STAND. COM. REP. NO. 1492

Honolulu, Hawaii

RE:    H.B. No. 912

       H.D. 2

       S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Twenty-Ninth State Legislature

Regular Session of 2017

State of Hawaii

Sir:

     Your Committee on Commerce, Consumer Protection, and Health, to which was referred H.B. No. 912, H.D. 2, entitled:

"A BILL FOR AN ACT RELATING TO NURSING,"

begs leave to report as follows:

     The purpose and intent of this measure is to allow advanced practice registered nurses who hold a national certification in a psychiatric specialization to offer care and services to minors and patients in assisted community treatment similar to care and services offered by physicians and other healthcare service providers.

     Your Committee received testimony in support of this measure from the Board of Nursing, Department of Health, Hawai‘i State Center for Nursing, Hawaii Substance Abuse Coalition, Hawaii Association of Professional Nurses, Mental Health Task Force, and three individuals.

     Your Committee finds that advanced practice registered nurses are licensed healthcare practitioners qualified to provide primary medical services to adolescents.  Your Committee further finds that advanced practice registered nurses fill an important role in caring for patients' current and future health needs, and can help improve timely access to qualified behavioral health services for individuals most in need of care, such as severely mentally ill patients in assisted community treatment.  Your Committee notes that while the State is experiencing a shortage of behavioral health specialists, the number of advanced practice registered nurses has nearly doubled in the years between 2005 and 2015.

     Your Committee additionally finds that removing barriers to practice for advanced practice registered nurses will produce better access to safe, timely, quality healthcare for patients in Hawaii.  More specifically, advanced practice registered nurses with psychiatric specialties are highly qualified to assess, diagnose, treat, and prescribe to patients with mental health conditions as well as adolescents in need of mental health services.

     Your Committee notes that advanced practice registered nurses are required to complete seventy-five continuing education credits every five years in their specialty area and twenty-five of these continuing education credits must be in pharmacotherapy.  Although advanced practice registered nurses inherently have ongoing training related to prescriptive knowledge, your Committee finds that it is prudent that the statutory language in this measure be forthright and clear in specifying throughout this measure that the advanced practice registered nurses who are authorized to treat minors and patients in assisted community treatment, as proposed by this measure, are advanced practice registered nurses who hold prescriptive authority and are certified in a psychiatric specialization.

     Accordingly, your Committee has amended this measure by:

     (1)  Inserting the phrase "advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization" to replace all references to "advanced practice registered nurse" in the provisions related to assisted community treatment;

     (2)  Inserting language to the definition of the term "advanced practice registered nurse" related to assisted community treatment to require that the individual:

          (A)  Holds an accredited national certification in an advanced practice registered nurse psychiatric specialization; and

          (B)  Holds prescriptive authority pursuant to section 457-8.6, Hawaii Revised Statutes;

     (3)  Clarifying that an advanced practice registered nurse can be considered a "licensed mental health professional" authorized to provide mental health treatment or counseling services to a minor only if the advanced practice registered nurse holds an accredited national certification in an advanced practice registered nurse psychiatric specialization; and

     (4)  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, Consumer Protection, and Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 912, H.D. 2, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 912, H.D. 2, S.D. 1, and be placed on the calendar for Third Reading.

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

________________________________

ROSALYN H. BAKER, Chair