STAND. COM. REP. NO. 1031

Honolulu, Hawaii

RE:    H.B. No. 1378

       H.D. 2

       S.D. 1

Honorable Colleen Hanabusa

President of the Senate

Twenty-Fifth State Legislature

Regular Session of 2009

State of Hawaii

Madam:

     Your Committee on Health, to which was referred H.B. No. 1378, H.D. 2, entitled:

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

begs leave to report as follows:

     The purpose of this measure is to increase access to health care by:

     (1)  Allowing insurers, mutual and fraternal benefit societies, and health maintenance organizations to recognize advanced practice registered nurses as primary care providers;

     (2)  Requiring participating providers to recognize advanced practice registered nurses as primary care providers;

     (3)  Increasing advanced practice registered nurses' signature and prescriptive authorities; and

     (4)  Making the Board of Nursing, rather than the Hawaii Medical Board and the Joint Formulary Advisory Committee, responsible for the oversight of the prescriptive authority of advanced practice registered nurses.

     Your Committee received testimony in support of this measure from Kaiser Permanente, Hawaii Primary Care Association, Healthcare Association of Hawaii, Hawaii State Center for Nursing, Hawaii Government Employees Association, the University of Hawaii System, Occupational Therapy Association of Hawaii, AARP, and the Lanai Women's Center.  Testimony in support of this measure with amendments was submitted by the Hawaii Association for Professional Nurses, Walgreens, and Hawaii Medical Service Association.  The Board of Nursing supports this measure with reservations.  Testimony in opposition to this measure was submitted by the Hawaii Medical Association.  Comments on this measure were submitted by the Department of Public Safety, Department of Human Services, the Hawaii Medical Board, and the Hawaii Association of Health Plans.  The Disability and Communication Access Board provided comments and amendments to this measure.

     Written testimony presented to the Committee may be reviewed on the Legislature's website.

     Your Committee finds that authorizing advanced practice registered nurses to be recognized as primary care providers with signature and prescriptive authority will help to alleviate the shortage of health care providers across the State by providing access to quality clinicians.

     Your Committee notes that it has worked in conjunction with insurers, health plans, the nursing school, the Center for Nursing, and the Board of Nursing to address the concerns raised by stakeholders regarding this measure.  Accordingly, your Committee has amended this measure by:

     (1)  Removing its contents and replacing it with language from S.B. No. 1045, S.D. 2; and

     (2)  Inserting language that provides for advanced practice registered nurse recognition by endorsement provided that:

          (A)  The person applying is licensed as a registered nurse in this State; and

          (B)  All nurse licenses, recognitions and prescriptive authorities or similar designations held by the person under the laws of this State, another state, or United States territory are unencumbered and if the originating state's requirements were equal to or greater than the Board of Nursing's advanced practice registered nurse requirements which were in effect prior to October 1, 2009.  The advanced practice registered nurse shall be eligible to renew that recognition as an advanced practice registered nurse; provided that all nurse licenses, recognitions and prescriptive authorities or similar designations held by the person in this State, another state or United States territory are unencumbered; and

     (3)  Changing the effective date to upon approval.

     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. 1378, H.D. 2, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 1378, H.D. 2, S.D. 1, and be referred to the Committee on Commerce and Consumer Protection.

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

____________________________

DAVID Y. IGE, Chair