97              
HOUSE OF REPRESENTATIVES             H.R. NO.              
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                     HOUSE  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   
45        (2)  States require professional boards to provide
46             practice-relevant information about their licensees
47             to the public in a clear and comprehensible manner;
48   

 
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 1        (3)  States provide the resources necessary to adequately
 2             staff and equip all health profession boards to meet
 3             their responsibilities expeditiously, efficiently,
 4             and effectively;
 5   
 6        (4)  States enact and implement scopes of practice that
 7             are nationally uniform for each profession and based
 8             on the standards and models developed by the national
 9             policy advisory body;
10   
11        (5)  States explore and develop mechanisms for existing
12             professions to evolve their existing scopes of
13             practice and for new professions (or previously
14             unregulated professions) to emerge;
15   
16        (6)  States require that their regulated health care
17             practitioners demonstrate their competence in the
18             knowledge, judgment, technical skills, and
19             interpersonal skills relevant to their jobs
20             throughout their careers;
21   
22        (7)  State use standardized and understandable language
23             for health profession regulation and its function to
24             clearly describe them for consumers, provider
25             organizations, businesses, and the professions;
26   
27        (8)  States standardize entry-to-practice requirements and
28             limit them to competence assessments for health
29             professions in order to facilitate the physical and
30             professional mobility of the health professions;
31   
32        (9)  States base practice acts on demonstrated initial and
33             continuing competence;
34   
35       (10)  States redesign health professional boards and their
36             functions to reflect the interdisciplinary and public
37             accountability demands of the changing health care
38             delivery system;
39   
40       (11)  Boards educate consumers to assist them in obtaining
41             the information necessary to make decisions about
42             practitioners and to improve the boards' public
43             accountability;
44   
45       (12)  Boards cooperate with other public and private
46             organizations in collecting data on regulated health
47             professions to support effective workforce planning;
48   

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

 
 
 
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 1        BE IT FURTHER RESOLVED that the Task Force is requested to
 2   submit its findings and recommendations to the Legislature
 3   twenty days prior to the convening of the Regular Session of
 4   2001; and
 5   
 6        BE IT FURTHER RESOLVED that a certified copy of this
 7   Resolution be transmitted to the Director of Commerce and
 8   Consumer Affairs, who in turn is requested to transmit copies
 9   to the chairs of all regulatory boards of the health
10   professions in the State.
11 
12 
13 
14                         OFFERED BY:  ____________________________