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February 11, 2020 <br /> Page 2 <br /> When I testified before your committee in favor of HB 138, I noted that I try to use <br /> the word "provider" because, in truth, our healthcare crisis goes beyond our physician <br /> shortage. For that reason, HB 2228 is the preferred approach if it is not too expensive, <br /> because it would create a general excise tax exemption for medical services provided <br /> both by physicians and by advanced practice registered nurses acting in the capacity of <br /> primary care provider. It seems to me that broadening the exemption to APRNs is a <br /> sensible way to go, if the State is able to absorb the initial additional loss of revenue <br /> ("initial" because most or all of the loss would be offset as the higher earnings of the <br /> APRNs are spent and circulate through the community, generating new tax revenue). <br /> I support both HB 2228 and HB 2235 and thank you again for addressing our <br /> healthcare dilemma. <br /> Res ectfully Submitted, <br /> 7 l l <br /> Harry Kim <br /> MAYOR <br /> County of Hawaii is an Equal Opportunity Provider and Employer. <br />