STAND. COM. REP. NO.  932

Honolulu, Hawaii

                , 2009

RE:   H.B. No. 1378

      H.D. 2

Honorable Calvin K.Y. Say

Speaker, House of Representatives

Twenty-Fifth State Legislature

Regular Session of 2009

State of Hawaii

Sir:

     Your Committee on Finance, to which was referred H.B. No. 1378, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO ADVANCED PRACTICE REGISTERED NURSES,"

begs leave to report as follows:

     The purpose of this bill is to increase access to health care by requiring insurers, mutual and fraternal benefit societies, and health maintenance organizations to recognize advanced practice registered nurses (APRN) as primary care providers.  This measure also increases APRN signature and prescriptive authorities.

      The University of Hawaii System, the Healthcare Association of Hawaii, the Occupational Therapy Association of Hawaii, AARP Hawaii, and several concerned individuals supported this bill.  The Hawaii Association of Professional Nurses, Hawaii Medical Association, and several concerned individuals opposed this bill.  The Department of Human Services, the Department of Public Safety, the Board of Nursing (Board), the Disability and Communication Access Board, Kaiser Permanente Hawaii, Hawaii Association of Health Plans, the Hawaii Medical Services Association, the Hawaii State Center for Nursing, and Walgreens submitted comments.

     Your Committee has amended this bill by:

     (1)  Adding a purpose section recognizing APRNs as an essential component of the primary health care team;

     (2)  Making the recognition of APRNs as primary care providers discretionary for insurers, mutual and fraternal benefit societies, and health maintenance organizations, while retaining the mandatory recognition of APRNs as participating providers;

     (3)  Clarifying that the insurer, mutual and fraternal benefit society, and health maintenance organizations retain the right to determine the contracting criteria for participating providers;

     (4)  Clarifying that the signatory and prescriptive authority granted in this bill is limited to the APRN's scope of practice or practice specialty;

     (5)  Making the new standards for a qualified APRN to be recognized by the Board effective on October 1, 2009, instead of June 30, 2009;

     (6)  Clarifying the conditions under which APRNs recognized prior to October 1, 2009, may be eligible to renew their recognition;

     (7)  Making the Board, rather than the Hawaii Medical Board and the Joint Formulary Advisory Committee responsible for the oversight of the prescriptive authority of ARPNs; and

     (8)  Making technical, nonsubstantive amendments for style, clarity, and consistency.

     As affirmed by the record of votes of the members of your Committee on Finance that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1378, H.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as H.B. No. 1378, H.D. 2.

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

____________________________

MARCUS R. OSHIRO, Chair