STAND. COM. REP. 2806
Honolulu, Hawaii
, 2004
RE: S.B. No. 3085
S.D. 2
Honorable Robert Bunda
President of the Senate
Twenty-Second State Legislature
Regular Session of 2004
State of Hawaii
Sir:
Your Committee on Commerce, Consumer Protection and Housing, to which was referred S.B. No. 3085, S.D. 1, entitled:
"A BILL FOR AN ACT RELATING TO NURSES,"
begs leave to report as follows:
The purpose of this measure is to statutorily require the Department of Commerce and Consumer Affairs to establish an advisory committee to advise the Board of Medical Examiners on issues relating to the formulary.
This measure specifically requires:
(1) The advisory committee to be comprised of three advanced practice registered nurses (APRNs) with prescriptive authority, three licensed physicians, and three licensed pharmacists;
(2) The advisory committee to make recommendations for the applicable formulary for APRNs to the Board of Medical Examiners who shall take such recommendations under consideration in adopting the formulary;
(3) That the amendments to section 457-8.6, Hawaii Revised Statutes, shall not be repealed on June 30, 2004, as provided in Act 192, Session Laws of Hawaii (SLH) 2002, as amended by Act 3, SLH 2003; and
(4) The advisory committee to report to the Legislature its activities and recommendations in regards to the prescriptive authority formulary, including justification by the Board of Medical Examiners as to the denial of any advisory committee recommendation.
Testimony in support of this measure was submitted by the Board of Nursing (BON), the Board of Medical Examiners (BME), the Hawaii Nurses' Association, and nine private citizens. Testimony in opposition to this measure was submitted by the Hawaii Medical Association.
Your Committee finds that APRNs play an important role in the provision of health care in our State, and that their prescriptive authority is essential to effective patient care. In an effort to streamline the regulatory process, the Legislature, pursuant to Act 192, Session Laws of Hawaii 2002, authorized the BON to grant prescriptive authority to qualified APRNs and required the Department of Commerce and Consumer Affairs (DCCA) to establish a joint formulary committee to recommend applicable formularies for the BME's consideration. Your Committee further finds that, as established by the BME, APRNs currently practice under an overly restrictive formulary.
Your Committee recognizes that there are concerns regarding the manner in which the BME has developed the formulary, including its consideration of the recommendations of the joint advisory committee. Absent input from APRNs, a formulary cannot be developed without the knowledge of their function and any other issues they may face in their daily practice. Therefore, your Committee determines that in order to allow APRNs to maximize their skills and abilities while continuing to provide patients with the best care possible, input must be received from APRNs as well as physicians and pharmacists. Your Committee also determines that an advisory committee must be statutorily established with safeguards for ensuring that the BME consider the advisory committee's recommendations and be otherwise accountable for its dismissal of such recommendations. Furthermore, the granting of prescriptive authority should ultimately remain within the authority of the BON, which is knowledgeable as to the practice of APRNs, rather than revert back to the DCCA.
Accordingly, your Committee has amended this measure by delaying its effective date to July 1, 2030, to facilitate further review and discussion of the issues, and by making technical, nonsubstantive amendments for purposes of clarity and style.
As affirmed by the record of votes of the members of your Committee on Commerce, Consumer Protection and Housing that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 3085, S.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 3085, S.D. 2.
Respectfully submitted on behalf of the members of the Committee on Commerce, Consumer Protection and Housing,
____________________________ RON MENOR, Chair |
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