107             
HOUSE OF REPRESENTATIVES             H.C.R. NO.            
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
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                     HOUSE  CONCURRENT
                        RESOLUTION

  CONVENING A STATE TASK FORCE TO STUDY THE REGULATION OF THE
    HEALTH PROFESSIONS AND REPORT RECOMMENDATIONS TO BETTER
    PROTECT HEALTH CARE CONSUMERS.
 


 1        WHEREAS, the President's Advisory Commission on Consumer
 2   Protection and Quality in the Health Care Industry recommends
 3   that all sectors of the health care industry should support the
 4   focused development of quality measures that enhance and
 5   improve the ability to evaluate and improve health care and
 6   should include steps to ensure that comparative information on
 7   health care quality is valid, reliable, comprehensible, and
 8   widely available in the public domain; and
 9   
10        WHEREAS, a recent report issued in October of 1998
11   entitled "Strengthening Consumer Protection:  Priorities for
12   Health Care Workforce Regulation" by the Task Force on Health
13   Care Workforce Regulation of the Pew Health Professions
14   Commission envisions a future health professions regulatory
15   system that meets consumers' reasonable expectations of access
16   to comprehensive, appropriate, cost-effective and high quality
17   health services and explores ways to move the current system
18   toward this future system; and
19   
20        WHEREAS, the Pew Commission acknowledges the challenge of
21   reforming a complex system and seeks with their report to
22   provide state legislators and regulators with a tool and
23   resource to understand and shape professional regulation so
24   that it meets evolving consumer protection needs; and
25   
26        WHEREAS, weaknesses in these regulatory structures have
27   been well documented and analyzed in national reports and
28   studies over the past twenty-five years indicating the
29   professionals need to guide their respective boards because
30   professional dominance on boards limits public accountability
31   and can promote self-interest in policy making; and
32   
33        WHEREAS, the scope of practice conferred upon some
34   licensed occupations and professions are unnecessarily
35   monopolistic, thereby restricting consumers' access to other
36   qualified practitioners and increasing costs of services; and
37   

 
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 1        WHEREAS, although a practitioner's competence is evaluated
 2   upon initial entry into a licensed profession, current state
 3   requirements do not assess or guarantee continuing competence;
 4   and
 5   
 6        WHEREAS, although several professions and states have made
 7   progress, national standards for entry to practice,
 8   professional mobility, scopes of practice, continuing
 9   competence, and discipline are still very limited; and
10   
11        WHEREAS, consumers' efforts to make informed decisions
12   about practitioner competence are hindered by the poor and
13   limited quality of information that boards release regarding
14   licensees; and
15   
16        WHEREAS, professional regulation is not sufficiently
17   integrated or coordinated with other public and private
18   consumer protection structures and processes; and
19   
20        WHEREAS, the Pew Commission believes that state-based
21   health care workforce regulation will best serve the public by
22   promoting effective health outcomes and protecting the public
23   from harm by holding regulatory bodies accountable to the
24   public; and
25   
26        WHEREAS, the Pew Commission also believes that consumers'
27   rights to choose their health care providers from a range of
28   safe options should be respected; and
29   
30        WHEREAS, the Pew Commission further believes that the
31   state-based health care workforce regulation will encourage a
32   flexible, rational and cost-effective health care system which
33   allows effective working relationships among health care
34   providers as well as facilitate professional and geographic
35   mobility of competent providers; and
36   
37        WHEREAS, the Pew Commission recommends, among other
38   things, that:
39   
40        (1)  Individual professional boards in the states be more
41             accountable to the public by significantly increasing
42             the representation of public, nonprofessional
43             members;
44   

 
 
 
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 1        (2)  States require professional boards to provide
 2             practice-relevant information about their licensees
 3             to the public in a clear and comprehensible manner;
 4   
 5        (3)  States provide the resources necessary to adequately
 6             staff and equip all health profession boards to meet
 7             their responsibilities expeditiously, efficiently,
 8             and effectively;
 9   
10        (4)  States enact and implement scopes of practice that
11             are nationally uniform for each profession and based
12             on the standards and models developed by the national
13             policy advisory body;
14   
15        (5)  States explore and develop mechanisms for existing
16             professions to evolve their existing scopes of
17             practice and for new professions (or previously
18             unregulated professions) to emerge;
19   
20        (6)  States require that their regulated health care
21             practitioners demonstrate their competence in the
22             knowledge, judgment, technical skills, and
23             interpersonal skills relevant to their jobs
24             throughout their careers;
25   
26        (7)  State use standardized and understandable language
27             for health profession regulation and its function to
28             clearly describe them for consumers, provider
29             organizations, businesses, and the professions;
30   
31        (8)  States standardize entry-to-practice requirements and
32             limit them to competence assessments for health
33             professions in order to facilitate the physical and
34             professional mobility of the health professions;
35   
36        (9)  States base practice acts on demonstrated initial and
37             continuing competence;
38   
39       (10)  States redesign health professional boards and their
40             functions to reflect the interdisciplinary and public
41             accountability demands of the changing health care
42             delivery system;
43   

 
 
 
 
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 1       (11)  Boards educate consumers to assist them in obtaining
 2             the information necessary to make decisions about
 3             practitioners and to improve the boards' public
 4             accountability;
 5   
 6       (12)  Boards cooperate with other public and private
 7             organizations in collecting data on regulated health
 8             professions to support effective workforce planning;
 9   
10       (13)  States require each board to develop, implement, and
11             evaluate continuing competency requirements to assure
12             the continuing competence of regulated health care
13             professionals;
14   
15       (14)  States maintain a fair, cost-effective, and uniform
16             disciplinary process to exclude incompetent
17             practitioners to protect and promote the public's
18             health;
19   
20       (15)  States develop evaluation tools that assess the
21             objectives, successes, and shortcomings of their
22             regulatory systems and bodies in order to best
23             protect and promote the public's health; and
24   
25       (16)  States understand the links, overlaps, and conflicts
26             between their health care workforce regulatory system
27             which affect the education, regulation, and practice
28             of health care practitioners and work to develop
29             partnerships to streamline regulatory structures and
30             processes;
31   
32   and
33   
34        WHEREAS, the citizens of the "Health State" of Hawaii will
35   be better served through the study and implementation of these
36   recommendations which will improve the quality of health care;
37   now, therefore,
38   
39        BE IT RESOLVED by the House of Representatives of the
40   Twentieth Legislature of the State of Hawaii, Regular Session
41   of 1999, the Senate concurring, that the Director of Commerce
42   and Consumer Affairs is requested to convene a Health
43   Profession Regulation Task Force to make a thorough examination
44   of the Pew Report and prepare a report containing findings and
45   recommendations including any proposed legislation; and
46   

 
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 1        BE IT FURTHER RESOLVED that the Director of Commerce and
 2   Consumer Affairs is requested to serve as a chair of the Task
 3   Force and appoint members including appropriate representations
 4   of consumers, providers, health care institutions such as
 5   hospitals and health plans, educational institutions,
 6   businesses, and government; and
 7   
 8        BE IT FURTHER RESOLVED that the Task Force is requested to
 9   submit its findings and recommendations to the Legislature
10   twenty days prior to the convening of the Regular Session of
11   2001; and
12   
13        BE IT FURTHER RESOLVED that a certified copy of this
14   Concurrent Resolution be transmitted to the Director of
15   Commerce and Consumer Affairs, who in turn is requested to
16   transmit copies to the chairs of all regulatory boards of the
17   health professions in the State.
18 
19 
20 
21                         OFFERED BY:  ____________________________