Honolulu, Hawaii


RE: H.B. No. 302

H.D. 1

S.D. 1




Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2021

State of Hawaii




Your Committee on Health, to which was referred H.B. No. 302, H.D. 1, entitled:




begs leave to report as follows:


The purpose and intent of this measure is to:


(1) Authorize advanced practice registered nurses to certify whether a person is totally disabled under the State income tax code;


(2) Authorize advanced practice registered nurses with psychiatric specializations to make capacity determinations; and


(3) Add advanced practice registered nurses with psychiatric specializations as primary providers in advance mental health care directives.


Your Committee received testimony in support of this measure from the Hawaii State Center for Nursing, Board of Nursing, Hawaii American Nurses Association, Hawaii Psychological Association, Hawaii Substance Abuse Coalition, National Association of Social Workers Hawaii Chapter, The Queen's Health Systems, Hawaii Association of Professional Nurses, and four individuals. Your Committee received comments on this measure from the Department of Taxation and one individual.


Your Committee finds that there is a need for greater access to health care in the State, especially in rural communities and on the neighbor islands. Because there is a well-documented physician shortage in the State, authorizing the readily-available advanced practice registered nurse (APRN) workforce to engage in activities within their scope of practice and in accordance with their education, training, and licensure provides a reasonable solution to this problem.


Your Committee recognizes the testimony of the Hawaii State Center for Nursing, which expressed concerns that the definition of "advanced practice registered nurse" currently in the measure is too restrictive and would unnecessarily limit the number of APRNs affected by the measure. The Hawaii State Center for Nursing also proposed an amendment that would adopt a provision that was passed in the Federal Coronavirus, Aid, Relief and Economic Security (CARES) Act authorizing APRNs to order home health care for Medicare patients.


Therefore, your Committee has amended this measure by:


(1) Including a provision authorizing APRNs to order home health care for Medicare patients in conformance with the CARES Act;


(2) Removing from the definition of "advanced practice registered nurse," the requirement that an APRN must hold an accredited national certification in an advanced practice registered nurse psychiatric specialization;


(3) Amending section 1 to reflect its amended purpose;


(4) Making it effective upon its approval; and


(5) 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 that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 302, H.D. 1, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 302, H.D. 1, S.D. 1, and be referred to your Committee on Commerce and Consumer Protection.


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