STAND. COM. REP. NO. 3^10
Honolulu, Hawaii
APR 1 9 2024
RE: H.C.R. No. 187
H.D. 1
S.D. 1
Honorable Ronald D. Kouchi
President of the Senate
Thirty-Second State Legislature
Regular Session of 2024
State of Hawaii
Sir:
Your Committee on Health and Human Services, to which was
referred H.C.R. No. 187, H.D. 1, entitled:
"HOUSE CONCURRENT RESOLUTION REQUESTING THE LEGISLATIVE
REFERENCE BUREAU TO CONDUCT A STUDY ON BEST PRACTICES FOR
NURSE STAFFING IN HEALTHCARE FACILITIES,"
begs leave to report as follows:
The purpose and intent of this measure is to request the
Legislative Reference Bureau to conduct a study on best practices
for nurse staffing in health care facilities.
Your Committee received testimony in support of this measure
from the Hawaii State AFL-CIO, Hawai‘i Nurses' Association-OPEIU
Local 50, and one individual.
Your Committee received comments on this measure from the
Legislative Reference Bureau, Healthcare Association of Hawaii,
and Hawai‘i State Center for Nursing.
Your Committee finds that the State is facing a persistent
health care staffing shortage, which has been exacerbated by the
challenges posed by the coronavirus disease 2019 pandemic. Your
Committee further finds that as a result of this ongoing shortage,
the staff-to-patient ratio has greatly increased, leading to
working conditions becoming increasingly unpredictable and unsafe
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 STAND. COM. REP. NO.
and increasing the rate of burnout among health care
professionals. This measure requests the Legislative Reference
Bureau to conduct a study to identify best practices in labor
standards for health care facilities to help inform lawmakers on
how to improve working conditions for health care professionals
and increase recruitment and retention.
Your Committee notes the concerns raised in the Legislative
Reference Bureau's testimony that the Bureau lacks specific
subject matter expertise necessary to conduct the requested study
and that they do not have any staff with specific expertise in or
particular knowledge of matters relating to health care, health
care staffing, patient safety and best practices, or occupational
safety. Therefore, there is a need to amend this measure to limit
the scope of the requested study.
Accordingly, your Committee has amended this measure by:
(1) Removing language that would have requested the
Legislative Reference Bureau to conduct a study on best
practices for nurse staffing in health care facilities
which would assess and discuss:
(A) Best practices, as set forth by entities such as
The Joint Commission, on staffing for hospitals and
other settings of care;
(B) The effectiveness of different types of staffing
standards in ensuring patient and worker safety,
and quality of care;
(C) Existing staffing standards and regulations in
other states;
(D) Alternative approaches to staffing standards, such
as acuity-based staffing models or nurse-driven
staffing decisions;
(E) The experiences and perspectives of health care
professionals, including nurses, administrators,
and other stakeholders, regarding staffing
standards;
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 STAND. COM. REP. NO. ^^10
Page 3
(F) The potential benefits and challenges associated
with implementing staffing standards in Hawaii; and
(G) The costs of implementing various staffing
standards, including nurse-to-patient ratios;
(2) Inserting language to request the Legislative Reference
Bureau to conduct a study on best practices for nurse
staffing in health care facilities which shall assess
and discuss:
(A) Existing nursing staffing standards and regulations
in other states; and
(B) A literature review of best practices for staffing
and workforce development, along with successful
efforts in other states to address the nursing
workforce shortage; 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 and Human Services that is attached to this
report, your Committee concurs with the intent and purpose of
H.C.R. No. 187, H.D. 1, as amended herein, and recommends its
adoption in the form attached hereto as H.C.R. No. 187, H.D. 1,
S.D. 1.
Respectfully submitted on
behalf of the members of the
Committee on Health and Human
Services,
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 The Senate
Thirty-Second Legislature
State of Hawai‘i
Record of Votes
Committee on Health and Human Services
HHS
Bill / Resolution No.:* Committee Referral: Date:
\4c-R WDi HUS
__ The Committee is reconsidering its previous decision on this measure.
If so, then the previous decision was to:________________________________________________
The Recommendation is:
__ Pass, unamended xz'^Pass, with amendments Hold Recommit
2312 2311 2310 2313
Members Aye Aye (WR) Nay Excused
SAN BUENAVENTURA, Joy A. (C)
AQUINO, Henry J.C. (VC)
KEOHOKALOLE, Jarrett
SHIMABUKURO, Maile S.L
AWA, Brenton
TOTAL
Recommendation:
Adopted [_] Not Adopted
Chair’s or Designee’s Sign atu
Distribution; Original Yellow Pink Goldenrod
File with Committee Report Clerk's Office Drafting Agency Committee File Copy
*Only one measure per Record of Votes
Revised; 12/27/23