STAND. COM. REP. NO. 1137

Honolulu, Hawaii

RE:    S.R. No. 34

       S.D. 1

Honorable Donna Mercado Kim

President of the Senate

Twenty-Seventh State Legislature

Regular Session of 2013

State of Hawaii

Madam:

     Your Committee on Commerce and Consumer Protection, to which was referred S.R. No. 34 entitled:

"SENATE RESOLUTION REQUESTING COLLABORATION AMONG VARIOUS STATE AGENCIES TO IDENTIFY BARRIERS RELATING TO THE PRACTICE OF ADVANCED PRACTICE REGISTERED NURSING TO THE FULL EXTENT OF THE NURSES' EDUCATION AND TRAINING IN THE STATE,"

begs leave to report as follows:

     The purpose and intent of this measure is to request collaboration among various state agencies to identify barriers relating to the practice of advanced practice registered nursing to the full extent of the nurses' education and training in the State.

     Your Committee received testimony in support of this measure from the Board of Nursing, Hawai‘i State Center for Nursing, University of Hawai‘i at Manoa School of Nursing and Dental Hygiene, University of Hawai‘i Maui College, Hawaii Long Term Care Association, Hawai‘i Association of Professional Nurses, and eleven individuals.  Your Committee received comments on this measure from the Department of the Attorney General and Legislative Reference Bureau.

     Your Committee finds that the Legislature has previously aligned Hawaii laws with national goals requiring the utilization of primary care providers, particularly Advanced Practice Registered Nurses, to the full extent of their education and training.  Advanced Practice Registered Nurses provide cost-effective, accessible, patient-centered care, including care coordination, chronic care management, and wellness and preventive care.

     Your Committee further finds that the Hawaii State Center for Nursing has identified barriers in the form of obsolete language in the Hawaii Revised Statutes and Hawaii Administrative Rules that preclude or impede Advanced Practice Registered Nurses from practicing to the full extent of their education and training.  This measure begins the process of removing barriers in the Hawaii Revised Statutes and Hawaii Administrative Rules to the practice of Advanced Practice Registered Nursing and underscores the fact that Advanced Practice Registered Nurses play a central role in nationwide health reform.  This measure also clarifies the national goal for a transformed health system that provides wide access to essential health services, improves quality, and controls costs, which cannot be achieved without maximizing the contributions of Advanced Practice Registered Nurses.

     Your Committee additionally finds that this measure requests the Department of the Attorney General to coordinate the various state agencies' positions and recommendations and prepare a draft report to submit to the Legislative Reference Bureau.  Your Committee notes that this requirement may interfere with the Department of the Attorney General's role as a legal advisor to the individual agencies.  Your Committee concludes that it would be more effective for the Hawaii State Center for Nursing to convene a working group composed of the various state agencies to identify Advanced Practice Registered Nursing scope of practice barriers, rather than requiring the Attorney General to obtain this information.  Therefore, amendments to this measure are necessary.

     Accordingly, your Committee has amended this measure by:

     (1)  Clarifying that the assistance and recommendations of the Department of the Attorney General and Legislative Reference Bureau will be needed to identify Advanced Practice Registered Nursing scope of practice barriers;

     (2)  Requesting the Hawaii State Center for Nursing to convene a working group composed of various state agencies to identify barriers relating to the practice of Advanced Practice Registered Nurses;

     (3)  Specifying the state agencies to be represented on the working group;

     (4)  Specifying that the working group may enlist the assistance of the Department of the Attorney General, other state agencies, or professional groups as needed to complete its task;

     (5)  Requesting the working group to transmit a draft report of the working group's findings and recommendations to the Legislative Reference Bureau by November 1, 2013, rather than requiring the Department of the Attorney General to transmit a draft report;

     (6)  Amending the organizations receiving a certified copy of this measure; and

     (7)  Updating its title to reflect its amended purpose.

     As affirmed by the record of votes of the members of your Committee on Commerce and Consumer Protection that is attached to this report, your Committee concurs with the intent and purpose of S.R. No. 34, as amended herein, and recommends that it be referred to the Committee on Ways and Means, in the form attached hereto as S.R. No. 34, S.D. 1.

Respectfully submitted on behalf of the members of the Committee on Commerce and Consumer Protection,

____________________________

ROSALYN H. BAKER, Chair