Legislature(2009 - 2010)CAPITOL 106
04/14/2009 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB71 | |
| HB190 | |
| HB188 | |
| HB50 | |
| HB126 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 32 | TELECONFERENCED | |
| += | HB 50 | TELECONFERENCED | |
| += | HB 190 | TELECONFERENCED | |
| += | HB 71 | TELECONFERENCED | |
| + | HB 126 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 188 | TELECONFERENCED | |
HB 50-LIMIT OVERTIME FOR REGISTERED NURSES 3:52:05 PM CO-CHAIR HERRON announced that the next order of business would be HOUSE BILL NO. 50, "An Act relating to limitations on mandatory overtime for registered nurses and licensed practical nurses in health care facilities; and providing for an effective date." CO-CHAIR KELLER moved to adopt the proposed Committee Substitute (CS) for HB 50, Version 26-LS0274\M, Wayne, 4/14/09, as the working document. 3:52:54 PM CO-CHAIR HERRON objected for the purpose of discussion. 3:53:30 PM REPRESENTATIVE PEGGY WILSON, Alaska State Legislature, as joint prime sponsor of HB 50, explained Version M reflects a five-year effort to protect patients by ensuring that nurses do not work an excessive amount of hours without adequate rest. The proposed legislation strikes a balance between maintaining flexibility in health care facilities and improving patient safety and healthful work environments. Under Version M, she relayed, nurses could not work more than 14 consecutive hours without at least ten hours of rest, unless needed for emergencies. Nor would they be forced to work overtime if, in their opinion, doing so would jeopardize patient safety. REPRESENTATIVE WILSON emphasized that the bill would not preclude the use of voluntary overtime and on-call work. She said she has heard the concerns of larger hospitals, rural communities, and Native facilities that flexibility [is needed] to provide for situations such as working on-call, dealing with weather, completing an ongoing surgery, or accommodating "reoccurring difficulties in smaller communities." She thanked the other sponsors of the bill and deferred to her staff to point out the specific changes made in Version M. 3:55:10 PM BECKY ROONEY, Staff, Representative Peggy Wilson, Alaska State Legislature, highlighted the changes made in Version M. She noted that witnesses in opposition have testified that although hospitals generally do not use mandatory overtime, in certain circumstances in remote, rural facilities, mandatory overtime is necessary. Version M reflects three changes addressing that concern. On page 4, line 19, a new exemption has been added called, "Temporary nurse staffing emergency." Under this provision, she explained, facilities would be allowed to declare a temporary nurse staffing emergency of up to 30 days, after making all reasonable efforts to "avoid this circumstance." The facilities would be required to file a report signed by the facility administrator, and send it to the Department of Labor & Workforce Development. The report must describe the facilities efforts to avoid the staffing emergencies. The reports must also be filed with the legislature if there are more than two such emergencies declared within six months, or three emergencies within one year. MS. ROONEY noted that the second mitigation provided in Version M is found on page 8, lines 19-21, and is a definition of a rural village or city as one with a population of less than 10,000 people, unless the village or city is in an organized borough with a population of more than 25,000. The third mitigation provided in Version M is an exemption for unforeseen weather conditions. That definition is on page 3, lines 11-18. The fourth issue addressed occurs on page 3, lines 2-3, and is an exemption for a nurse participating in an ongoing surgery of medical procedure. MS. ROONEY noted that the committee had heard testimony describing a situation in which a "modified Baylor program" was used by North Star Behavioral Health. She stated, "This staffing situation is used only at psychiatric hospitals and residential treatment centers that treat adolescents and children - and only on the weekends." Language on page 3, line 31, through page 4, line 15, describes a specific practice exemption "for just this situation." Another concern expressed during testimony both by those in support of and in opposition to the bill was in regard to mandatory on-call being used more frequently as a staffing tool than mandatory overtime. The practice often requires nurses to work beyond the number of hours that are safe for both the patient and the nurse, Ms. Rooney said. Language has been added on page 3, lines 23-25, of Version M, which would allow nurses the ability to refuse mandatory on-call if they believe they are too tired to perform their duties safely. MS. ROONEY noted another concern expressed during testimony was that an 80-hour limitation in a 14-day period would not be flexible enough for some facilities. That requirement was deleted and replaced by a provision that would allow nurses to work as many shifts as they feel safe working, as long as those shifts do not exceed the 14 consecutive hours with the aforementioned 10-hour rest limit. MS. ROONEY pointed out that a Tanana Chief's letter, dated 4/10/09 and the Alaska Native Tribal Health Consortium position paper, dated 3/9/09, both allude to possible legal problems pertaining to jurisdiction. In order to satisfy those concerns, all federal and Native facilities would be exempted from the statute, as shown on page 7, lines 13-17. MS. ROONEY relayed that during the April 11, 2009, House Health, Education and Social Services Standing Committee meeting, it was brought up that the reporting requirements for a facility that does not use mandatory overtime or mandatory on-call practices were much too arduous. She said a provision on page 7, lines 6- 10, of Version M, would allow a facility to submit a statement that there are no hours to report. Furthermore, the requirement for the data to be reported was changed to overtime and on-call hours only, with no distinction between mandatory and voluntary. MS. ROONEY highlighted two other changes. First, facilities would be required to post signs that describe the statutes created by the proposed legislation. The signs would be distributed by the Department of Labor (DOL) and would have to be displayed in a conspicuous work area in all facilities. Second, the language on page 4, line 16, was changed from a one- hour exemption to a two-hour exemption while a health care facility is obtaining another nurse to work in place of the nurse in overtime status. She explained that the extension to two hours was made because "we feel that people have to get their lives together to get back to the facility if they are called in." Ms. Rooney concluded by noting that there were also a couple of typographical errors that were corrected. 4:02:11 PM CO-CHAIR HERRON expressed concern that even with the changes made in Version M, he is still concerned about the reporting requirements. He said clarification is needed so that pre- scheduled on-call is not counted as part of the aforementioned 14 consecutive hours. In response to Representative Cissna, he said these are concerns that he looks forward to addressing with the sponsor in the next committee of referral; he does not want to hold the bill up in this committee. 4:03:46 PM REPRESENTATIVE CISSNA noted that her district is the seat of the health consortium that "looks over the whole state," and she emphasized the importance of hearing from as many voices as possible, including those from rural communities. 4:05:15 PM CO-CHAIR HERRON said no one has signed up to testify presently. He noted that he has been working closely with all the stakeholders who have agreed to "the federal facilities carve out" and the tribes, but still has concern about the issue. He indicated that concern is that the exemption could create two classes of nurses. 4:06:13 PM REPRESENTATIVE SEATON told Representative Cissna that one of the reasons the 80-hour in 14 days requirement was taken out was regarding scheduling conflict. 4:07:10 PM REPRESENTATIVE SEATON asked about the first sentence beginning on page 5, line 21, which read: (b) A complaint alleging a violation of AS 18.20.400 - 18.20.499 must be filed with the commissioner within 30 days after the date of the alleged violation. REPRESENTATIVE SEATON said the violations might be an ongoing process. He said he would like the sponsor's intent regarding the 30-day filing date to be stated on the record. REPRESENTATIVE WILSON said rules would be posted for all employees to see. 4:09:55 PM MS. ROONEY said she thinks the intent is that if there is an ongoing practice, "it's 30 days from the last occurrence of that incident." Ms. Rooney, in response to Representative Seaton, indicated that the sponsor would make that intent clear. 4:10:22 PM CO-CHAIR HERRON removed his objection to Version M. There being no further objection, Version M was before the committee as the working document. 4:10:42 PM REPRESENTATIVE CISSNA said she has visited rural hospitals that are taking on enormous challenges beyond the understanding of urban Alaska. She said it is possible that these discussions may not include all who will be impacted, and she reiterated her desire to hear from a wider range of people. She stated that she would probably object to Version M, not because she does not want it to pass, but because of a gut feeling. 4:12:36 PM CO-CHAIR HERRON said he shares Representative Cissna's concerns. He reiterated that he has worked with the federal facilities. Neither the federal entity nor the nurses are really happy with the legislation, but it is a work in progress. He expressed confidence in moving the bill on to the next committee. 4:13:27 PM CO-CHAIR KELLER moved to report CSHB 50, Version 26-LS0274\M, Wayne, 4/14/09, out of committee with individual recommendations and the accompanying fiscal notes. 4:13:49 PM REPRESENTATIVE CISSNA objected. A roll call vote was taken. Representatives Keller, Herron, Lynn, Coghill, Holmes, and Seaton voted in favor of reporting Committee Substitute (CS) for HB 50, Version 26-LS0274\M, Wayne, 4/14/09, out of committee with individual recommendations and the accompanying fiscal notes. Representative Cissna voted against it. Therefore, CSHB 50(HSS) was reported out of the House Health and Social Services Standing Committee by a vote of 6-1. The committee took an at-ease from 4:14 p.m. to 4:16 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Backup.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| Backup - Ca. study.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| Sponsor Statement.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| Sectional.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| CS Version C.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| CS version P.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| Departments Affected.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| Local Educational Agency Requirements.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |
| Newspaper article.PDF |
HHSS 4/14/2009 3:00:00 PM |
HB 126 |