SB517.DOC

SECTION 1. The legislature finds that nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants are often asked by their patients to complete and sign medical certifications for various purposes including physical examinations, handicapped parking permits, physical and speech therapy forms, and financial assistance certifications. Current Hawaii law allows only physicians to sign documents attesting to their patients' health, capabilities, or medical needs. Often, a physician who did not provide care to the patient must be found to sign these documents. At times, no physician can be located causing difficulties for patients.

The legislature further finds that nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants provide a wide variety of health care to the people in this State. Allowing these health care professionals to sign certain medical certification documents will enable them to expedite the processing of paperwork and provide optimal care at the first point of access for their patients, especially in rural and underserved areas.

The purpose of this Act is to permit nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants, who provide the actual care, to sign certain medical certification forms for their patients applicable to the care provided within each practitioner's scope of practice.

SECTION 2. Chapter 453, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§453- Physician assistant; power to sign certain documents. Each physician assistant licensed under this chapter is authorized to sign the following documents relating to patients to whom the physician assistant provides actual care within each practitioner's scope of practice:

(1) Certification of psychiatric medical condition of the parents of a child applicant for aid from the temporary assistance for needy families program;

(2) Evaluation forms for Hansen's disease patients;

(3) Orders for physical therapy and plans of care;

(4) Pharmacist orders to assist in monitoring and management of anticoagulation anemia and atrial fibrillation;

(5) Orders for speech therapy and plans of care;

(6) Applications for bracelets indicating compassionate care only;

(7) Admissions applications for foster homes;

(8) Dietary consultations forms;

(9) Applications for handicapped parking permits; and

(10) Medicaid application forms for nursing care facility admission."

SECTION 3. Chapter 457, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§457- Registered nurse; advanced practice registered nurse; certified nurse midwife; clinical nurse specialist; power to sign certain documents. Each registered nurse, advanced practice registered nurse, certified nurse midwife, and clinical nurse specialist licensed under this chapter is authorized to sign the following documents relating to patients to whom the registered nurse, advanced practice registered nurse, certified nurse midwife, or clinical nurse specialist provides actual care within each practitioner's scope of practice: