Honolulu, Hawaii


RE: S.B. No. 839

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 S.B. No. 839 entitled:




begs leave to report as follows:


The purpose and intent of this measure is to:


(1) Authorize advanced practice registered nurses, in addition to physicians, to practice medical aid in dying in accordance with their scope of practice and prescribing authority;


(2) Authorize psychiatric mental health nurse practitioners, in addition to psychiatrists, psychologists, and clinical social workers, to provide counseling to a qualified patient;


(3) Reduce the mandatory waiting period between oral requests from twenty days to fifteen days; and


(4) Waive the mandatory waiting period for those terminally ill individuals not expected to survive the mandatory waiting period.


Your Committee received testimony in support of this measure from Hawaii Psychological Association, Compassion & Choices, Hawaii Society of Clinical Oncology, Hawaiian Islands Association for Marriage and Family Therapy, Hawaii Association of Professional Nurses, Hawaii American Nurses Association, National Association of Social Workers, and forty-nine individuals. Your Committee received testimony in opposition to this measure from Hawaii Family Forum, Hawaii Professionals for Appropriate and Compassionate Care, and seven individuals. Your Committee received comments on this measure from the Board of Nursing and Hawaii State Center for Nursing.


Your Committee finds that the Our Care, Our Choice Act (OCOCA) allows terminally ill individuals to request and receive prescription medication that allows them to pass away in a peaceful, humane, and dignified manner. Your Committee further finds that since the OCOCA was enacted, the Department of Health solicited input from the medical community on the law's implementation. This process has revealed that a shortage of physician on the neighbor islands unintentionally created barriers and burdens in care. This measure amends the OCOCA to ease those barriers while maintaining the safeguards intended to protect patients. Your Committee heard the testimony of the Board of Nursing, which noted that the measure as written excludes clinical nurse specialists who specialize in adult psychiatric mental health from providing care.


Therefore, your Committee has amended this measure by:


(1) Amending the definition of "counseling" to include consultations from clinical nurse specialists;


(2) Amending section 1 of the measure to reflect its amended purpose; and


(3) 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 S.B. No. 839, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 839, S.D. 1, and be referred to your Committee on Judiciary.


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