SB2274 SD2

SECTION 1. The legislature finds that Act 198, Session Laws of Hawaii 2003 (Act 198), established the Hawaii state center for nursing (HSCN) to collect and analyze data and prepare and disseminate written reports and recommendations regarding the current and future status and trends of the nursing workforce; conduct research on best practices and quality outcomes; develop a plan for implementing strategies to recruit and retain nurses; and research, analyze, and report data related to the retention of the nursing workforce. Act 198 also requires that nurses shall fund the activities of the HSCN through an additional fee assessed upon the issuance and renewal of each nurse license.

The legislature further finds that, since 2003, the HSCN has created multiple statewide initiatives and programs to address nursing workforce needs, prevent anticipated workforce shortages, and conduct workforce research on the nursing supply and education capacity for nurse education. Many of these programs are notable for being the first statewide programs in the nation and having broad partnerships with nursing employers and schools of nursing. Specifically, the HSCN's Hawaii academic progression in nursing initiative led the State to become the most highly educated nursing workforce in the nation by 2019. The outcomes of increasing the minimum education for nurses include improved patient care and safety; reduction by readmission rates, lengths of stay, and deaths; and improved cost savings. Additionally, the HSCN led the State by developing the Hawaii nurse residency program collaborative, which, as of 2020, has facilitated the hiring and support of over one thousand new graduate nurses in their first year of employment and increased retention rates.

The legislature further finds that HSCN has helped increase access to health care services in rural and underserved communities in the State through policy reforms, program development, and initiating changes in the nursing environment. Through collaborative efforts led by the HSCN, the advanced practice registered nurse workforce in the State has doubled, making health care more accessible, especially for neighbor island residents.

The legislature further finds that the HSCN has maintained continuous workforce research efforts since 2007 and improved the visibility of the nursing workforce and education capacity. Most recently, the HSCN produced data reports that the department of health and the Hawaii emergency management agency used for crisis response, vaccination planning, and other uses. The HSCN continues to play a critical role in the response to the coronavirus disease 2019 (COVID-19) pandemic. The HSCN also participated in increasing relevant, locally-produced, and accredited nursing professional development content on COVID-19 for nurses in all settings of care, and co-led an initiative with stakeholders to identify and tactically respond to provider shortages.

The legislature further finds that, since 2003, when the center for nursing fee was established, the cost of goods and services have increased in Hawaii. Additionally, the legislature finds that challenges to securing adequate nursing workforce supply survey responses have severely limited the HSCN's ability to continue to inform policy makers, health care leaders, and others on the availability and characteristics of the nursing workforce in the State. To ensure public safety during episodes of critical health care demands, including pandemics and natural disasters, as well as providing robust nursing care and a resilient nursing workforce at all times, crucial information and additional funding is needed. Therefore, the purpose of this Act is to:

(1) Require all nurses to respond to the center for nursing workforce supply survey in conjunction with license renewal; provided that license renewal shall not be contingent upon responding to the workforce supply survey and failure to respond to the workforce supply survey shall not result in encumbrance of the nurse's license; and

(2) Increase the additional center for nursing fee from $40 per licensing biennium to $60 per licensing biennium.

SECTION 2. Section 457-9, Hawaii Revised Statutes, is amended to read as follows:

"§457-9 Renewal of license; inactivation and reactivation of license; restoration of forfeited license. (a) The license of every person licensed or granted prescriptive authority shall expire on June 30 of every odd-numbered year and shall be renewed biennially, except as provided in this section. Biennially in each odd-numbered year, the board shall make available an application for renewal of license before the deadline set forth by the board to every person to whom a license was issued or renewed during the biennium. The applicant shall complete the application and submit it to the board with a renewal fee, and shall also submit, beginning with the July 1, 2019, licensing biennium, a full set of electronic fingerprints for the purpose of obtaining federal and state criminal history record checks in accordance with section 846‑2.7, directly to the Hawaii criminal justice data center for processing with the Federal Bureau of Investigation. The applicant shall bear the cost of the fingerprint processing and the application shall not be considered complete until the results of the criminal history record check has been received by the board; and all required documents on or before the deadline set by the board. The applicant shall provide documents from proper agencies or parties of any criminal conviction or any disciplinary action taken or pending in this State or any other state in the United States or any territory or possession under the jurisdiction of the United States within the two years prior to application for renewal of license. Upon receipt of the application and fee, the board shall verify the accuracy of the application and issue to the applicant a certificate of renewal for the biennium expiring two years hence on the deadline set by the board. The renewal shall render the holder thereof a legal practitioner of nursing for the period stated on the renewal form. The applicant shall respond to the center for nursing workforce supply survey in conjunction with each license renewal application submitted pursuant to this subsection; provided that no license renewal shall be contingent upon responding to the center for nursing workforce supply survey; provided further that failure to properly respond to the center for nursing workforce supply survey shall not result in an encumbrance on the applicant's license.

(b) Any licensee who fails to renew a license as provided in subsection (a) but continues to practice shall be considered an illegal practitioner and shall be subject to the penalties provided for violations of this chapter. The failure to timely renew a license[,]; the failure to pay all applicable fees[,]; the dishonoring of any check upon first deposit[,]; or the failure to comply with any other requirement provided by law, except the requirement to complete the center for nursing workforce supply survey pursuant to subsection (a), shall cause the license to be automatically forfeited; provided that the person's license may be restored by the board within two years after the date of forfeiture upon compliance with the licensing renewal fees, penalty fees, and compliance resolution fund fees.

A nurse who does not intend to practice nursing in the State and elects to be placed on inactive status shall so indicate in writing during the license renewal period or by so indicating on the license renewal application, and paying inactivation and all appropriate fees. Should the nurse wish to resume nursing at some future time, the nurse shall notify the board in writing and remit the reactivation and renewal fees; submit an application form as provided in subsection (a); and beginning with the July 1, 2019, licensing biennium, submit a full set of electronic fingerprints for the purpose of obtaining federal and state criminal history record checks in accordance with section 846-2.7, directly to the Hawaii criminal justice data center for processing with the Federal Bureau of Investigation. The applicant shall bear the cost of the fingerprint processing and the application shall not be considered complete until the results of the criminal history record check has been received by the board. A nurse who has not actively practiced in this State or any other state in the United States or any territory or possession under the jurisdiction of the United States for more than five years may be required by the board to submit proof of continued competency by retaking and passing the licensing examination or successfully completing appropriate continuing education recognized by the board.

(c) As used in this section, "center for nursing workforce supply survey" means the nursing workforce supply survey conducted biennially by the center for nursing that asks nurses to provide information about each nurse's demographics, specialty, setting of work, and other information necessary to inform the State on the status and characteristics of the State's nursing workforce."

SECTION 3. Section 457-9.5, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"[[](a)[]] Upon the issuance of a new license and at each license renewal period, each nurse shall pay an additional fee of [~~$40,~~] $60, which shall be deposited in a separate account in the compliance resolution fund established pursuant to section 26-9(o)."

SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2050.

THE SENATE	S.B. NO.	2274
THIRTY-FIRST LEGISLATURE, 2022		S.D. 2
STATE OF HAWAII