Honolulu, Hawaii
                                                   , 1999

                                 RE: S.B. No. 498
                                     S.D. 1

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


     Your Committee on Health, to which was referred S.B. No.
498, S.D. 1, entitled: 


begs leave to report as follows:

     The purpose of this bill is to allow the Board of Nursing
(Board), instead of the Department of Commerce and Consumer
Affairs (DCCA), to grant prescriptive authority to advanced
practice registered nurses (APRNs), provided that an advisory
committee provides recommendations to the Board regarding
prescriptive authority, including the prescribing of controlled
substances in schedules II to V under the Uniform Controlled
Substances Act by recognized APRNs.

     The Board, the Hawai'i Nurses' Association, the Hawaii Long
Term Care Association, Ohana Counseling Services, the University
of Hawaii at Manoa School of Nursing, the National Association of
Social Workers, Hawaii Chapter, the American Psychiatric Nurses
Association, Hawaii Chapter, and several individuals testified in
support of this bill.  The Department of Health, the Board of
Medical Examiners, and two individuals commented on this bill.
The Hawaii Medical Association, the Hawaii Psychiatric Medical
Association, the Pharmacy Association of Hawaii, the Honolulu
County Medical Society, and several individuals testified in
opposition to this bill.

                                 STAND. COM. REP. NO. 1282
                                 Page 2

     Your Committee recognizes that of the 33 states that allow
APRNs to prescribe controlled substances, 23 of those states
allow APRNs to prescribe schedule II-V controlled substances.  In
its deliberations, your Committee raised the following concerns:

     (1)  To what extent is there a need to allow APRNs to
          prescribe schedule II-V controlled substances; and

     (2)  How many practitioners would be allowed to prescribe
          schedule II-V controlled substances under this bill.

     Your Committee requests the subsequent Committee to examine
whether the Board is the appropriate entity to grant prescriptive
authority to APRNs, rather than DCCA.

     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 S.B. No.
498, S.D. 1, and recommends that it pass Second Reading and be
referred to the Committee on Consumer Protection and Commerce.

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

                                   ALEXANDER C. SANTIAGO, Chair