STAND. COM. REP. NO. 161-26

Honolulu, Hawaii

, 2026

RE: H.B. No. 1857

H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

Your Committee on Health, to which was referred H.B. No. 1857 entitled:

"A BILL FOR AN ACT RELATING TO HEALTH CARE,"

begs leave to report as follows:

The purpose of this measure is to implement the recommendations of the Hawaii State Center for Nursing's Healthcare Provider Barriers to Practice Law Review Task Group to remove existing barriers within professional practice acts and support expanded access to care throughout the State.

Your Committee received testimony in support of this measure from the Department of Education; Department of Health; University of Hawaiʻi at Hilo; Board of Nursing; Hawaii Affiliate of the American College of Nurse Midwives; Hawaiʻi State Center for Nursing; Hawaiʻi Psychological Association; Hawaiʻi Association of Professional Nurses; Hawaii Medical Association; Hawaiʻi – American Nurses Association; Hawaiʻi Academy of Family Physicians Legislative Committee; Hawaiʻi Pharmacists Association; Kuaʻana Project; American Association of Nurse Practitioners; Hawaiʻi Academy of Physician Assistants; and six individuals. Your Committee received comments on this measure from the Department of Commerce and Consumer Affairs; Department of Labor and Industrial Relations; Department of Human Services; Department of the Attorney General; Board of Naturopathic Medicine; Board of Pharmacy; Board of Psychology; Hawaii Medical Board; Board of Physical Therapy; Hawaiʻi Association of Nurse Anesthesiology; and numerous individuals.

Your Committee finds that, in 2022, the Hawaii State Center for Nursing convened an interprofessional task group, including advanced practice registered nurses, physician assistants, psychologists, pharmacists, and physicians, to review health care-related provisions of the Hawaii Revised Statutes as compared to each profession's scope of practice established in state law. The task group examined more than five hundred statutes and found widespread inconsistencies in statutory terminology related to health care providers. The task group also identified numerous areas of statute with restrictive language that act as barriers to health care providers practicing within their profession's scope of practice. As a result of the task group's analysis, this measure proposes amendments to nearly two hundred statutes to enable health care providers to fully practice within their scope of practice and fulfill their health care duties for their patients, which will improve access to care in the State.

Your Committee has amended this measure by:

(1) Changing the effective date to July 1, 3000, to encourage further discussion; and

(2) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1857, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 1857, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.

Respectfully submitted on behalf of the members of the Committee on Health,

____________________________

GREGG TAKAYAMA, Chair