STAND. COM. REP. NO. 3855

Honolulu, Hawaii

RE: H.B. No. 1823

H.D. 2

S.D. 2

Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2022

State of Hawaii

Sir:

Your Committees on Commerce and Consumer Protection and Judiciary, to which was referred H.B. No. 1823, H.D. 2, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO HEALTH,"

beg leave to report as follows:

The purpose and intent of this measure is to:

(1) Authorize advanced practice registered nurses and physician assistants to practice medical aid in dying or provide counseling to a qualified patient;

(2) Require a prescribing provider to conduct an initial visit in-person;

(3) Amend the mandatory waiting period between oral requests and the provision of a prescription; and

(4) Prohibit the disclosure, discovery, or compelled production of information collected or retained pursuant to incidental or routine communication between the Department of Health and qualified patients or providers.

Your Committees received testimony in support of this measure from the Stonewall Caucus of the Democratic Party of Hawai‘i, Compassion & Choices, Hawai‘i Pacific Health, Aloha Care, Hawai‘i Society of Clinical Oncology, Hawai‘i Association of Professional Nurses, Hawaiian Islands Association for Marriage and Family Therapy, National Association of Social Workers – Hawai‘i, and twenty-nine individuals. Your Committees received testimony in opposition to this measure from St. Michael the Archangel Church, Hawai‘i Family Forum, and five individuals. Your Committees received comments on this measure from the Department of Health, Hawai‘i Medial Board, Board of Nursing, Hawai‘i State Center for Nursing, Hawai‘i Association for Justice, Hawai‘i Medical Association, Hawai‘i Association of Nurse Anesthetists, Hawai‘i Psychiatric Medical Association, and four individuals.

Your Committees find that the Our Care, Our Choice Act was implemented to provide peace of mind to terminally ill patients in the State. However, a subsequent report to the Legislature found that, while compassionately implemented, some of the well-intentioned regulatory requirements outlined in the Act have created unintended barriers and unnecessary burdens. Coupled with the State's ongoing physician shortage, these barriers have made it difficult for terminally ill patients seeking access to medical aid in dying. This measure will allow more providers to voluntarily participate in providing assistance to medical aid in dying patients, especially to those patients in rural areas.

Your Committees further note the concerns raised in testimony that this measure, as currently drafted, requires attending providers to make an in-person, initial determination of eligibility for medical aid in dying. This amendment would place an additional burden on patients, particularly those in rural areas, to secure an in-person visit to fulfill the requirements of an initial request, even if the provider and patient have a long-standing relationship. Existing state law already requires that providers have an in-person consultation with a patient prior to prescribing controlled substances. Accordingly, amendments to this measure are necessary to address this concern.

Your Committees have amended this measure by:

(1) Clarifying that the attending provider shall make the initial determination of whether a patient has a terminal disease, is capable of medical decision-making, and has made the request for the prescription voluntarily, provided that this initial determination may be made in-person or via telehealth;

(2) Amending section 1 to reflect its amended purpose; and

(3) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

As affirmed by the records of votes of the members of your Committees on Commerce and Consumer Protection and Judiciary that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 1823, H.D. 2, S.D. 1, as amended herein, and recommend that it pass Third Reading in the form attached hereto as H.B. No. 1823, H.D. 2, S.D. 2.

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

________________________________ KARL RHOADS, Chair

________________________________ ROSALYN H. BAKER, Chair