STAND. COM. REP. NO. 496

Honolulu, Hawaii

RE: S.B. No. 620

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2021

State of Hawaii

Sir:

Your Committees on Health and Commerce and Consumer Protection, to which was referred S.B. No. 620 entitled:

"A BILL FOR AN ACT RELATING TO ADVANCED PRACTICE REGISTERED NURSES,"

beg leave to report as follows:

The purpose and intent of this measure is to:

(1) Authorize advanced practice registered nurses to certify whether a person is totally disabled under the income tax code;

(2) Authorize advanced practice registered nurses to make capacity determinations; and

(3) Add advanced practice registered nurses as primary providers in advance mental health care directives.

Your Committees received testimony in support of this measure from the Hawai‘i State Center for Nursing, Hawai‘i – American Nurses Association, Hawai‘i Association of Professional Nurses, The Queen's Health Systems, Hawaii Nurses' Association, and five individuals. Your Committees received testimony in opposition to this measure from one individual. Your Committees received comments on this measure from the Department of Taxation, Board of Nursing, and Hawai‘i Psychological Association.

Your Committees find that there is a need for greater access to healthcare in the State, especially in rural communities and on the neighbor islands. Because there is a well-documented physician shortage in the State, authorizing the readily-available advanced practice registered nurse (APRN) workforce to engage in activities within their scope of practice and in accordance with their education, training, and licensure provides a reasonable means of addressing this problem.

Your Committees also find that there are APRNs in all regions of the State with more than twenty-five percent working in rural areas. A majority of APRNs who work on the neighbor islands are also located in federally designated medically underserved areas. Expanding their authority could bring valuable services to those communities. Your Committees further find that this measure would allow APRNs to assist in important and high-demand services such as certifying whether a person is totally disabled under the income tax code, making capacity determinations, and serving as primary providers in advance mental health care directives.

Your Committees have amended this measure by:

(1) Inserting an effective date of July 1, 2050, to encourage further discussion; and

(2) 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 Health and Commerce and Consumer Protection that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 620, as amended herein, and recommend that it pass Second Reading in the form attached hereto as S.B. No. 620, S.D. 1, and be referred to your Committee on Judiciary.

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

________________________________ ROSALYN H. BAKER, Chair

________________________________ JARRETT KEOHOKALOLE, Chair