BOARD OF NURSING Professional and Vocational Licensing Division

Department of Commerce and Consumer Affairs State of Hawaii

MINUTES OF MEETING

The agenda for this meeting was filed with the Office of the Lieutenant Governor as required by Section 92-7(b), Hawaii Revised Statutes (“HRS”).

Date: Thursday, June 6, 2019 Time: 9:00 a.m. Place: Queen Liliuokalani Conference Room

King Kalakaua Building 335 Merchant Street, 1st Floor Honolulu, Hawaii 96813

Members Present: Thomas Joslyn, MS, CRNA, Chair Olivia Kim, BSN, BS, RN, LPN, NHA, Vice Chair

Karen Boyer, MS, RN, FNP Katharyn Daub, MNEd, EdD, RN Jomel Duldulao, Public Member

Judy Kodama, MSN, MBA, RN, CNML Tammie Napoleon, DNP, APRN, PPCNP-BC

Carrie Oliveira, Public Member Amy Stone-Murai, APRN Staff Present: Lee Ann Teshima, Executive Officer (“EO”) Shari Wong, Deputy Attorney General (“DAG”) Nohelani Jackson, Secretary Guests: Dean Yamamoto, Narcotics Enforcement Division Kelsey Trujillo, DKICP, NED Intern Laura Reichhardt, Executive Director, Hawaii State Center for Nursing (“HSCFN”) Shawn Luiz Laura Ozak Jailu Navarrete, American Nurses Association (“ANA”) of Hawaii Call to Order: The Chair called the meeting to order at 9:25 a.m. at which time quorum was

established. Chair’s Report: Announcements/Introductions The Chair asked the audience to introduce themselves and welcomed the Board’s

new member, Ms. Amy Stone-Murai.

Board of Nursing Minutes of June 6, 2019 Meeting Page 2

Approval of the Previous Minutes –May 2, 2019

The Chair called for a motion regarding the minutes of the May 2, 2019 meeting. Upon a motion by Ms. Daub, seconded by Dr. Napoleon, it was voted on and unanimously carried to approve the minutes of the May 2, 2019 meeting as circulated.

Executive Officer’s Conferences/Seminars/Meetings Report:

The EO announced the individuals would be attending the following: 2019 Discipline Case Management Conference, June 10-12, 2019, Memphis,

Tennessee – DAG Attending

2019 NCSBN Annual Meeting, August 21-23, 2019, Chicago, Illinois – The Vice Chair and Mr. Duldulao Attending The following information was distributed to the Board members. i. Summary of Recommendations to the 2019 Delegate Assembly ii. NCSBN Strategic Plan – Proposed iii. Advanced Practice Registered Nurse Compact – Revisions iv. NCSBN Associate Member Application – Puerto RICO v. NCSBN Associate Member Application – Spanish General Council of

Nursing vi. 2020 NCLEX-PN Test Plan vii. 2019 Slate of Candidates

The Chair asked the Board members to email the EO any concerns for discussion at the July meeting. 2019 NCLEX Conference, September 9, 2019, Phoenix, Arizona – Ms. Boyer Attending

The EO reminded the members that if they are attending any NCSBN

meeting/conference/seminar, that their NCSBN account must be “active”. 2019 Legislative Session The EO gave the following report on the remaining bills. APRN Reimbursement

SB 25, SD2, HD1, CD1 Relating to Insurance – This bill was enrolled to the Governor on 5/6/2019.

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APRN Related HB 658, HD1, SD1, Relating to Health – This bill establishes the advanced practice registered nurse medical leadership working group chaired by the Department of Health to research and make recommendations regarding advanced practice registered nurses' eligibility for medical leadership positions. (SD1) The House originally disagreed with the Senate’s amendments ( (1) Include a purpose section; (2) Establish the advanced practice registered nurse medical leadership working group (“working group”) to be convened by the Department of Health and chaired by the Director of Health; (3) Specify that the working group is to research and make recommendations regarding APRNs' eligibility for medical leadership positions and identify any circumstances where that eligibility may be inappropriate; (4) Require the working group to report its findings and any proposed legislation to the Legislature prior to the 2020 Regular Session; and (5) Change its effective date to upon approval.), however, the House reconsidered and agreed with the Senate draft. This bill passed final reading on 5/1/19 and was transmitted to the Governor on 5/1/2019.

Other

SB 1404, SD2, HD1, Relating to Loan Repayment for Health Care Professionals – This bill appropriates funds for the Health Care Provider Loan Repayment Program administered through the John A. Burns School of Medicine of the University of Hawaii at Manoa; provided that the funds are matched on a dollar-for-dollar basis by a private or another public source. (CD1). Section 1 of the bill clarifies further that the purpose of this Act is to appropriate funds to the Department of Health to fund the health care provider loan repayment program administered through the John A. Burns school of medicine to provide loan repayment for physicians, physician assistants, psychologists, nurse practitioners, social workers, marriage and family therapists, and nurses who agree to work in a federally-designated health professional shortage area or in a geographic area of Hawaii found to be underserved. This bill passed final reading on 4/30/19 and was enrolled to the Governor on 5/6/2019.

SB 385, SD1, HD2, CD1, Relating to Professional and Vocational Licensing – This bill repeals defaults on student loans, student loan repayment contracts, and scholarship contracts as grounds for sanctioning professional and vocational licensees. (CD1). This bill was amended in conference by: (1) Repealing language that allows the right to a hearing and appeal from an order suspending, revoking, or refusing to extend any license by the Insurance Commissioner; (2) Reverting to the existing statutory language that requires the Insurance Commissioner, under certain conditions, to renew, reinstate, or grant an insurance producer's license only upon receipt of an authorization from the administering entity; (3) Changing the effective date to upon approval; and (4) Making technical, non-substantive amendments for the purposes of clarity and consistency. This bill passed final reading on 4/30/19 and was enrolled to the Governor on 5/6/2019.

Working Solutions – May 2019 A copy was distributed to the Board members as information only.

Board of Nursing Minutes of June 6, 2019 Meeting Page 4

2019 Renewal Continuing Competency

Advanced Wilderness Life Support Certification Course

The Board discussed an email request for this certification course to see if it would qualify for CE and/or a Board recognized national certification.

The national certification, AWLS certification is not currently listed in the continuing

competency booklet. So, the Board considered the course for continuing education. The information reviewed by the Board indicated that AWLS is approved for AMA

PRA Category 1 credits through the Wilderness Medical Society and that the AWLS program is also approved by ACEP, AAFP and AAPA, which are not listed on the approved provider list for CE in the Continuing Competency booklet

The Board discussed if the course met the following definitions: "Certification" means a form of specialized credentialing, under sponsorship of a

recognized national certifying body that has verified an applicant's advanced knowledge, skills, and abilities in defined areas of nurse practice specialties as listed in section 16-89-85. (Definition of “Certification” in HAR 16-89-2)

"Competency" means the ability of a nurse to integrate knowledge, skills, judgment

and personal attributes to practice safely and ethically in the professional nursing position and in accordance with the scope of nationally recognized nursing practices. (Definition of “Competency” in HRS 457-2)

"Continuing competency" means the long-term educational and professional

process by which an individual undertakes and documents with verifiable evidence a personal learning plan that encompasses a periodic self-assessment of personal strengths and weaknesses as present in the individuals practice as a nurse as well as a commitment to furthering the individual's professional knowledge relating to the nursing field. (Definition of “Continuing competency” in HRS 457-2)

After careful consideration, it was the consensus of the Board that the above-

mentioned course hours would count towards the continuing education hours because of the AMA credits by the ACCME, who is a Board recognized provider of continuing education for nurses.

Board of Nursing Minutes of June 6, 2019 Meeting Page 5

Request for Extension (of continuing competency requirement(s))

The EO requested clarification from the Board for requests for extension of the continuing competency requirements. She stated that HRS §457-9.2 allows the Board to extend the deadline for compliance with the continuing competency requirements on a case by case basis and that prior to the expiration of the license, a nurse may submit a written request for an extension and any documentation, including documentation requested by the Board to substantiate the reason for the extension of the deadline for compliance with the continuing competency requirement based on the following:

(1) Illness, as certified by a physician or osteopathic physician licensed under

chapter 453 or advanced practice registered nurse licensed under chapter 457 in the jurisdiction in which the licensee was treated; or

(2) Military service under extended active duty with the armed forces of the United

States.

After further discussion, it was the consensus of the Board:

1. Delegate to the EO to approve extension requests that: a) Illness – Up to 6 months, unless specified in the physician or APRNs note; b) Military service – Dependent on the orders

2. If the physician or APRN is NOT licensed pursuant to HRS Chapters 453 or

457, the Board is unable to approve the extension request. The Board did note that this section specifying that the physician or APRN be licensed pursuant to these specific sections should be reconsidered and possibly amended in case the nurse is living in another jurisdiction and is under the care of a physician or APRN who is not licensed pursuant to HRS Chapters 453 or 457.

Criminal History Background Check Request for Extension (of fingerprint for criminal background history check)

The EO requested clarification for extension requests for fingerprinting requirement for those randomly selected for the purpose of renewal of a nurse license pursuant to HRS §§457-5 and 457-9.

The EO also reported that if a nurse is unable to be fingerprinted at an authorized

Fieldprint site, i.e. out of the country, the nurse may request fingerprint cards be mailed to them. Individuals then get fingerprinted by an authorized vendor of Fieldprint and mail the fingerprint cards directly to the Hawaii Criminal Justice Data Center.

After further discussion and review of HRS §§457-5 and 457-9, the Board

determined that these sections do not authorize the Board to grant extensions for the criminal history records check.

Board of Nursing Minutes of June 6, 2019 Meeting Page 6

Correspondence: NCSBN Legislative Updates The Board noted the following bills introduced or new laws enacted in other states:

• 5/3/2019 ENACTED

IN H 1344 SUMMARY: Enacts the nurse licensure compact. IN H 1652 SUMMARY: Provides that a qualified medication aide certified may administer insulin to residents of a licensed health facility if a registered nurse supervises the administration. MD H 648 SUMMARY: Enters state into the Interstate Physical Therapy Licensure Compact. NE L 556 SUMMARY: Along with other amendments, provides that prior to prescribing Schedule II drugs, a physician, physician assistant, dentist, pharmacist, optometrist, certified nurse midwife, certified registered nurse anesthetist or nurse practitioner shall discuss with the patient the risks of addiction and overdose associated with controlled substances or the opiates being prescribed. OK H 1057 SUMMARY: Creates the Psychology Interjurisdictional Compact. OK S 388 SUMMARY: Allows certified nurse aides to assist with self-administration of medication under certain conditions. OK S 670 SUMMARY: Directs the acceptance of licenses and certifications from other states for certain military persons entering this state; requires temporary reciprocal license and certifications; provides for temporary license terms. TN S 53 SUMMARY: Creates exemptions to licensure requirements, for health professionals–including chiropractors, dentists, physicians, nurses, optometrists, psychologists, veterinarians, occupational therapists–who are participating in federal Innovative Readiness Training programs. INTRODUCED APRN LA S 240 SUMMARY: Provides authority for APRNs and physician assistants to provide MAT; in order to provide MAT their collaborating or supervising physician shall also be authorized and in compliance with all federal and state laws and rules authorizing the provision of MAT. LA SCR 78 SUMMARY: Requests the State Board of Nursing and the State Board of Medical Examiners to report on the number of APRNs and the number of physician assistants that provide MAT in the State.

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OPIOID EPIDEMIC ME H 1192 SUMMARY: Requires a health care provider, who is a prescriber of any opioid medication or a medication that is a Schedule II drug, to inform a patient of the risks of using the medication. OTHER NOTABLE BILLS NY S 5424 SUMMARY: Assesses an employer a civil penalty when they requires a nurse to work more than their regularly scheduled work hours; further provides that the employee shall receive an additional fifteen percent of the overtime payment from the employer for each violation. RI S 826 SUMMARY: Amends the definition of the practice of pharmacy to include the authority to prescribe drugs and devices. SC H 4522 SUMMARY: Allows volunteer school personnel who have been trained by a registered nurse to administer glucagon or insulin to certain students.

• 5/10/2019 ENACTED

AL S 38 SUMMARY: Enacts the Enhanced Nurse Licensure Compact. IA H 694 SUMMARY: Establishes an emergency medical services personnel

licensure interstate compact. IN S 141 SUMMARY: Requires physician supervising health care providers

providing MAT to obtain a waiver under the federal Drug Addiction Treatment Act and creates practice requirements for office-based MAT treatments by health care providers.

TN H 1350 SUMMARY: Requires the executive director of the Board of

Nursing to report concerning workforce needs for nurses in healthcare institutions and facilities in this state and the need for any beneficial changes to the educational training of nurses in order to meet those needs to the health committee of on or before January 15, 2020.

INTRODUCED APRN MA H 3722 SUMMARY: Expands the role of nurse practitioners in psychiatric

facilities. OPIOID EPIDEMIC RI H 6086 SUMMARY: Increases the members of public school personnel to

include all trained school administrators, teachers, or school resource officers among those authorized to administer an opioid antagonist where there is an emergency drug overdose in a school setting.

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MED MARIJUANA DE S 79 SUMMARY: A registered qualifying patient shall not be subject to

arrest, prosecution, or denial of any right or privilege, including but not limited to civil penalty or disciplinary action by a court or occupational or professional licensing board or bureau, for the medical use of marijuana.

NY A 7467 SUMMARY: Provides that medical marijuana may be used as part

of the treatment of a patient's condition and removes the serious designation of such condition; provides that a practitioner be authorized to prescribe controlled substances in the state and removes the requirement that a physician prescribe such medical marijuana;

STAFF RATIO SIMILAR: US S 1357 SUMMARY: US H 2581 Establishes direct care

registered nurse-to-patient staffing ratio requirements in hospitals. OTHER NOTABLE BILLS DE H 144 SUMMARY: Expands the offense of Assault in the Second

Degree to include the intentional assault of ambulance operators, rescue squad members, and nurses injured while performing work-related duties.

DE S 83 SUMMARY: Authorizes state to join the Physical Therapy

Licensure Compact. US S 1362 SUMMARY: Makes demonstration grants to eligible local

educational agencies in order to increase the numbers of school nurses in public elementary schools and secondary schools.

• 5/17/2019 ENACTED MD H 116 SUMMARY: Repeals the requirement for inmates be placed on methadone detoxification under certain circumstances; requires State and local correctional facilities to provide certain treatments to inmates suffering from opioid use disorder.

MD H 605 SUMMARY: Includes psychiatric nurse practitioners who are providing Assertive Community Treatment or mobile treatment services to Medical Assistance Program recipients in the types of providers eligible to receive reimbursement for health care services. SIMILAR: MD S 944 MD H 1122 SUMMARY: Includes provisions authorizing a psychiatric nurse practitioner to serve as a medical director of a certain outpatient mental health center, including through telehealth. NV A 147 SUMMARY: Authorizes an APRN to order home health care for a patient. OK H 1373 SUMMARY: Requires certain entities list criminal records that disqualify applicant from licensure or certification.

Board of Nursing Minutes of June 6, 2019 Meeting Page 9

SC S 132 SUMMARY: Provides certain orders physician assistants may place to be performed by licensed personnel pursuant to the scope of practice of the physician assistant; provides that the board of medical examiners may approve physician assistants to enter into nondisciplinary alternative programs. TO GOVERNOR CO H 1203 SUMMARY: Concerns the creation of a grant program to increase the number of school nurses in the Department of Public Health and Environment. CO S 227 SUMMARY: Authorizes schools to obtain a supply of opiate antagonists. NH H 350 SUMMARY: Adds physician assistants as prescribing providers for purposes of the Use of Cannabis for Therapeutic Purposes Law.

OR H 3030 SUMMARY: Allows professional licensing board to issue temporary authorization to spouse of member of Armed Forces who holds out of state authorization to provide occupational or professional service. INTRODUCED APRN IL S 2256 SUMMARY: Provides that a person licensed as a CRNA may administer radiation to a human being (if accredited by the Emergency Management Agency, or under supervision), apply ionizing radiation to human beings as required by their course of study, or perform certain diagnostic radiography procedures. NY S 5885 SUMMARY: Relates to CRNAs; provides that for such certification an applicant shall file an application, be licensed as a registered professional nurse, have satisfactorily completed educational preparation for the administration of anesthesia by an accredited entity and pay a fee. OH H 11 SUMMARY: Creates a grant program to increase provision of prenatal services by health care providers including CNMs and NPs. OTHER NOTABLE BILLS ME S 580 SUMMARY: Adds failure by a licensee to provide treatment records to a patient within a reasonable time when requested by the patient in writing as a new ground for discipline. NJ S 3664 SUMMARY: Concerns professional licensing and application fees for spouse or dependent of active duty member of the Armed Forces. NV A 534 SUMMARY: Grants the governor powers to authorize providers of emergency medical services and providers of mental health services who are

Board of Nursing Minutes of June 6, 2019 Meeting Page 10

not licensed, certified or registered, as applicable, in the State but hold a similar credential in good standing in another state or territory to assist in responding to the emergency or disaster.

• 5/23/2019 ENACTED NV S 134 SUMMARY: Authorizes an APRN to make certain certifications, diagnoses and determinations in lieu of a physician or other health care provider. OR S 136 SUMMARY: Removes ten-day supply limitation on prescriptions for certain controlled substances issued by CRNAs. TX H 278 SUMMARY: Requires APRNs and collaborating physicians meet once a month; eliminates requirement that the meetings be face-to-face. TO GOVERNOR AL H 245 SUMMARY: Provides for direct reimbursement for the services of a CRNA by insurers. CO S 228 SUMMARY: Requires APRNs and other prescribers to complete substance use disorder training; prohibits APRNs and other prescribers from accepting benefits for prescribing specific medications; requires opioid prescriptions to bear warning labels. OK H 2341 SUMMARY: Broadens practitioners who may make referrals by including APRNs. SC H 3821 SUMMARY: Allows APRNs to sign death certificates. INTRODUCED HEALTH PROFESSIONAL COMPACTS NJ A 5406 SUMMARY: Enters State into Interstate Medical Licensure Compact. PA S 655 SUMMARY: Authorizes the Commonwealth to join the Nurse Licensure Compact. OTHER NOTABLE BILLS AL S 425 SUMMARY: Establishes guidelines for the use of buprenorphine in nonresidential treatment programs. MI S 340 SUMMARY: Allows for remote pharmacies under certain circumstances.

Board of Nursing Minutes of June 6, 2019 Meeting Page 11

MN S 2901 SUMMARY: Requires hospitals to provide registered nurse staffing at levels consistent with nationally accepted standards.

New Safe Harbor for Nurses Law in New Mexico The Vice Chair reported that a new law in New Mexico, the Safe Harbor Nurses Act, is intended to protect nurses from adverse action by a facility when a nurse makes a good faith request to be allowed to reject an assignment on the basis of the nurse’s assessment of his/her education, knowledge, competence or experience and the nurse’s immediate assessment of the risk for patient safety, or violation of the nurse practice act or board of nursing rules. The law allows a nurse to invoke the safe harbor law when he/she questions the medical reasonableness of another health care provider’s order that the nurse is required to execute.

eNLC Update

The Chair reported that Indiana and Alabama have joined the eNLC bringing the number to 33 states who have joined the compact.

The Chair also recommended that a committee be formed to address the Board’s

concerns and to dialogue with NCSBN.

Scope of Practice

Nurse Performing Battlefield Acupressure The Board discussed the following email inquiry: “I work at VA Pacific Islands in the Nursing Education office as the Health Promotion Disease Prevention Program Manager and the Whole Health Lead. I am wanting to coordinate an acupressure course (Battlefield Acupressure – for pain) for nurses here at our facility. Is this permissible according to our scope of practice?”

Ms. Boyer stated that according to the Scope of Practice Decision Making Framework, acupressure is not specifically prohibited in the nurse practice act.

The EO noted that she checked with the Board of Massage Therapy and was informed that acupressure is considered an advanced modality of massage therapy and therefore falls within the practice of massage therapy which requires a massage therapist license, however, HRS Chapter 452-21 refers to an exemption for “healing arts” and that nurses may fall under that exemption.

After careful consideration, it was the consensus of the Board to refer the inquirer to the Scope of Practice Decision Making Framework posted on the Board’s webpage.

Board of Nursing Minutes of June 6, 2019 Meeting Page 12

Widespread Misapplication by Physicians, Pharmacies of CDC Guidelines The Board discussed the following email: “Aloha,

I am writing to ask the MEDICAL BOARD and the PHARMACY BOARD: What are you doing to mitigate the damages done and continue to be done to stable long-term pain Hawaiian patients by mis-informed physicians and pharmacies in Hawaii, who continue to lie to patients, errantly blaming the state government and DEA, and errantly citing CDC guidelines as a justification for forcing opioid dosage limits and tapers in stable long-term pain patients?

At this point, both boards need the to emergently inform all physicians and pharmacies against such practices since the CDC justification has been found to be groundless, and in my opinion, does constitute medical malpractice. It is immoral and goes completely against ADA statutes that protect the disabled.

I will again cite recent CDC warnings against such practices: ““In 2016, the Centers for Disease Control and Prevention (CDC) issued prescribing guidelines to reduce the risks associated with long-term opioid therapy for chronic pain. What followed, however, was widespread misapplication by physicians, as well as insurers, government agencies, pharmacy chains, and health employers, which invoked the guideline as grounds to involuntarily reduce — and in some cases cease — opioid treatment for many chronic pain patients.” ( https://www.aei.org/press/chronic-pain-patients-to-benefit-as-centers-for-disease-control-and-prevention-reexamines-opioid-prescription-guidelines/)

I write this as a member of the Oahu medical community who has direct knowledge that such widespread misapplication practices continue by physicians who must be ill-informed or lacking common sense. I hear it in the cries of patients being forcibly reduced or completely off their pain meds, even though they are long term stable patients. They also inform me of the practice of forced invasive procedures and surgeries as a requirement for opioid medical management. These are practices that need to be condemned immediately. It certainly has in many cases led to patient abandonment by physicians. Worse, it has led to an increase in suicides in chronic pain patients.

You can read the most recent full CDC response here: https://www.aei.org/wp-content/uploads/2019/04/CDC-Director-Response-Letter-to-Dr.-Satel.pdf. The CDC does not condone the misapplication of their guidelines meant for new pain patients and not stable long-term patients. Physicians who continue in these errors are put at legal risks for medical malpractice and damages done to patients by the cited errant policies which have resulted in real harm to patients suffering from chronic pain.

Sincerely,

David J Barton MD HIPPPC, Waimanolo”

Board of Nursing Minutes of June 6, 2019 Meeting Page 13

Ms. Stone Murai provided a summary of the April 10, 2019 letter from the CDC, referred to by Dr. Barton, in which the CDC states in part, “The Guidelines does not endorse mandated or abrupt dose reduction or discontinuation, as these actions can result in patient harm. The Guideline includes recommendations for clinicians to work with patients to taper or reduce dosage only when patient harm outweighs patient benefit of opioid therapy.”

After careful consideration, it was the consensus of the Board to post the CDC April 10, 2019 letter on their web page in conjunction with the CDC Checklist on prescribing opioids for chronic pain.

Emails from Billy Dickson – Praises for Nurses

The Board reviewed and discussed an email from Billy Dickson praising the following nurses who are caring for his mother:

Nurse Heliry Nurse Sunshine Nurse Tim Nurse M.J. Nurse Gina Nurse Erin Nurse Michelle Sato Hawaii State Center Ms. Reichhardt reported on the following: for Nursing:

• Workforce Survey for Nurse Renewal – 8,900 (64%) nurses have completed the Center’s workforce survey;

• The Education Capacity Survey for Academic year 2017-2018 is almost completed. After review of the draft, there were some great new findings in improving the usability of its data and increasing its resourcefulness for our state.

• HSFCN received a grant from the Department of Labor to hold conversations about financial barriers for nursing educations including students who are unable to complete their education or achieve their goaled degree. The outcomes will be released in the Fall.

• Locally, there are a few initiatives that are going on including HB 658 which hopefully will begin in August. Preceptor tax credits are also coming along.

• HSFCN has been working with statewide partners on workforce development and workforce pipelines. The Chamber of Commerce and HAH are doing a Demand Survey, which may be the most detailed nursing demand survey that the state will have in its history. However, it will only be looking at the funded positions. The report will become available on Labor Day. In regarding to education, clinical placements continue to be the biggest constraints of nursing education. Not just as the RN level, but also LPNs and APRNs are experiencing difficulties.

Board of Nursing Minutes of June 6, 2019 Meeting Page 14

American Nurses Association – Hawaii Chapter: Ms. Navarrete provided the Board with a status report of ANA of Hawaii’s progress

towards becoming established as state nurse association affiliate of the ANA.

• Established online presence within the ANA Online Community Forum “Hawaii Nurses” and engage at least to members in discussion participation- Achieved 12/1/18

• Increase ANA membership in Hawaii by 20% in 1st year- Achieved 12/1/18

• Less than 20% of members opt out of on-going participation in ANA Online Community emails- Achieved; loss of 1 member as of 9/18

• Interim progress report to ANA Board at February 2019 meeting- Achieved 02/19. Draft report provided to Tina McRae-Phelps, ANA Staff to present to Board Meeting.

• Survey current ANA-Hawaii members to acquire 50% approval to move from ANA-Only membership to Hawaii state association (dues increase from $191 to $250/yr)- Achieved 4/2/19

• Survey of non-members (RNs in Hawaii)-200 individuals most identify “definite interest” in ANA state association membership- Pending dissemination by ANA staff; draft has been created.

• Standards of Excellence Training and Assessment for non-profit governance- Pending ANA staff to send electronic assessment of each Hawaii leadership member (8 leaders). Will be completed during the weeks of 6/3/19-6/19/19. Results should be available 7/10/19

• American Nurses Association Membership Assembly- June 22-23, 2019 in Washington D.C.- Pending

• Final report and request to ANA Board to form Hawaii state association of ANA- Resolution to be brought forward at ANA Membership Assembly June 22 and 23, 2019 to recognize the “American Nurses of Hawaii” as the official state nurses’ association of all registered nurses living in Hawaii.

Chapter 91, HRS - At 10:44 a.m., the Chair called for a recess of the meeting to discuss and Adjudicatory Matters: deliberate on the following adjudicatory matters:

In the Matter of the License to Practice Nursing of Sharon K. Alameda; RNS 2017-76-L, Compliance with Board’s Final Order dated December 6, 2019

Upon a motion by the Chair, seconded by the Vice Chair, it was voted on and unanimously carried to approve the following courses to be completed within sixty (60) days of respondent’s receipt of the Board’s notice and submit copies of the completion certificates within thirty (30) days of completion of all courses:

NCSBN courses:

• Professional Boundaries in Nursing (3.0 contact hours);

• Ethics of Nursing Practice (4.8 contact hours);

• Righting a Wrong: Ethics & Professionalism in Nursing (3.0 contact hours); and

• Professional Accountability and Legal Liability for Nurses (4.6 hours)

Board of Nursing Minutes of June 6, 2019 Meeting Page 15

In the Matter of the License to Practice Nursing of Malia P. Asing; RNS 2018-39-L, Settlement Agreement Prior to Filing of Petition for Disciplinary Action and Board’s Final Order; Exhibits “1”

Upon a motion by the Chair, seconded by Ms. Boyer, it was voted on and unanimously carried to approve the Board’s Final Order. Following the Board’s review, deliberation, and decision in these matters, pursuant to Chapter 91, HRS, the Chair announced that the Board was reconvening its scheduled meeting at 10:55 a.m.

Executive Session: At 11:02 a.m., upon a motion by Ms. Stone Murai, seconded by Ms. Kodama, it

was voted on and unanimously carried to move into Executive Session in accordance with HRS, 92-5(a) (1), “To consult with the board’s attorney on questions and issues pertaining to the board’s powers, duties, privileges, immunities, and liabilities”.

At 12:08 p.m., upon a motion by the Vice Chair, seconded by Dr. Napoleon, it was voted on and unanimously carried to move out of executive session.

Applications: Licensed Practical Nurses

Ratification List Upon a motion by the Chair, seconded by Dr. Napoleon, it was voted on and unanimously carried to ratify the attached list of LPNs – 19566-19595 (29)

LPN Applicant(s)

Upon a motion by the Vice Chair, seconded by Ms. Oliveira, it was voted on and unanimously carried to approve the following application for LPN license:

Yan Yan Shen

Registered Nurses Ratification List

Upon a motion by the Chair, seconded by Ms. Stone-Murai, it was voted on and unanimously carried to ratify the attached list of RNs – 93440 - 93646 (206)

Board of Nursing Minutes of June 6, 2019 Meeting Page 16

RN Applicant(s) Upon a motion by the Vice Chair, seconded by Dr. Napoleon, it was voted on and unanimously carried to approve the following applications for RN exam/license:

Shawn K. Bannister Michelle Miller Barbara W. Blum Pauline C. Nnawuba Dunja Pavlic

Mary J.S. Rabara Upon a motion by the Vice Chair, seconded by Dr. Napoleon, it was voted on and unanimously carried to deny the following application pursuant to HRS §436B-19(4) and (8):

Marcia K. McKinzie

Upon a motion by the Vice Chair, seconded by Ms. Kodama, it was voted on and unanimously carried to deny the following application pursuant to HRS §§436B-19(8) and 457-12(a)(8):

Dennis J. Tognoli

The following application was deferred:

Ellen Hansen Upon a motion by the Vice Chair, seconded by Dr. Napoleon, it was voted on and unanimously carried to grant the request for reconsideration for the following application:

Rhonda Freepartner

Upon a motion by the Vice Chair, seconded by Ms. Stone-Murai, it was voted on and unanimously carried to approve the following application:

Rhonda Freepartner Conditional License Upon a motion by the Vice Chair, seconded by Ms. Kodama, it was voted on and unanimously carried to approve the request to remove the condition(s) for the following license:

Kellen Smith

Board of Nursing Minutes of June 6, 2019 Meeting Page 17

Upon a motion by the Vice Chair, seconded by Mr. Duldulao, it was voted on and unanimously carried to deny the request to release the conditions placed on the following licensee:

Kimberly Soileau

The Board acknowledged the information submitted but determined that the licensee did not present or demonstrate any evidence to warrant removal of all the conditions. The reporting to any and all employers of her conditional license and the submission of quarterly reports by the licensee’s nurse supervisor or Director of Nursing or supervising practitioner is still required Advanced Practice Registered Nurses (APRN)

Ratification List

Upon a motion by the Chair, seconded by Dr. Napoleon, it was voted on and unanimously carried to ratify the attached list of APRNs and APRNs-Rx.

Next Meeting: July 11, 2019 8:30 a.m. Queen Liliuokalani Conference Room

King Kalakaua Building, 1st Floor 335 Merchant Street

Honolulu, Hawaii 96813

The Chair announced the next scheduled Board meeting and asked if everyone was available to attend. Ms. Boyer and Dr. Napoleon said they will not be able to attend.

Adjournment: There being no further business to discuss, the meeting was adjourned at 12:25 p.m.

Taken by: __/s/ Lee Ann Teshima__________________ Lee Ann Teshima, Executive Officer LAT 6/7/19 [ X ] Minutes approved as is. [ ] Minutes approved with changes; see minutes of _____________________________

ADVANCED PRACTICE REGISTERED NURSES

RATIFICATION LIST

June 6, 2019 APRN ONLY

Pre-October 2009 Requirements: Christine M. Lutz, Gerontological NP MSN Degree

Current Requirements: Michael Todd Adams, CRNA

Karen Carroll, Family NP

Dahlia Levin, Women’s Health Care NP

Trisha A. Dmytruk, Family NP

Ruth A. Chong, Family NP

Shardai N. Shelton, Family NP

Stephanie A. Merget, CRNA

Dina Whiteaker, Family NP

Mark T. Herrington, Family NP

Eric M. Hough, CRNA

Deidamia A. Monfort, Family NP

Stephanie K. Glick, Family NP

Kristin M. Cootey, Adult-Gerontology Acute Care NP

Hidemi K. Dela Cruz, Family NP

Antoinette D. Hemmings, Adult-Gerontology CNS

Gary K. Barnett, CRNA

Andre D. Tarin, Adult-Gerontology Primary Care NP

Maria G. Figueroa, Family NP

Desiree T. Tricarico, Family NP

Mica John Daniel Crisp, Family NP

Molly K. Brown, Family NP

Natasha Olavarria, Adult-Gerontology Acute Care NP

Alexandra H. Pandajis, Adult-Gerontology Primary Care NP

Steven Coppock, CRNA

Lisa Elizabeth Cuff, Family NP

Nicolas Phetniranh Sengdara, Family NP

Margena Staten-Branch, Adult NP

Jeremy Creekmore, Psychiatric-Mental Health NP

Kirby R. Lee, Adult-Gerontology CNS

APRN W/ PRESCRIPTIVE AUTHORITY

Karen Carroll, Family NP

Dahlia Levin, Women’s Health Care NP

Trisha A. Dmytruk, Family NP

Ruth A. Chong, Family NP

Shardai N. Shelton, Family NP

Dina Whiteaker, Family NP

Mark T. Herrington, Family NP

Deidamia A. Monfort, Family NP

Stephanie K. Glick, Family NP

Kristin M. Cootey, Adult-Gerontology Acute Care NP

Hidemi K. Dela Cruz, Family NP

Antoinette D. Hemmings, Adult-Gerontology CNS

Gary K. Barnett, CRNA

Andre D. Tarin, Adult-Gerontology Primary Care NP

Desiree T. Tricarico, Family NP

Mica John Daniel Crisp, Family NP

Molly K. Brown, Family NP

Natasha Olavarria, Adult-Gerontology Acute Care NP

Alexandra H. Pandajis, Adult-Gerontology Primary Care NP

Lisa Elizabeth Cuff, Family NP

Nicolas Phetniranh Sengdara, Family NP

Jeremy Creekmore, Psychiatric-Mental Health NP

Kirby R. Lee, Adult-Gerontology CNS

Ratification List June 6, 2019 Board Meeting

Licensed Practical Nurse (LPN)

LPN 19566 CORTES CARL

LPN 19567 PROFETA CHARLES G

LPN 19568 WHYLAND JUSTINE C

LPN 19569 GALO DANA JANE D

LPN 19570 HICKS AMY

LPN 19571 SIMON CAROLA L

LPN 19572 OGUNLEYE KOLAPO A

LPN 19573 FORBES KAREN M

LPN 19574 MAI VAN T

LPN 19575 MALLARI HAROLD V

LPN 19576 PABLO PHILIP A

LPN 19577 SINGH TAMAR S

LPN 19578 JACKSON DENNISHA

LPN 19579 SALES KRISTINA M

LPN 19580 ESPERANCE MARCIENNE

LPN 19581 CHING GARY A

LPN 19582 BASILE VICKIE D

LPN 19583 DESTINE-DUPUY CARLIN

LPN 19584 CENATUS ICIANISE

LPN 19585 CUMMINGS RASHAD L

LPN 19586 CADET JOSEPH LOVELY

LPN 19587 KIM KRISTI A S

LPN 19588 REALGO NIKKI FAY S

LPN 19589 MANASSE MARIE L

LPN 19590 MANGALVEDKAR ACHYUT

LPN 19591 WHITEHEAD MICHELLE

LPN 19592 HINSON ROBBIN D

LPN 19593 COLIS ASHLEY M

LPN 19594 TUCKER ELIZABETH

LPN 19595 CADIZ GRACE S

Ratification List June 6, 2019 Board Meeting

Registered Nurse (RN) RN 93440 MITCHELL BEVERLY J

RN 93441 MARTINEZ ADELA E

RN 93442 MARTIN LORI A

RN 93443 ANELE BLESSING N

RN 93444 CAMEAU JENNY S

RN 93445 ALUNAN CYRUS A

RN 93446 NOBLES AMBER N

RN 93447 LORENZO CASSAUNDRA M

RN 93448 OUBRE LAUREN N

RN 93449 ROCHE ARLENE A L

RN 93450 FERRER ZAILYN

RN 93451 PIERRE GILENE

RN 93452 JOYCE AUDREY J

RN 93453 LASALLE MARIA A

RN 93454 LOONEY GABRYANNA S

RN 93455 CASILLAS ANNA M

RN 93456 NGUYEN KHANH LINH Q

RN 93457 ADAGBOR CYNTHIA O

RN 93458 BINNS SHAKERA

RN 93459 JEAN CASSANDRA

RN 93460 MOMSEN LARA M

RN 93461 AGPOON KRIZTEL M D

RN 93462 GALBRAITH PATRICIA A

RN 93463 PAPPATERRA BIANNCA C

RN 93464 GONZALES ALEXANDRIA

RN 93465 EMMONS SUE A

RN 93466 SUAREZ-OQUENDO GABRI

RN 93467 PAULA THAMYRIS SANTO

RN 93468 RAYMOND DARLINE

RN 93469 ANDERSON JUDY Z

RN 93470 ST ROSE JULIA

RN 93471 PRUDENCIO ANDREA D

RN 93472 BLANCHARD JACQUELINE

RN 93473 DAVIS KRISTIN N

RN 93474 STANGE NATALIE

RN 93475 HENLEY ROBIN M

RN 93476 MACADANGDANG JULIE A

RN 93477 PERALTA JANET S

RN 93478 VITA JOANA M H

RN 93479 MOLIGA JENNA R

RN 93480 GAMA NATALIE S

RN 93481 KIRK ROGER L

RN 93482 ADAMS MICHAEL T

RN 93483 KIRBY KATHY L

RN 93484 BAILEY CHRISSIE

RN 93485 BURGESS KAYLA M

RN 93486 HESTER LAURA K

RN 93487 IRESON JANICE R

RN 93488 OGUNJOBI BABADAYO

RN 93489 TRAZILIEN SANETTE

RN 93490 SALES EDWIN A

RN 93491 EARLS STEPHANIE M

RN 93492 HARRIS GWENDOLYN G

RN 93493 BLACKFORD BETTY L

RN 93494 PENMAN BRITTANY M

RN 93495 CHONG RUTH A

RN 93496 JACKSON BRITTNEY C

RN 93497 PIERRE-LOUIS RONALD

RN 93498 CRUZAT CHRISTIAN MYR

RN 93499 DOCUS DARRYL S

RN 93500 BOATENG STELLA F

RN 93501 GRIFFIN DAWN M

RN 93502 DUBOIS TATIANA

RN 93503 AGYEMANG VICTORIA

RN 93504 DUARTO FRANKLIN S

RN 93505 CHIASSON MEGAN

RN 93506 SPENCER SHAWN V

RN 93507 BENNETT DOROTHY D

RN 93508 BATTLE KETOURA S

RN 93509 JOHNSON SHEKIA L

RN 93510 BRANCHEDOR FRANCESCA

RN 93511 SPENCER DANIEL A

RN 93512 ORTIZ-RUIZ ROSE MARY

RN 93513 CAMPOLLO SNYRA GEE M

Ratification List June 6, 2019 Board Meeting

RN 93514 TAYLOR JUDITH S N

RN 93515 DELOS REYES AGNES VE

RN 93516 KIRSTEIN BRANDY S

RN 93517 FRANCOIS FRANTZ

RN 93518 TONEATTO CARMEN M

RN 93519 EKPRI ANIEBIET I

RN 93520 JONES CARISSA LA SHE

RN 93521 CASTRO-FERNANDEZ ENM

RN 93522 BRESC VENITIA S

RN 93523 COTTAM TAYLOR E

RN 93524 OGUNMOKUN SAMSON KUN

RN 93525 DICKEY JUDITH A

RN 93526 BREEDING WENDY B

RN 93527 HYDE EMMALEE E

RN 93528 FORTE TONYA R

RN 93529 HIGGINS DIANNE M

RN 93530 KELLEY DILYANA B

RN 93531 TATAROWICZ BENJAMIN

RN 93532 ALEXANDRE GARRYDSON

RN 93533 DONAGHY JAVIER A

RN 93534 BAEZA SAMUEL

RN 93535 CAJUSTE MARIE M

RN 93536 DELVA CHRISTINE

RN 93537 KAMARA SUSAN D

RN 93538 OSNE NOELUS CARME RO

RN 93539 GAAL EMILY M

RN 93540 HARRISON GLENDA M

RN 93541 CHAVARRIA STEPHANIE

RN 93542 CRILLY JULIA M

RN 93543 ANSON JENNIFER L

RN 93544 ANDERSON-NEAL DEVON

RN 93545 KATHI A <KING HORNE)

RN 93546 KOOIMAN KRISTIN M

RN 93547 SUCCES CHRISLENE

RN 93548 ELSTON JOSEPH G JR

RN 93549 MOJUMDAR CHRISTOPHER

RN 93550 LAWAL NOSIMOT A

RN 93551 MENCIAS KATHLEEN J V

RN 93552 SQUIRES LATONYA H

RN 93553 COLE JEFFREY E

RN 93554 HINES MARGARET A

RN 93555 FOSCANTE-BOWLING STE

RN 93556 CRUMB MANDY R

RN 93557 HALL DEVIN A

RN 93558 PASCUA DIANA P

RN 93559 JACKSON APRILE M

RN 93560 CZENKUSCH JUDITH K

RN 93561 FIGUEROA MARIA G

RN 93562 SAWYER SHERRY L

RN 93563 JEAN BARRET JACQUELI

RN 93564 DOTILLOS MARIA C R

RN 93565 JEAN EDELYNE

RN 93566 PERRY PENNY J

RN 93567 PEAVY LYDIA K

RN 93568 LE BLANC KEISHA S

RN 93569 RUPP JENNIFER

RN 93570 BONNER STACEY

RN 93571 MCDERMOTT CORREY A

RN 93572 BROWN DEANNA J

RN 93573 LAWSON SHEILA D

RN 93574 PETIT NOEL ALOURDES

RN 93575 WILLIAMS MILFORD

RN 93576 KING ARCHBOLD KAREN

RN 93577 LIWAG KARMELA A M

RN 93578 NARTATEZ CLARISSA H

RN 93579 TAROY AUDREY MARIE L

RN 93580 MACANDILE JAN KENNET

RN 93581 MAS MARANTE TAIMARIS

RN 93582 GRUVER TRACY L

RN 93583 OROZCO VANESSA

RN 93584 KUPFER HAYLEY R

RN 93585 KELLY ALYXANDREA M

RN 93586 PALLARES MENGUAL KAT

RN 93587 TOYO SYLVYNA

RN 93588 METELLUS CYNTHIA

RN 93589 NESBITT GENEVIEVE

Ratification List June 6, 2019 Board Meeting

RN 93590 MIDDLETON QUANTISHA

RN 93591 LOUIS CHARLES DUMAIN

RN 93592 LOPEZ JENNIFER PAULA

RN 93593 OBAS CANTAVE

RN 93594 WILSON GRACE M

RN 93595 MANIO ARISTOTLE A

RN 93596 LOPEZ VIVIANA C

RN 93597 OLAVARRIA NATASHA

RN 93598 SIMS BEATRICE TAIYE

RN 93599 WORLEY REANA N

RN 93600 MCCALEB ASHLEY D

RN 93601 BISHER WASEF TALEB

RN 93602 COOK JEFFREY J

RN 93603 FANG ANDREW ZJ

RN 93604 ANAZODO ONYEKA N

RN 93605 DEDICATORIA GOOD ARI

RN 93606 SMITH CHRISTOPHER M

RN 93607 LEWIS KYLIE T

RN 93608 NESTER COURTENAY E

RN 93609 OCHE EUCHARIA O

RN 93610 WILLIAMS KELSY N

RN 93611 JOHNSON CHARLONA S

RN 93612 PUGH CORISSA Y

RN 93613 WINFREY JASON M

RN 93614 JEAN BETTIE

RN 93615 MARSHALL CATHERINE O

RN 93616 HALL PAULA G

RN 93617 DULA-BOWERS ALAINA D

RN 93618 GAWLITZA MORAIG J

RN 93619 JOHNSON-FONDA DEBBIE

RN 93620 PANDAJIS ALEXANDRA H

RN 93621 KNIGHT HANNAH N

RN 93622 SARTHOU LESLEY M

RN 93623 STATEN-BRANCH MARGEN

RN 93624 TRIMMER SHANNON N

RN 93625 MONAGHAN CHRISTY D

RN 93626 BOARDMAN LORALEE D

RN 93627 DUNCAN NATASHA N

RN 93628 SURIN NANCIE

RN 93629 KRAMER CHRISTINE M

RN 93630 LLOYD DANIELLE L

RN 93631 PANGANIBAN DAPHNY GA

RN 93632 AKINS HEATHER R

RN 93633 COLEMAN CAROLYN H

RN 93634 RACZ CYNTHIA L

RN 93635 TESTA SABRA

RN 93636 PHILLIPS VERONA E

RN 93637 SLONSKI MARIAH J

RN 93638 YARBROUGH AMBER R

RN 93639 FISCHER NICHOLAS W

RN 93640 TURNER JEWELL R

RN 93641 RIPPENBAUM STEFANIE

RN 93642 JONES SHANNON D

RN 93643 DAMON MARSHA M

RN 93644 JOHNSON RANDALL R

RN 93645 WEIDENKOPF LISA S

RN 93646 COLLOPY STEPHANIE L