STAND. COM. REP. NO. 3910

Honolulu, Hawaii

RE: H.C.R. No. 187

H.D. 1

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Second State Legislature

Regular Session of 2024

State of Hawaii

Sir:

Your Committee on Health and Human Services, to which was referred H.C.R. No. 187, H.D. 1, entitled:

"HOUSE CONCURRENT RESOLUTION REQUESTING THE LEGISLATIVE REFERENCE BUREAU TO CONDUCT A STUDY ON BEST PRACTICES FOR NURSE STAFFING IN HEALTHCARE FACILITIES,"

begs leave to report as follows:

The purpose and intent of this measure is to request the Legislative Reference Bureau to conduct a study on best practices for nurse staffing in health care facilities.

Your Committee received testimony in support of this measure from the Hawaii State AFL-CIO, Hawaiʻi Nurses' Association-OPEIU Local 50, and one individual.

Your Committee received comments on this measure from the Legislative Reference Bureau, Healthcare Association of Hawaii, and Hawaiʻi State Center for Nursing.

Your Committee finds that the State is facing a persistent health care staffing shortage, which has been exacerbated by the challenges posed by the coronavirus disease 2019 pandemic. Your Committee further finds that as a result of this ongoing shortage, the staff-to-patient ratio has greatly increased, leading to working conditions becoming increasingly unpredictable and unsafe and increasing the rate of burnout among health care professionals. This measure requests the Legislative Reference Bureau to conduct a study to identify best practices in labor standards for health care facilities to help inform lawmakers on how to improve working conditions for health care professionals and increase recruitment and retention.

Your Committee notes the concerns raised in the Legislative Reference Bureau's testimony that the Bureau lacks specific subject matter expertise necessary to conduct the requested study and that they do not have any staff with specific expertise in or particular knowledge of matters relating to health care, health care staffing, patient safety and best practices, or occupational safety. Therefore, there is a need to amend this measure to limit the scope of the requested study.

Accordingly, your Committee has amended this measure by:

(1) Removing language that would have requested the Legislative Reference Bureau to conduct a study on best practices for nurse staffing in health care facilities which would assess and discuss:

(A) Best practices, as set forth by entities such as The Joint Commission, on staffing for hospitals and other settings of care;

(B) The effectiveness of different types of staffing standards in ensuring patient and worker safety, and quality of care;

(C) Existing staffing standards and regulations in other states;

(D) Alternative approaches to staffing standards, such as acuity-based staffing models or nurse-driven staffing decisions;

(E) The experiences and perspectives of health care professionals, including nurses, administrators, and other stakeholders, regarding staffing standards;

(F) The potential benefits and challenges associated with implementing staffing standards in Hawaii; and

(G) The costs of implementing various staffing standards, including nurse-to-patient ratios;

(2) Inserting language to request the Legislative Reference Bureau to conduct a study on best practices for nurse staffing in health care facilities which shall assess and discuss:

(A) Existing nursing staffing standards and regulations in other states; and

(B) A literature review of best practices for staffing and workforce development, along with successful efforts in other states to address the nursing workforce shortage; and

(3) 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 Health and Human Services that is attached to this report, your Committee concurs with the intent and purpose of H.C.R. No. 187, H.D. 1, as amended herein, and recommends its adoption in the form attached hereto as H.C.R. No. 187, H.D. 1, S.D. 1.

Respectfully submitted on behalf of the members of the Committee on Health and Human Services,

________________________________

JOY A. SAN BUENAVENTURA, Chair