Legislature(2005 - 2006)CAPITOL 17
03/22/2005 01:00 PM LABOR & COMMERCE
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* first hearing in first committee of referral
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HB 120-HEALTH CARE EMPLOYEE PROTECTION CHAIR ANDERSON announced that the first order of business would be HOUSE BILL NO. 120, "An Act relating to safety devices and sharp instruments for the prevention of the spread of bloodborne pathogens in health care employees; and providing for an effective date." REPRESENTATIVE PEGGY WILSON, Alaska State Legislature, sponsor, announced that this bill basically brings Alaska standards up to the federal standards. The main difference between Alaska's regulations [for bloodborne pathogens] and those of the federal government is that Alaska's regulations didn't inlcude dental offices and other medical offices with less than 25 [employees]. 1:17:46 PM REPRESENTATIVE WILSON said that there were two reasons for this improvement. She explained that if [these procedures for bloodborne pathogens] weren't already being used, the effects would be disastrous to those already working in these offices. Therefore, this is almost a housekeeping matter. However, the larger issue is that failure to comply with the federal minimum standards jeopardizes the state's eligibility for federal grants. 1:19:10 PM CHAIR ANDERSON highlighted that HB 120 already went through the House Health, Education and Social Services Standing Committee and the Department of Labor & Workforce Development recommended its introduction. REPRESENTATIVE GUTTENBERG asked if there were any statistics regarding people who have been exposed to bloodborne pathogens at dental offices, and if it was greater or less than the exposure rates at regular medical offices. REPRESENTATIVE WILSON answered that dentists weren't included original because when these regulations were originally implemented a member of the House of Representatives, who happened to be a dentist, feared that including dentists would cost dentists more. Therefore, dentists were exempted. 1:19:48 PM REPRESENTATIVE ROKEBERG asked if the language referring to having "not more than 25 employees" exempts dentists. REPRESENTATIVE WILSON indicated that the aforementioned language was used to exempt dentists. 1:20:21 PM REPRESENTATIVE ROKEBERG recalled that there was concern for all health care providers in all small settings, not just dentists. REPRESENTATIVE WILSON announced that almost all health care providers are already in compliance with [what is proposed in HB 120]. GREY MITCHELL, Director, Division of Labor Standards & Safety, Department of Labor & Workforce Development (DLWD), spoke in support of HB 120. He characterized it as a housekeeping measure. He explained that at the time this law was created, there were no federal standards for bloodborne pathogens. In the year 2000, the federal employee protection law was created and special exemptions were created for small employer groups and dental groups. 1:22:15 PM MR. MITCHELL then stated that in the following year, the federal government came out with comprehensive regulations for bloodborne pathogen standards. However, these two professional exemptions were not included in the new regulations and thus the state was at odds with the federal Occupational Safety and Health Administration (OSHA) program because the state had a less strict interpretation regarding when the protective regulations had to be in place to keep workers safe. He noted that these regulations also protect customers at these facilities. 1:23:34 PM MR. MITCHELL turned to the earlier questions regarding the number of incidences and the number of employees. Referring to a list he had that didn't detail employers with less than 25 employees, he guesstimated that 30 percent of these were employers with less than 25 employees. There is a total of 85 businesses that had incidences between October 2003 and September 2004, 12 of which were dental establishments and the other 73 were other health care-related businesses. He then said that the other confusing element is that the state law, AS 18.60.030(6), established when the state was given jurisdiction over occupational safety and health issues required the state to maintain standards as effective as federal standards. Therefore, there is a conflict between statute and federal standards. The legislation simply intends to eliminate the conflict and clarifies the obligation of these health care businesses in protecting their employees and the public from bloodborne pathogens. 1:25:24 PM MR. MITCHELL characterized this matter as a common sense issue. He related that the [department's] occupational safety and health industrial hygienist has found that all of the dentists are complying because they don't want to risk exposure. 1:26:29 PM REPRESENTATIVE ROKEBERG, referring to AS 18.60.890(G), pointed out that this statute, which came out a couple of years ago, states that a employer who employs 10 or more front-line health care workers shall be required to establish an evaluation committee. He then asked what businesses are to do if they have very small practices and the exemption is eliminated. MR. MITCHELL answered that right now state law requires that the business review the safety products on the market. If there are 10 employees or less, there has to be one person who is directly involved in reviewing safety products. Regardless of the ratio of employees, 50 percent of the employees that do the review must have direct involvement with patient care or lab work. The intent is to provide a way for the people who are using the products to have a say in evaluating the safety procedures in their clinic or lab. REPRESENTATIVE ROKEBERG clarified that he is concerned with throwing away the provision. He then asked how the department would enforce this and determine that the business, however small, had an evaluation committee. MR. MITCHELL answered that this was essentially the case. He noted that the dental community doesn't have much concern with HB 120 because there isn't a lot of technology available for dental facilities to use. There is a lot of common sense in the [existing] statutes, he said. 1:30:10 PM MR. MITCHELL said that there are provisions that allow for individual analysis of each practitioner's situation. If, in the mind of the doctor, the use of the equipment would not provide any additional safety margin, then they do not bother purchasing the equipment. The dental community cannot use a lot of the equipment that is on the market so they do not have any consternation about the issue, as long as they comply as best they can and are in compliance with federal law. PAT SENNER, Nurse, Alaska Nurses Association, announced that she as in support of the bill and that she was involved with the enactment of the original Act. She informed the committee that since the federal act took place in 2001, there has been a 50 percent reduction in needle sticks. She related that the infection of one person can cost the system over a million dollars in long-term care. The safety devices being discussed were originally very expensive, which is why the exemptions were put into place. However, the cost has since decreased then, and should no longer be an issue. She ended by expressing the hope that this bill would pass so that state law can be in compliance with federal law. 1:33:06 PM REPRESENTATIVE ROKEBERG asked if the Alaska State Medical Association (ASMA) had taken a position on this or any of the other parts of the bill concerning sharps and other devices. He surmised that some of the smaller practitioners would be the ones to testify because the larger entities are covered. CHAIR ANDERSON said that he did not think the packet included anything [from the small practitioners or ASMA]. He suggested that the lack of testimony or endorsement could be the result of the matter not being on "their radar". REPRESENTATIVE ROKEBERG recalled relating that the Dental Society is amenable to HB 120, although there is no information in the committee packet specifying the aforementioned. He expressed concern about the teeth cleaning devices and asked whether they would qualify as sharps. CHAIR ANDERSON answered that this will be addressed by Representative Wilson before it goes to the House floor. REPRESENTATIVE LEDOUX moved to report HB 120 out of committee with individual recommendations and the accompanying zero fiscal note. There being no objection, it was so ordered.