STAND. COM. REP. NO. 2809

Honolulu, Hawaii

RE: S.B. No. 2445

S.D. 2

Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2022

State of Hawaii

Sir:

Your Committee on Commerce and Consumer Protection, to which was referred S.B. No. 2445, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO PHYSICIAN ASSISTANTS,"

begs leave to report as follows:

The purpose and intent of this measure is to expand the authorized scope of practice for physician assistants.

Your Committee received testimony in support of this measure from the Department of Labor and Industrial Relations, Hawai‘i Medical Board, Hawai‘i Public Health Association, Hawai‘i Academy of Physician Assistants, Hawai‘i Public Health, Kaiser Permanente Hawai‘i, The Queen's Health Systems, Occupational Therapy Association of Hawai‘i, and twenty-two individuals.

Your Committee finds that many residents of the State lack sufficient access to timely, high-quality health care due in part to a shortage of qualified physicians. By some estimates, the State has an unmet need for seven hundred thirty-two full time physicians, with the most severe shortages reaching almost forty percent in Maui County and Hawai‘i County. Studies suggest this shortage will continue to worsen over time.

Your Committee further finds that physician assistants serve a critical role in addressing the most acute impacts of Hawai‘i's physician shortage. Fortunately, the practice of physician assistants is rapidly growing in the State. However, because Hawai‘i has some of the nation's most restrictive scope of practice laws for physician assistants, these providers are prevented from meeting many of their patients' needs, such as certifying the need for temporary disability insurance, disability parking permits, and provider orders for life-sustaining treatment forms.

Your Committee additionally finds that there is a disconnect between the skills and qualifications of physician assistants and the permissible scope of practice provided under existing law. Because of their rigorous medical training, physician assistants are skilled health care providers who routinely take medical histories, perform physical examinations, order and interpret laboratory tests, diagnose illnesses, develop and manage treatment plans, prescribe medications, and assist in surgery. Moreover, these professionals can work in a multitude of clinical settings, locations, and specialties, and because physician assistants can work off-site from their collaborating physician as long as the physician remains available via telecommunication, physician assistants have been helping to fill Hawai‘i's rural health care gap with high quality care.

Accordingly, your Committee finds that this measure will improve patient access to health care services and provide optimal care for Hawai‘i patients, especially those in rural and underserved areas, by expanding the permissible scope of practice in which physician assistants may engage.

Your Committee has amended this measure by:

(1) Inserting an effective date of January 1, 2023; and

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

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 is in accord with the intent and purpose of S.B. No. 2445, S.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 2445, S.D. 2.

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

________________________________

ROSALYN H. BAKER, Chair