STAND. COM. REP. NO. 325

Honolulu, Hawaii

RE:    S.B. No. 1610

       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. 1610 entitled:

"A BILL FOR AN ACT RELATING TO MEDICAL ORDERS,"

begs leave to report as follows:

     The purpose of this measure is to clearly define the role of physician assistants regarding medical orders issued to a registered nurse by clarifying that:

     (1)  Physician assistants may act as agents of a supervising physician when issuing a medical order; and

     (2)  A medical order issued by a physician assistant to a registered nurse is a specific direction from the supervising physician.

     Your Committee received testimony in support of this measure from Hawaii Medical Service Association, the Board of Nursing, Puna Community Medical Center, and five individuals.  The Hawaii Academy of Physician Assistants submitted testimony in support of the measure with amendments.  Comments on this measure were received from Kaiser Permanente and the Hawaii Medical Board.

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

     Your Committee finds that physician assistants serve a vital role in the health care community.  Clearly authorizing physician assistants to issue medical orders to be executed by nursing personnel will help to clear any ambiguities in the current statutes and ensure safe patient care in the hospital setting.  The measure does not relieve physician assistants or registered nurses from exercising due care in performing within their respective scope of practice.

     Your Committee has amended this measure by adopting the recommendations of the Hawaii Academy of Physician Assistants by:

     (1)  Removing the requirement that the supervising physician must affirmatively authorize the physician assistant to issue a medical order;

     (2)  Removing the requirement that a supervising physician must personally review patient records within seven days of the issuance of a medical order by a physician assistant;

     (3)  Requiring the supervising physician to conduct record review in compliance with section 16-85-49, Hawaii Administrative Rules; and

     (4)  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. 1610, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1610, 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