and the designation of drug formularies from the Director of Commerce and Consumer Affairs and the Board of Medical Examiners, respectively, to the Board of Nursing.

Your Committees received testimony in support of this measure from the Board of Nursing, Hawaii Nurses' Association, Chapter of Pediatric Nurse Practitioners, University of Hawaii at Manoa, Hawaii Association of Nurse Anesthetists, Hawaii Government Employees Association, and twenty-nine individuals. The Hawaii Medical Association and Hawaii Society of Anesthesia opposed the measure.

Currently, all fifty states and the District of Columbia have some form of prescriptive authority for APRNs, and in the vast majority of these jurisdictions, prescriptive authority is granted by the nursing board. Hawaii is the only state in which APRNs are regulated by the nurses' regulatory board, APRN prescriptive authority is granted by the regulatory agency, and the drug formulary is designated by the physicians' regulatory board.

Your Committees find that placing oversight of prescriptive authority for APRNs with the Board of Nursing, as effected by this measure, is logical, appropriate, and efficient given the Board's responsibility for oversight of APRN practice, generally, and will eliminate the confusion that results from having three entities involved in the regulation of APRN prescriptive authority.

Further, while this measure places oversight of APRN prescriptive authority with the Board of Nursing, it provides for consultation and collaboration with other health professionals by establishing an advisory committee on formulary matters with representatives from related health fields, including medicine and pharmacy.

Your Committees have amended this measure by delaying its effective date to July 1, 2050, to ensure further discussion and by making a technical amendment to delete duplicative language.

As affirmed by the records of votes of the members of your Committees on Commerce, Consumer Protection and Housing and Health and Human Services that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 2065, H.D. 1, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 2065, H.D. 1, S.D. 1, and be placed on the calendar for Third Reading.