Honorable Robert Bunda

President of the Senate

Twenty-Third State Legislature

Regular Session of 2005

State of Hawaii

Sir:

Your Committee on Commerce, Consumer Protection, and Housing, to which was referred H.B. No. 1118 entitled:

begs leave to report as follows:

The purpose of this measure is to broaden the standard for Board of Nursing administrative rules relating to the working relationship between an advanced practice registered nurse (APRN) with prescriptive authority and a licensed physician.

The Board of Nursing (BON), Hawaii Nurses' Association, and Hawaii Association of Pediatric Nurse Practitioners testified in support of this measure.

Currently, the law requires BON administrative rules to reflect a "collegial" working relationship between APRNs granted prescriptive authority and licensed physicians. This law is consistent with the initial formulary developed by the joint formulary advisory committee established under section 457-8.6(b), Hawaii Revised Statutes, that authorized APRNs with the authority to prescribe non-controlled substances to have collegial relationships with licensed physicians.

In November 2004, the formulary was amended to allow APRNs with prescriptive authority to prescribe controlled substances under the supervision of a licensed physician. This change requires that the law be amended to authorize BON rules to reflect a "supervisory" relationship between the professions in the case of the prescription of controlled substances.

In the interest of flexibility, and in order to accommodate future changes or additions to the standards for the working relationship between the nursing and medical professions with respect to prescriptive authority, this measure amends the law to require BON rules to reflect "the appropriate", rather than "a collegial" working relationship between APRNs with prescriptive authority and licensed physicians.

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 H.B. No. 1118, and recommends that it pass Third Reading.