STAND. COM. REP. NO. 296

Honolulu, Hawaii

RE:    S.B. No. 1045

       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 S.B. No. 1045 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 improve access to quality health care by:

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

     (2)  Granting global signature authority to advanced practice registered nurses;

     (3)  Authorizing prescriptive authority to advanced practice registered nurses; and

     (4)  Abolishing the Joint Formulary Advisory Committee.

     Your Committee received testimony in support of this measure from Hawaii Primary Care Association, the School of Nursing and Dental Hygiene at the University of Hawaii at Manoa, Hawaii Government Employees Association, the Hawaii State Center for Nursing, Lanai Women's Center, Walgreens, and ten individuals.

Your Committee received testimony in opposition to this measure from Kaiser Permanente, Hawaii Medical Association, and one individual.  Comments on this measure were received from the Department of Human Services, the Board of Nursing, and Hawaii Medical Service Association,

     Copies of written testimony are available for review 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 has adopted the recommendations of the Board of Nursing and amended this measure by:

     (1)  Clarifying the definition of advanced practice registered nurse to require either a Master of Science in Nursing degree or a passing score on a national certification examination;

     (2)  Deleting the additional definition of "advanced practice registered nurse";

     (3)  Re-inserting the Board's authority to designate the requirements for advanced practice registered nursing practice related to prescriptive authority;

     (4)  Re-inserting the Board's authority to establish nursing requirements for education, experience, and national certification pursuant to rules adopted in accordance with chapter 91, Hawaii Revised Statutes;

     (5)  Clarifying that advanced practice registered nurses are authorized to diagnose, prescribe, and institute therapy or referrals of patients, within their practice specialty; and

     (6)  Changing the effective date to July 1, 2050, to encourage further discussion on this matter.

     Your Committee has further amended this measure by making technical, nonsubstantive amendments for the purposes of clarity and style.

     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 S.B. No. 1045, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1045, 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