THE SENATE                           S.C.R. NO.            5
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                    SENATE  CONCURRENT
                        RESOLUTION

  REQUESTING THE CONVENING OF 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 (Pew Commission) envisions a future health
15   professions regulatory system that meets consumers' reasonable
16   expectations of access to comprehensive, appropriate, cost-
17   effective and high quality health services and explores ways to
18   move the current system 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 that the
29   professions need to guide their respective boards because
30   professional dominance on boards limits public accountability
31   and can promote self-interest in policymaking; and
32   
33        WHEREAS, some scopes of practice conferred upon licensed
34   occupations and professions are unnecessarily monopolistic,
35   thereby restricting consumers' access to other qualified

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

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

 
 
 
 
 
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 1             initial and continuing competence;
 2   
 3       (10)  States should redesign health professional boards and
 4             their functions to reflect the interdisciplinary and
 5             public accountability demands of the changing health
 6             care delivery system;
 7   
 8       (11)  Boards should educate consumers to assist them in
 9             obtaining the information necessary to make decisions
10             about practitioners and to improve the boards' public
11             accountability;
12   
13       (12)  Boards should cooperate with other public and private
14             organizations in collecting data on regulated health
15             professions to support effective workforce planning;
16   
17       (13)  States should require each board to develop,
18             implement, and evaluate continuing competency
19             requirements to assure the continuing competence of
20             regulated health care professionals;
21   
22       (14)  States should maintain a fair, cost-effective, and
23             uniform disciplinary process to exclude incompetent
24             practitioners to protect and promote the public's
25             health;
26   
27       (15)  States should develop evaluation tools that assess
28             the objectives, successes, and shortcomings of their
29             regulatory systems and bodies in order to best
30             protect and promote the public's health; and
31   
32       (16)  States should understand the links, overlaps, and
33             conflicts between their health care workforce
34             regulatory system which affect the education,
35             regulation, and practice of health care
36             practitioners, and work to develop partnerships to
37             streamline regulatory structures and processes;
38   
39   and
40   
41        WHEREAS, the citizens of the "Health State" of Hawaii
42   would be better served through the study and implementation of

 
 
 
 
 
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 1   these recommendations which would improve the quality of health
 2   care; now, therefore,
 3   
 4        BE IT RESOLVED by the Senate of the Twentieth Legislature
 5   of the State of Hawaii, Regular Session of 1999, the House of
 6   Representatives concurring, that the Director of Commerce and
 7   Consumer Affairs is requested to convene a Health Profession
 8   Regulation Task Force (Task Force) to make a thorough
 9   examination of the Pew Report and prepare a report containing
10   its findings and recommendations, including any proposed
11   legislation; and
12   
13        BE IT FURTHER RESOLVED that the Director of Commerce and
14   Consumer Affairs is requested to serve as Chair of the Task
15   Force and appoint members of the task force to include
16   appropriate representation of consumers, providers, health care
17   institutions such as hospitals and health plans, educational
18   institutions, business, and government; and
19   
20        BE IT FURTHER RESOLVED that the Task Force is requested to
21   submit its findings, report, and recommendations twenty days
22   before the convening of the Regular Session of 2001; and
23   
24        BE IT FURTHER RESOLVED that certified copies of this
25   Concurrent Resolution be transmitted to the Director of
26   Commerce and Consumer Affairs, the Director of Health, and the
27   Chairs of all the regulatory boards of the health professions
28   in the State of Hawaii.  
29 
30 
31 
32                         OFFERED BY:  ____________________________