HOUSE OF REPRESENTATIVES

H.B. NO.

678

THIRTIETH LEGISLATURE, 2019

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


     SECTION 1.  The legislature finds that the continued training and support of advanced practice registered nurses is necessary to address the State's shortage of primary care providers.  Residents in rural areas often do not have direct access to physicians.  Hospitals have had to expend millions of dollars in order to address the medical issues associated with people experiencing homelessness.  For example, in 2017, Hawaii's largest hospital reported that caring for homeless patients had cost about $90 million per year.  Further, because Medicaid did not reimburse all of the expenses, the hospital absorbed almost $40 million in expenses over a four-year period.

     The purpose of this Act is to support the expansion of primary medical care in the State by: (1) establishing a residency program at the University of Hawaii center for nursing to assist newly-graduated advanced practice registered nurses in transitioning into clinical practice; (2) appropriating funds to the University of Hawaii center for nursing to fund the advanced practice registered nurse residency program; and (3) appropriating funds to the University of Hawaii John A. Burns school of medicine for the advanced practice registered nurse residency loan repayment program.

     SECTION 2.  Chapter 304A, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§304A-    Advanced practice registered nurse residency program; establishment; center for nursing.  (a)  There is established within the University of Hawaii center for nursing an advanced practice registered nurse residency program.  The residency program shall be a six- to nine-month program to provide eligible residency participants with clinical practice experience, with the aim of improving patient care.

     (b)  The dean of the University of Hawaii school of nursing and dental hygiene shall be responsible for:

(1)  Developing and implementing the residency program in cooperation with the nursing profession, medical residency programs, hospitals, and clinics located throughout the State;

(2)  Overseeing the advanced practice registered nurses supervising the eligible residency participants;

(3)  Ensuring that the advanced practice registered nurses supervising the eligible residency participants represent a wide range of specialties;

(4)  Using the Fellowship and Residency Electronic Interactive Database Access System or developing an alternate selection process and procedure to select eligible residency participants;

(5)  Determining the education and training locations for the residency program; provided that priority consideration shall be given to communities in the State where the population, facilities, number of advanced practice registered nurses, and interest in the nursing profession are conducive to success of the residency program and will augment the provision of health care in the State; and

(6)  Adopting rules pursuant to chapter 91 to effectuate the purpose of this section, including determining penalties for violations of subsection (c); establishing the selection criteria for the stipend and loan repayment plans under subsections (d) and (e), respectively; and detailing the notification and process to accelerate loans provided under subsection (e).

     (c)  Service commitment.  Upon completion of the residency program, eligible residency participants may be required to commit to two years of full-time employment at the facility where the residency occurred in the State.  Failure to complete the service commitment by the eligible residency participant may result in financial penalties.

     (d)  An eligible residency participant may qualify for a stipend as part of the residency program.  Any stipend paid to an eligible residency participant shall be paid from the general medical education fund.

     (e)  An eligible residency participant may qualify for a loan repayment plan through the advanced practice registered nurse residency loan repayment program administered through the University of Hawaii John A. Burns school of medicine as follows:

     (1)  The term of any loan to an eligible residency participant shall not exceed seven years from the date of the completion of the residency program by the eligible residency participant or the date that the eligible residency participant leaves full-time practice in a qualified rural area, whichever is sooner;

     (2)  If the eligible residency participant leaves full-time practice in a qualified rural area, the eligible residency participant shall notify the University of Hawaii John A. Burns school of medicine within      days of leaving full-time practice and the loan shall accelerate and become due in full within      days after the notice; and

     (3)  Loans awarded from the advanced practice registered nurse residency loan repayment program shall not exceed       per cent of the total tuition of the residency program.

     (f)  For the purposes of this section:

     "Eligible residency participant" means a person who:

     (1)  Graduated from an accredited graduate nursing program recognized by the Accreditation Commission for Education in Nursing or the Commission on Collegiate Nursing Education and:

          (A)  Holds a current unencumbered license as an advanced practice registered nurse in this State under chapter 457, or successfully obtains licensure prior to participating in the residency program; and

          (B)  Has less than twelve months of experience working in their field of licensure; or

     (2)  Applied for the residency program in the final semester of study at an accredited advanced practice registered nurse program or accredited graduate nursing program recognized by the Accreditation Commission for Education in Nursing or the Commission on Collegiate Nursing Education, and successfully obtains licensure prior to participating in the residency program.

"Qualified rural area" means any area designated as a

medically underserved area/population by the United States health resources and services administration or an area for which the governor has requested designation as an exceptional medically underserved area/population from the United States health resources and services administration."

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $         or so much thereof as may be necessary for fiscal year 2019-2020 to carry out the purposes of this Act; provided that no funds authorized pursuant to this section shall be released unless the University of Hawaii center for nursing secures dollar-for-dollar matching funds for the residency program.

     The sum appropriated shall be expended by the University of Hawaii center for nursing for the purposes of this Act.

     SECTION 4.  There is appropriated out of the general revenues of the State of Hawaii the sum of $         or so much thereof as may be necessary for fiscal year 2019-2020 for the advanced practice registered nurse residency loan repayment program.

     The sum appropriated shall be expended by the University of Hawaii John A. Burns school of medicine for the purposes of this Act.

     SECTION 5.  New statutory material is underscored.

     SECTION 6.  This Act shall take effect on July 1, 2019.

 

INTRODUCED BY:

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Report Title:

Advanced Practice Registered Nurse Residency Program; University of Hawaii; Center for Nursing; Loan Repayment Program

 

Description:

Establishes a residency program to assist newly-graduated advanced practice registered nurses (APRN)in transitioning into a clinical practice.  Appropriating funds for the APRN residency program and the APRN residency loan repayment program.

 

 

 

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