Legislature(2007 - 2008)BELTZ 211

01/22/2008 01:30 PM Senate LABOR & COMMERCE


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 147 WORKERS' COMP EMPLOYER LIABILITY TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled
Including But Not Limited to:
+= SB 120 UNEMPLOYMENT COMPENSATION BENEFITS TELECONFERENCED
Scheduled But Not Heard
+= SB 28 LIMIT OVERTIME FOR REGISTERED NURSES TELECONFERENCED
Moved CSSB 28(L&C) Out of Committee
+= SB 107 NATUROPATHS TELECONFERENCED
Heard & Held
          SB  28-LIMIT OVERTIME FOR REGISTERED NURSES                                                                       
                                                                                                                                
1:34:18 PM                                                                                                                    
CHAIR ELLIS announced  SB 28 to be up for  consideration and that                                                               
the  committee had  been working  from the  CSSB 28(HES)  version                                                               
[25-LS0212\L].  The committee  now had  a Labor  and Commerce  CS                                                               
before it, which he asked his staff to explain.                                                                                 
                                                                                                                                
DANA OWEN, Staff to Senator  Ellis, explained the changes in CSSB
28(L&C) [25-LS0212\V]. The  first change was on page  2, line 24,                                                               
that  added to  the exceptions  a  new paragraph  (1) to  include                                                               
nurses at an occasional school  event. It was suggested by nurses                                                               
who pointed out  that they often accompany field  trips that last                                                               
longer than the normal work day.                                                                                                
                                                                                                                                
1:35:32 PM                                                                                                                    
The second change was on page 4,  line 25, where a new section AS                                                               
18.20.440   spells  out   an   enforcement   mechanism  for   the                                                               
prohibition  against retaliation  set out  in AS  18.24.30. Under                                                               
this section the commissioner has  90 days to determine whether a                                                               
facility has violated this statute.  If the determination is yes,                                                               
the commissioner  must request  that the  Office of  the Attorney                                                               
General represent  the department in  the complaint and  seek all                                                               
appropriate  relief.  The  Department   of  Labor  and  Workforce                                                               
Development  (DOLWD) suggested  this  amendment. The  idea is  to                                                               
provide clear authority to the  department to investigate and act                                                               
on allegations of  violations. This provision is  similar to that                                                               
for violations of occupational safety and health.                                                                               
                                                                                                                                
1:36:22 PM                                                                                                                    
The  third change,  he said,  was on  page 5,  line 4,  where new                                                               
language specifies that the report  required by Section 18.20.445                                                               
is to be  submitted to the division  responsible for enforcement.                                                               
Earlier  drafts sent  the  report to  the  research and  analysis                                                               
section of  the department, which also  requested this amendment.                                                               
The  effective  dates  had  all  been moved  a  year  forward  to                                                               
recognize the current year.                                                                                                     
                                                                                                                                
1:36:56 PM                                                                                                                    
CHAIR ELLIS  asked if it  was fair to say  the changes in  the CS                                                               
improve the legislation.                                                                                                        
                                                                                                                                
MR. Owen replied yes.                                                                                                           
                                                                                                                                
CHAIR ELLIS stated he would hold  consideration of the CS to have                                                               
the benefit of public testimony.                                                                                                
                                                                                                                                
NANCY DAVIS, Vice President, Alaska  Nurses Association, said she                                                               
has been a  registered nurse for the past 39  years and supported                                                               
the proposed CS to  SB 28. This bill is a  great step forward for                                                               
a number of  reasons, she said, to protect the  health and safety                                                               
of patients  and nurses alike.  The CS recognizes the  impacts of                                                               
fatigue  on  nurses  who  are  the  mainstay  of  round-the-clock                                                               
patient care.                                                                                                                   
                                                                                                                                
She said,  "It's well  known that excessive  work hours  for some                                                               
occupations become  a critical issue  for safety.  Excessive work                                                               
hours  for  nurses is  a  very  risky  response to  the  staffing                                                               
crisis."  Errors may  be made  due to  fatigue, which  is bad  in                                                               
terms of  patient care, but it  is also a liability  for workers'                                                               
compensation  issues. Nurses  are more  prone to  be injured  and                                                               
this is exacerbated  by the fact that this  professional group is                                                               
already  facing a  shortage, which  could get  worse. Many  other                                                               
opportunities  exist  in  the  workforce for  nurses  and  it  is                                                               
getting more difficult to encourage people into the profession.                                                                 
                                                                                                                                
MS. DAVIS  said that a  number of states have  passed legislation                                                               
similar to CSSB 28(L&C).                                                                                                        
                                                                                                                                
1:43:14 PM                                                                                                                    
SENATOR BUNDE said  he didn't want people to work  overtime if it                                                               
harms patients. However there is  a nursing shortage and he asked                                                               
if this would create more of a nursing shortage.                                                                                
                                                                                                                                
MS. DAVIS replied that there  are different management approaches                                                               
to  the nursing  shortage. It  will  continue, but  it won't  get                                                               
better if people keep leaving the profession.                                                                                   
                                                                                                                                
1:44:55 PM                                                                                                                    
SENATOR  STEVENS followed  up  by asking  for  statistics on  why                                                               
people are leaving the profession.                                                                                              
                                                                                                                                
MS. DAVIS  replied that this  is the  hard part; nurses  say they                                                               
can't  do 12-hour  shifts or  double shifts;  so they  pick other                                                               
employment   like  home   care  and   out-of-institution  places.                                                               
"Clearly the 24/7  patient situations are the  most critical ones                                                               
for which this  makes a difference." She said  this is considered                                                               
a problem nationally, especially as the nursing workforce ages.                                                                 
                                                                                                                                
1:46:23 PM                                                                                                                    
MR. TOM  RENKES, Executive  Director, Alaska  Nurses Association,                                                               
added that the  record on mandatory overtime  is mostly anecdotal                                                               
at this  point. They know  the shortage of nurses  will encompass                                                               
millions of  nurses in the  future. Fourteen states  have already                                                               
passed the mandatory  overtime legislation and it  has been shown                                                               
that the  hospitals that work  toward garnering  better workforce                                                               
working conditions  have a virtually 0  to 3 percent rate  on the                                                               
RN positions. The hospitals that  continue to use the practice of                                                               
mandatory overtime and mandatory call  can have open positions up                                                               
to the 10 - 20 percent around the country.                                                                                      
                                                                                                                                
1:48:03 PM                                                                                                                    
ROD  BETIT, Alaska  State Hospital  and Nursing  Home Association                                                               
(ASHNHA), said  he still could  not support CSSB 28(L&C).  He has                                                               
been monitoring mandatory  overtime use in the  Alaska. Hard data                                                               
from member  facilities indicate  that mandatory overtime  is not                                                               
one of the tools they use  to close the nursing shortage gap, but                                                               
they rather use temporary nursing  staff. In addition, facilities                                                               
have been  working hard to try  to produce an adequate  number of                                                               
nurses for health  care in Alaska by working  with the University                                                               
of Alaska  Anchorage to increase  the nursing  student graduation                                                               
rate from  about 100 students  a year (four  years ago) to  200 a                                                               
year. Data shows  that 93 percent of those nurses  are staying in                                                               
Alaska to practice.                                                                                                             
                                                                                                                                
1:50:11 PM                                                                                                                    
He also  said that going down  this road will not  really improve                                                               
health  care  or help  support  facilities  attempting to  strike                                                               
reasonable  working  conditions  for  nurses,  which  is  locally                                                               
managed now  mostly through collective bargaining.  He didn't see                                                               
any evidence presented  to the committee that  would suggest this                                                               
is an area that requires legislative attention at this time.                                                                    
                                                                                                                                
CHAIR  ELLIS   asked  if   he  wanted  to   comment  on   the  CS                                                               
specifically.                                                                                                                   
                                                                                                                                
MR.  BETIT  replied   no;  most  of  those   changes  impact  the                                                               
department that  is responsible for managing  the reporting. That                                                               
reporting requirement  would be  onerous to facilities  to comply                                                               
with without having any concrete evidence that a problem exists.                                                                
                                                                                                                                
1:52:34 PM                                                                                                                    
SENATOR  BUNDE asked  if  this  bill would  leave  wards or  beds                                                               
uncovered.                                                                                                                      
                                                                                                                                
MR. BETIT replied he thought so.  His members say the shortage is                                                               
improving and not worsening.                                                                                                    
                                                                                                                                
1:54:06 PM                                                                                                                    
SENATOR BUNDE  said one  nursing organization  suggested doubling                                                               
nursing wages,  but he  wondered if that  would just  elevate the                                                               
cost of health care.                                                                                                            
                                                                                                                                
MR. BETIT replied that was an astute observation.                                                                               
                                                                                                                                
1:55:26 PM                                                                                                                    
SENATOR STEVENS  asked if complaint investigations  were still an                                                               
issue for him and what did it mean.                                                                                             
                                                                                                                                
MR. BETIT replied that the  whole complaint investigation area is                                                               
of concern if  it's to be done  any time someone wants  to file a                                                               
complaint. This  particular bill  requires the kind  of reporting                                                               
that  goes down  to the  individual nurse  using overtime  rather                                                               
than the aggregate kind of  facility reporting that is applicable                                                               
in other states that have adopted this kind of approach.                                                                        
                                                                                                                                
1:56:30 PM                                                                                                                    
SENATOR DAVIS moved  to adopt CSSB 28(L&C) version  V. There were                                                               
no objections and it was so ordered.                                                                                            
                                                                                                                                
CHAIR  ELLIS  said  he  is  personally  persuaded  that  this  is                                                               
reasonable  public policy,  because he  has been  concerned about                                                               
the nursing  shortage. He thought  this bill would help  with it.                                                               
Other states  have moved  in this direction  and have  reported a                                                               
positive effect.                                                                                                                
                                                                                                                                
1:57:27 PM                                                                                                                    
SENATOR BUNDE  commented if mandatory  overtime isn't  being used                                                               
in Alaska, this won't help much.  He didn't think the problems in                                                               
the nursing field were over.                                                                                                    
                                                                                                                                
CHAIR ELLIS responded that it may be an incremental change.                                                                     
                                                                                                                                
1:59:08 PM                                                                                                                    
SENATOR  DAVIS moved  to pass  CSSB 28(L&C)  from committee  with                                                               
individual recommendations  and accompanying fiscal  notes. There                                                               
were no objections and it was so ordered.                                                                                       

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