STAND. COM. REP. NO. 1355

                                   Honolulu, Hawaii
                                                     , 1999

                                   RE:  S.C.R. No. 193
                                        S.D. 1




Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committees on Health and Human Services and Commerce
and Consumer Protection, to which was referred S.C.R. No. 193
entitled:

     "SENATE CONCURRENT RESOLUTION ESTABLISHING A TASK FORCE TO
     CONDUCT A COMPREHENSIVE REVIEW AND IDENTIFY THE RESOURCES
     NECESSARY TO ENSURE A PATIENT'S RIGHT TO SAFETY AND QUALITY
     NURSING CARE IN HOSPITALS, CLINICS, AND HOME HEALTH CARE
     SETTINGS,"

beg leave to report as follows:

     The purpose of this measure is to establish a task force to
conduct a comprehensive review and to identify resources
necessary to ensure a patient's right to safety and quality
nursing care in hospitals, clinics, and home health care
settings.

     Your Committees received testimony in support of this
measure from the Department of Health (DOH), Hawaii Nurses'
Association (HNA), Hawaii Chapter of the American Psychiatric
Nurses Association, and two private individuals.  Testimony in
opposition was received from the Healthcare Association of
Hawaii. 

     Hawaii's health care system is undergoing a dramatic
transformation due to an increased emphasis on managed care,
changes in health care financing and delivery of service, and
deregulation of the industry, resulting in unprecedented
competition and consolidation among providers.  These trends have

 
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resulted in an increased focus by many Hawaii providers on
survival with a strong emphasis on financial performance,
blurring their mission of providing accessible, high quality
health care.

     Nurses are the front line of medical care in hospitals,
clinics, and home health care.  Nurses are also employees of
institutional or corporate providers of medical care who are most
affected by the transformation in the health care system.  This
measure is intended to ensure that quality patient care from
nurses is not sacrificed or compromised in the name of cost
containment initiatives.

     Your Committees have amended this measure on the
recommendation of the Healthcare Association of Hawaii (HAH) by:

     (1)  Deleting the title and inserting a new title to urge
          the HNA and HAH to begin discussions to identify
          problems and provide solutions for acute-care issues
          relating to patient safety, nursing care, and the
          potential nursing shortage;

     (2)  Deleting Whereas clauses referencing trends, cost
          containment effects, Lewin-VHI Inc.'s report, longer
          hospital stays, mortality rates, Institute of
          Medicine's report, and American Nurses' Association
          activities;

     (3)  Deleting BE IT RESOLVED clauses relating to the task
          force and the tramsmittal clause; 

     (4)  Inserting new BE IT RESOLVED clauses requesting the HNA
          and HAH to:

          (A)  Begin discussions to identify and solve acute-care
               issues relating to patient safety, nursing care,
               and the potential nursing shortage; and

          (B)  Submit a report to the legislature; and

     (5)  Amending the BE IT RESOLVED clause relating to
          transmittal of certified copies to reflect the
          amendments to the measure.

     As affirmed by the records of votes of the members of your
Committees on Health and Human Services and Commerce and Consumer
Protection that are attached to this report, your Committees
concur with the intent and purpose of S.C.R. No. 193, as amended
herein, and recommend that it be referred to the Committee on

 
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Ways and Means, in the form attached hereto as S.C.R. No. 193,
S.D. 1.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committees on Health and Human
                                   Services and Commerce and
                                   Consumer Protection,



____________________________       ______________________________
BRIAN KANNO, Co-Chair              SUZANNE CHUN OAKLAND, Chair



____________________________       
BRIAN T. TANIGUCHI, Co-Chair

 
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