!!! HAWAII LEGISLATIVE ALERT !!!

Aloha-
I just sent the following letter to Nadine Nakamura, my rep in Kauai. I thought this could be copied and pasted by all to send to your representative. Here is where you find who is your district rep: https://www.capitol.hawaii.gov/fyl/

Dear Representative Nakamura:
My name is JoAnn Lepke, I live in Kilauea and own a private dermatology medical practice in Kapaa (since August 2017) with my husband, Barry Linton. We employ 7 people full time and offer generous benefits to them. Hawaii already has a severe shortage of healthcare providers, one of the worst in the nation. Passage of this bill opens the door to ensure we have even LESS access to quality health care. I am urging you to vote against HCR 139, “REQUESTING THE AUDITOR TO CONDUCT AN ANALYSIS REGARDING THE SCOPES OF PRACTICE FOR ADVANCED PRACTICE REGISTERED NURSES AND PHYSICIAN ASSISTANTS.”
I am writing because it has come to my attention that the Hawaii House of Representatives Health, Human Services, & Homelessness committee plan to present a House Resolution on March 29th at 10am that proposes to erode Full Practice Authority that was granted Hawaii’s APRNs in 2011. There is concerning and damaging language in the introduction to this resolution (whereas), however, our main concerns rely in the request for the (be it resolved) State Auditor who is “requested to conduct an analysis regarding the scopes of practice for advanced practice registered nurses…”. Our significant concerns continue with regard to examining “whether the scope of practice for advanced practice registered nurses… should be expanded in certain areas of medical care and services, including: 4. The records review process for prescriptions of controlled substances, 5. Clinical Laboratory Improvement Amendments waived tests, and 7. Other medical care and services”. As full practice authority APRNs, we are able to prescribe all medications not found on our exclusionary formulary, do not require records reviewed, and are able to receive CLIA waivers for their clinics. Language surrounding changing who can have a waiver as noted in #5 is of concern. Other medical care and services to be reviewed by the Auditor is so nebulous that it threatens the work we do every day. Numbers 1, 2, 3, and 6 are part of other bills that have been introduced this session and are also concerning that they are in this resolution.
Additional concerns include that the “Auditor may include in its analysis a comparison to other jurisdictions and whether those jurisdictions allow for similar expanded scopes of practice…”. Finally, we are concerned “that the Auditor is requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature…”. The State Auditor is NOT a healthcare professional. Hawaii has a long tradition of granting the decision-making regarding each profession to the individual professions’ boards. This removes the review and decision-making process from Nursing.

This is great! Thank you for posting this! I am working out HAPN's response in the next few days. I know that other entities are working out responses too! Keep the ideas coming!

Allowing a non-medical person (the State Auditor) to conduct an audit of medical professionals could set a dangerous precedence. I hope that HAPN members will oppose this and PAs will too.