STAND. COM. REP. NO. 216________

                                 Honolulu, Hawaii
                                                   , 1999

                                 RE: H.B. No. 743
                                     H.D. 1




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

Sir:

     Your Committee on Health, to which was referred H.B. No. 743
entitled: 

     "A BILL FOR AN ACT RELATING TO ADVANCED PRACTICE REGISTERED
     NURSES,"

begs leave to report as follows:

     The purpose of this bill is to improve access to safe and
cost-effective health care by including Advanced Practice
Registered Nurses (APRN) as providers under workers'
compensation, no-fault, and prepaid health care plans.

     The Department of Health, the Hawaii Nurses' Association,
the Hawaii Psychiatric Medical Association, the Hawaii Certified
Nurse-Midwives, the Hawaii Chapter of the American Psychiatric
Nurses Association, and several individuals submitted testimony
in support of this measure.  The Hawaii Medical Service
Association submitted testimony in support of the intent of this
measure.  The Hawaii Medical Association submitted testimony in
opposition of this measure.  Kaiser Permanente submitted
comments.

     Your Committee finds that APRNs are currently recognized as
providers under Medicare and Medicaid, and some categories of
APRNs are recognized as providers under Hawaii's Med-QUEST
program.  APRNs are currently rendering health care services in
their specialty area, and should be covered and reimbursed just
as other providers are.


 
 
                                 STAND. COM. REP. NO. 216________
                                 Page 2

 
     Your Committee has amended this measure by clarifying that
health plans are responsible for providing reimbursement for
covered benefits and services of a plan, not all services that
any provider might make available.

     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.
743, as amended herein, and recommends that it pass Second
Reading in the form attached hereto as H.B. No. 743, H.D. 1, 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