HB 17: "An Act repealing the certificate of need program for health care facilities; making conforming amendments; and providing for an effective date."

00                              HOUSE BILL NO. 17                                                                          
01 "An Act repealing the certificate of need program for health care facilities; making                                    
02 conforming amendments; and providing for an effective date."                                                            
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1. AS 18.20.400(c) is amended to read:                                                                   
05            (c)  Subsection (a) of this section does not apply to                                                        
06 (1)  a nurse who is employed by a health care facility providing                                                        
07 services for a school, school district, or other educational institution, when the nurse is                             
08 on duty for more than 14 consecutive hours during an occasional special event, such as                                  
09       a field trip, that is sponsored by the employer;                                                                  
10 (2)  a nurse voluntarily working overtime on an aircraft in use for                                                     
11 medical transport, so long as the shift worked is allowable under regulations adopted                                   
12 by the Board of Nursing based on accreditation standards adopted by the Commission                                      
13       on Accreditation of Medical Transport Systems;                                                                    
14                 (3)  a nurse on duty in overtime status                                                                 
01 (A)  who is participating in the performance of a medical                                                               
02            procedure or surgery that has begun but has not been completed;                                              
03 (B)  because of an unforeseen emergency situation that could                                                            
04 jeopardize patient safety; in this subparagraph, "unforeseen emergency                                                  
05 situation" means an unusual, unpredictable, or unforeseen situation caused by                                           
06 an act of terrorism, disease outbreak, natural disaster, major disaster as defined                                      
07 in 42 U.S.C. 5122, or disaster emergency under AS 26.23.020 or 26.23.140,                                               
08 but does not include a situation in which a health care facility has reasonable                                         
09 knowledge of increased patient volume or inadequate staffing because of some                                            
10            other cause, if that cause is foreseeable;                                                                   
11 (C)  because the health care facility has a scheduling problem                                                          
12 caused by unforeseen weather conditions that prevent a second nurse from                                                
13 arriving at the facility to relieve the nurse on duty; in this subparagraph,                                            
14 "unforeseen weather conditions" means unusual, unpredictable, or unforeseen                                             
15 weather so extreme as to impair travel to the health care facility, but does not                                        
16 include a situation in which the health care facility has knowledge of the                                              
17 weather conditions far enough in advance to act so that a scheduling problem                                            
18            under this subparagraph can reasonably be avoided; or                                                        
19 (D)  at a health care facility located in a rural community that                                                        
20            declares a temporary nurse staffing emergency under AS 18.20.410;                                            
21 (4)  a nurse fulfilling on-call time that is agreed on by the nurse and a                                               
22 health care facility before it is scheduled unless fulfilling the on-call time would, in the                            
23 nurse's judgment, create an unacceptable risk to the physical safety of the nurse, a                                    
24       patient, or an employee of the facility;                                                                          
25 (5)  a nurse voluntarily working overtime so long as the work is                                                        
26 consistent with professional standards and safe patient care and does not exceed 14                                     
27       consecutive hours;                                                                                                
28 (6)  a nurse voluntarily working beyond 80 hours in a 14-day period so                                                  
29 long as the nurse does not work more than 14 consecutive hours without a 10-hour                                        
30       break and the work is consistent with professional standards and safe patient care;                               
31                 (7)  a nurse who                                                                                        
01                      (A)  is employed                                                                                   
02 (i)  at a psychiatric treatment hospital that treats only                                                               
03 children or at a residential psychiatric treatment center, as defined in                                            
04 (d) of this section [UNDER AS 18.07.111], that treats only children; in                                             
05 this sub-subparagraph, "children" means persons under 19 years of age                                                   
06 who are receiving psychiatric treatment from a hospital or center or                                                    
07 who are residing in a center and who were under 18 years of age on the                                                  
08                 date that the treatment or period of residence commenced;                                               
09 (ii)  at a residential psychiatric treatment center as                                                                  
10                 defined under AS 47.32.900; or                                                                          
11 (iii)  at a secure residential psychiatric treatment center                                                             
12                 as defined under AS 47.12.990;                                                                          
13 (B)  voluntarily agrees to work a 16-hour shift for the period                                                          
14 between 5:00 p.m. on a Friday and 8:00 a.m. on the Monday that immediately                                              
15 follows and receives pay and benefits for that work that are equal to or greater                                        
16 than the pay and benefits the nurse would receive for working 20 regular hours                                          
17            in the same position; and                                                                                    
18 (C)  during the period described in (B) of this paragraph does                                                          
19 not work a 16-hour shift consecutive with another shift of eight hours or more                                          
20            without an intervening break of at least eight hours;                                                        
21 (8)  the first two hours on overtime status when the health care facility                                               
22 is obtaining another nurse to work in place of the nurse in overtime status, so long as                                 
23       the nurse in overtime status is not on duty for more than 14 consecutive hours.                                   
24    * Sec. 2. AS 18.20.400 is amended by adding a new subsection to read:                                              
25 (d) In (c)(7)(A)(i) of this section, "residential psychiatric treatment center"                                         
26 means a secure or semi-secure psychiatric facility or inpatient program in a psychiatric                                
27 facility that is licensed by the Department of Health and Social Services and that                                      
28 provides therapeutically appropriate and medically necessary diagnostic, evaluation,                                    
29       and treatment services                                                                                            
30 (1) 24 hours a day for children with severe emotional or behavioral                                                     
31       disorders;                                                                                                        
01                 (2) under the direction of a physician; and                                                             
02 (3) under a professionally developed and supervised individual plan of                                                  
03 care designed to achieve the recipient's discharge from inpatient status at the earliest                                
04 possible time that is intensively and collaboratively delivered by an interdisciplinary                                 
05       team involving medical, mental health, educational, and social service components.                                
06    * Sec. 3. AS 18.20.499(2) is amended to read:                                                                      
07 (2)  "health care facility" means a private, municipal, or state hospital;                                              
08 independent diagnostic testing facility; primary care outpatient facility; skilled nursing                              
09 facility; kidney disease treatment center, including freestanding hemodialysis units;                                   
10 intermediate care facility; ambulatory surgical facility; Alaska Pioneers' Home or                                      
11 Alaska Veterans' Home administered by the Department of Health and Social Services                                      
12 under AS 47.55; correctional facility owned or administered by the state; private,                                      
13 municipal, or state facility employing one or more public health nurses; long-term care                                 
14 facility; psychiatric hospital; residential psychiatric treatment center, as defined in                                 
15 AS 18.20.400(d) [AS 18.07.111] or AS 47.32.900; secure residential psychiatric                                      
16 treatment center as defined in [UNDER] AS 47.12.990; juvenile detention facility;                                   
17 juvenile detention home, juvenile work camp, or treatment facility as defined in                                        
18       AS 47.12.990;                                                                                                     
19    * Sec. 4. AS 18.26.220 is amended to read:                                                                         
20 Sec. 18.26.220. Facility compliance with health and safety laws and                                                   
21 licensing requirements. A medical facility constructed, acquired, improved, financed,                                 
22 or otherwise under the provisions of this chapter and all actions of the authority are                                  
23 subject to [AS 18.07,] AS 47.32 [,] and any other present or future state licensing                                     
24 requirements for the facilities or services provided under this chapter. [A MEDICAL                                     
25 FACILITY ISSUED A CERTIFICATE OF NEED UNDER SEC. 4, CH. 275, SLA                                                        
26 1976, BY VIRTUE OF BEING IN EXISTENCE OR UNDER CONSTRUCTION                                                             
27 BEFORE JULY 1, 1976, MUST FULLY MEET THE REQUIREMENTS OF                                                                
28 AS 18.07 IN ORDER TO BE ELIGIBLE FOR FUNDING UNDER THIS                                                                 
29       CHAPTER.]                                                                                                         
30    * Sec. 5. AS 18.07.021, 18.07.031, 18.07.035, 18.07.041, 18.07.043, 18.07.045, 18.07.051,                          
31 18.07.061, 18.07.071, 18.07.081, 18.07.091, 18.07.101, 18.07.111; AS 21.86.030(c)(1);                                   
01 AS 44.64.030(a)(18); and AS 47.80.140(b) are repealed.                                                                  
02    * Sec. 6. Section 4, ch. 275, SLA 1976, is repealed.                                                               
03    * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to                          
04 read:                                                                                                                   
05 CERTIFICATES OF NEED; APPLICABILITY.  The Department of Health and                                                      
06 Social Services may not take action on or after the effective date of this Act to revoke,                               
07 enforce, or modify a certificate of need issued to a health care facility before the effective date                     
08 of this Act.                                                                                                            
09    * Sec. 8. This Act takes effect July 1, 2020.