Honolulu, Hawaii
                                                   , 1999

                                 RE: S.B. No. 40
                                     H.D. 2

Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii


     Your Committee on Consumer Protection and Commerce, to which
was referred S.B. No. 40, H.D. 1, entitled: 


begs leave to report as follows:

     The purpose of this bill is to change the terminology used
to describe the regulation of physician assistants (PAs), from
"certification" to "licensing."

     Your Committee received testimony supporting this bill from
the Board of Medical Examiners (Board), Hawaii Academy of
Physician Assistants, and several PAs.

     Your Committee finds that the change in terminology proposed
by the bill is intended to allow full implementation of the
Board's PA rules, adopted in 1997 in response to recommendations
of the Legislative Auditor (Auditor), who found that previous
rules were overly restrictive to the detriment of optimal PA
practice and utilization.  In 1998, the Auditor reviewed the
terminology change and found that it would more accurately
reflect regulatory intent and practice, and would have minimal
effect on insurance coverage, and a minimal fiscal impact on the
Department of Commerce and Consumer Affairs.  In addition, the
Auditor found there would be a minimal effect on public health
and safety because the change would not alter safeguards inherent
in the existing supervisory relationship between physicians and

                                 STAND. COM. REP. NO. 1729
                                 Page 2

     Your Committee notes that this bill reflects the substance
of the House companion to this measure, H.B. No. 47, H.D. 1.
Your Committee anticipates that the terminology change proposed
in this bill would have a substantial and intended effect in two
respects, by allowing PAs to:

     (1)  Deliver certain health services that heretofore could
          not be provided because of the "certification"
          terminology used; and

     (2)  Be registered by the Narcotics Enforcement Division to
          prescribe controlled substances in schedules III to V,
          as authorized by the Board in its 1997 rules.

     Your Committee would like to assure that safety concerns are
further considered regarding the ability of PAs to prescribe
controlled substances.  These concerns were expressed when your
Committee heard the House companion to this bill.

     Your Committee has amended this bill to take effect at an
unspecified date for purposes of continued discussion. 

     As affirmed by the record of votes of the members of your
Committee on Consumer Protection and Commerce that is attached to
this report, your Committee is in accord with the intent and
purpose of S.B. No. 40, H.D. 1, as amended herein, and recommends
that it pass Third Reading in the form attached hereto as S.B.
No. 40, H.D. 2.

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

                                   RON MENOR, Chair