Legislature(2005 - 2006)Anch LIO Conf Rm
09/23/2005 08:00 AM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB271 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 271 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
Anchorage, Alaska
September 23, 2005
8:19 a.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Paul Seaton, Vice Chair
Representative Tom Anderson
Representative Vic Kohring
Representative Berta Gardner
MEMBERS ABSENT
Representative Lesil McGuire
Representative Sharon Cissna
COMMITTEE CALENDAR
HOUSE BILL NO. 271
"An Act relating to limitations on overtime for registered
nurses in health care facilities; and providing for an effective
date."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 271
SHORT TITLE: LIMIT OVERTIME FOR REGISTERED NURSES
SPONSOR(s): REPRESENTATIVE(s) WILSON
04/15/05 (H) READ THE FIRST TIME - REFERRALS
04/15/05 (H) L&C, HES, FIN
04/30/05 (H) L&C AT 1:00 PM CAPITOL 17
04/30/05 (H) Moved Out of Committee
04/30/05 (H) MINUTE(L&C)
05/02/05 (H) L&C RPT 4DP 3NR
05/02/05 (H) DP: CRAWFORD, LYNN, GUTTENBERG,
ANDERSON;
05/02/05 (H) NR: LEDOUX, ROKEBERG, KOTT
05/03/05 (H) HES AT 3:00 PM CAPITOL 106
05/03/05 (H) Heard & Held
05/03/05 (H) MINUTE(HES)
08/29/05 (H) HES AT 1:30 PM Anch LIO Conf Rm
08/29/05 (H) Status of Personal Care Attendant regs
09/23/05 (H) HES AT 8:00 AM Anch LIO Conf Rm
WITNESS REGISTER
JANET CLARKE, Assistant Commissioner
Central Office
Finance And Management Services
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified during the hearing on HB 271.
MIKE TIBBLES, Deputy Commissioner
Office of the Commissioner
Department of Administration
Juneau, Alaska
POSITION STATEMENT: Testified during the hearing on HB 271.
REPRESENTATIVE CARL GATTO
Alaska State Legislature
POSITION STATEMENT: Suggested topics to consider for HB 271.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 8:19:51 AM.
Representatives Seaton, Anderson, Gardner, and Wilson were
present at the call to order. Representative Kohring arrived as
the meeting was in progress.
8:21:33 AM
HB 271-LIMIT OVERTIME FOR REGISTERED NURSES
8:21:47 AM
CHAIR WILSON announced that the first order of business was
HOUSE BILL NO. 271, "An Act relating to limitations on overtime
for registered nurses in health care facilities; and providing
for an effective date."
CHAIR WILSON said the committee would discuss a committee
substitute for HB 271, [Version 24-LS0838\Y, Bullock, 9/21/05],
but would not "act on it." [Therefore, some of the following
discussion relating to changes to the bill are in reference to
Version Y.]
8:22:03 AM
JANET CLARKE, Assistant Commissioner, Central Office, Finance
And Management Services, Department of Health and Social
Services (DHSS), revealed that a contract [for a long-term care
study] has been awarded to the Public Consulting Group (PCG).
She said she is not "up-to-speed" regarding the personal care
attendant regulation process. Notwithstanding that, she noted
that "the team and group is reviewing the public comments that
were extensive." She said all the information from the public
hearings had to be transcribed and many written comments are
being reviewed.
8:23:18 AM
CHAIR WILSON surmised that the information would be ready for
the committee by the time session begins again in January
[2006].
8:24:08 AM
CHAIR WILSON reminded the committee that it had discussed all
the pros and cons of the different aspects of the bill, and
recalled that Representative Seaton had a concern about triple
overtime, which is addressed in the aforementioned CS [not
adopted as a work draft].
8:24:37 AM
REPRESENTATIVE SEATON noted that during [the last] hearing,
concerns were expressed by those in the health care industry
that "having the triple overtime paid to nurses could have the
unintended consequence of reducing voluntary overtime." He
indicated that it's human nature that someone would opt to get
paid twice as much through working mandatory overtime, rather
than making less through volunteering for overtime. He said
[Version Y] would keep the overtime amount paid to nurses
exactly the same, but a like amount would serve as a fine. The
fine, he explained, would be based on hours as well as a set
amount. He said the aforementioned would get back to purpose of
bill: giving consequence to those requiring mandatory overtime.
8:26:31 AM
CHAIR WILSON said she thinks that's a good change.
8:26:39 AM
REPRESENTATIVE SEATON said the language to which he is referring
is in Version Y, on page 3, beginning on line 14, and read as
follows:
(c) Upon a finding by the commissioner that a
health care facility has violated a provision of this
chapter, the following civil penalties shall apply:
(1) for a first violation of this chapter,
the health care facility shall receive a reprimand and
be assessed a penalty equal to the amount of overtime
compensation paid to a nurse for each hour worked in
violation of this chapter;
(2) for a second violation of this chapter
within 12 months, the health care facility shall
receive a reprimand and be assessed a penalty equal to
the amount of overtime compensation paid to a nurse
for each hour worked in violation of this chapter plus
$500;
(3) for a third or subsequent violation of
this chapter within 12 months, the health care
facility shall be assessed a penalty equal to the
amount of overtime compensation paid to a nurse for
each hour worked in violation of this chapter plus an
additional amount of not less than $2,500 but not more
than $5,000 for each violation.
8:29:18 AM
MIKE TIBBLES, Deputy Commissioner, Office of the Commissioner,
Department of Administration, directed attention to a
spreadsheet he provided to the committee. He said that during
the last hearing on HB 271, there had been a comment regarding a
pay reduction. He pointed out some letter coding on the
spreadsheet. He noted that the third column read "GGU" [general
government unit], which includes nursing staff. He indicated
that the spreadsheet shows historical benefits from 1984 to the
present. He offered further details.
8:32:00 AM
REPRESENTATIVE WILSON indicated that she was expecting further
comparisons across the state of hospitals, pioneers' homes, and
the Alaska Psychiatric Institute (API).
8:32:11 AM
MR. TIBBLES said the focus of his testimony today would be
regarding the issues of recruitment and salaries.
8:32:51 AM
CHAIR WILSON mentioned having heard that there was an issue of a
raise that was taken away.
8:33:36 AM
REPRESENTATIVE ANDERSON asked Chair Wilson to review the major
points of the bill.
8:34:22 AM
CHAIR WILSON said nurses from API, the pioneers' homes, and the
Department of Corrections were represented by the state nurses
organization to bring to attention the issue of the shortage of
nurses and the fact that nurses have been working more than one
shift to cover that shortfall. The state was mandating that the
nurses work overtime. Research has proven that when nurses work
overtime for a sustained period of time, it's not healthy for
the nurses and it's a safety issue for patients. Many states
have laws that don't allow mandatory overtime.
CHAIR WILSON said nurses belong to a union that also includes
other health care workers; therefore, changes made for the
nurses would affect the others. She said, for example, lab
technicians and radiology technicians may be part of the same
union.
8:38:18 AM
MR. TIBBLES, in response to a question from Representative
Gardner, explained that the GGU refers to the collective
bargaining [unit], while Alaska State Employees Association
(ASEA) is the union. He confirmed that the unit is very
diverse.
8:38:48 AM
REPRESENTATIVE GARDNER, [referring to the aforementioned spread
sheet], observed that the increase of the Consumer Price Index
(CPI) in '85 of 2 percent with the GGU wage increase of 5
percent "would have been a good year," and then there were not
pay raises until 1990, when "it went up 3.3 [percent] for that
classification." She concluded, "So, during those years where
the CPI change was really small but there still was an increase,
they basically ... lost ground?"
8:39:20 AM
MR. TIBBLES answered that's correct. He noted that a contract
submitted to the legislature in 1987 was disapproved. He noted
that sometimes it takes multiple years for negotiations. He
offered further details.
REPRESENTATIVE GARDNER stated, "[The] bottom line is that over
time, compared to 20 years ago, the members of this bargaining
unit have lost ground as the CPI increased. It looks pretty
dramatic."
MR. TIBBLES, regarding recruitment, said the Department of
Administration and the Department of Health & Social Services
have collectively held a number of meetings to forward
initiatives to address the issue of recruitment. The staff
within the Division of Personnel in the Department of
Administration has been reorganized in order to set up a
professional recruitment position. That position will
concentrate on those difficult-to-recruit areas, such as nurses.
In response to a question from Chair Wilson, he said he doesn't
know whether any RNs have been hired, but could find out. He
explained that the position of professional recruiter is not
expected to be filled until approximately November 1, [2005].
He gave an example whereby "looking at recruitment a little bit
differently really did pay off for the Department of
Corrections."
MS. CLARKE said since the House Health, Education and Social
Services Standing Committee's hearing a couple of weeks ago, the
department has held a couple sessions with its head nursing
management staff and a comprehensive meeting with the University
of Alaska's nursing school, talking about what's being done for
other private providers and what the state and, particularly,
[the Department of Health and Social Services] can do to try to
increase recruitment efforts related to the nursing students
attending the University of Alaska. She said there are a number
of management tools to propose, including making attempts to
increase the number of nurses that go through clinical rotations
and state facilities. Other ideas to consider include whether
to develop a stipend program for nurses, tuition reimbursement,
and a loan repayment program.
8:45:45 AM
CHAIR WILSON said, "That sounds absolutely wonderful." She said
those types of programs have been used to attract physicians and
physicians' assistants to work in the Bush.
8:46:47 AM
MR. TIBBLES said the Division of Personnel is "creating a single
point of contact ... regarding employment opportunities for
nurses." For example, a person may "inquire into Department of
Corrections about a nursing position." He said, "Right now,
we're not talking to them about other nursing opportunities
within the state." He added, "We're going to try to take a step
back and look at a bigger view of it and see ...: maybe if
someone's not appropriate or even interested, or even hired for
one area of nursing within the state, maybe we could use them in
another area."
MR. TIBBLES said [the Department of Administration] is holding
conversations with hiring managers regarding how to best market
state positions because some of the benefits of working for the
State of Alaska are not widely known. There is more to consider
than just the salary, for example, a generous leave with cash
value. He offered other examples. Mr. Tibbles said the
department is also working with DHSS on developing recruitment
materials.
8:48:52 AM
MR. TIBBLES, in response to a question from Chair Wilson, said
there will be many opportunities to distribute the information,
for example, to people attending job fairs.
8:49:01 AM
MR. TIBBLES, regarding compensation, said there is a draft
policy that is currently under review and should be implemented
by mid-October. The policy will allow hiring managers to be
preapproved to offer advance step placement.
8:52:12 AM
MR. TIBBLES reminded the committee that the department is
working on a system that will allow it to introduce market data.
He said there are two processes to assigning ranges: collective
bargaining, in which a dollar amount is negotiated per range,
and assigning a range to a particular range. He offered an
example.
8:53:21 AM
MR. TIBBLES, regarding current employees, said that DHSS
management is reviewing the workflow process to ensure that
staff resources are being used most efficiently. He offered
examples. He said DHSS is also collecting information regarding
current working conditions and what nonmonitary changes might
create more desirable working conditions. He mentioned the
National Association of State Personnel and Executives (NASPE),
an association that has talked about what other states have done
that have been attractive. Flexible staffing was one item; more
training was another. He mentioned working with hiring managers
and staff to improve conditions for nurses.
8:55:12 AM
CHAIR WILSON asked if job sharing has been considered as an
option to offer nurses.
8:57:44 AM
CHAIR WILSON welcomed Representative Kohring via teleconference
and reviewed the change that would be made to the bill in
Version Y. She stated that she is open to any changes that can
be made so that people are comfortable with the bill, while
still trying to address not forcing nurses to work overtime.
9:01:04 AM
REPRESENTATIVE SEATON offered three points for consideration:
First, he stated, "I'm wondering whether the nurses actually
have the ability to influence and to set these regulations
through their bargaining units, and whether that's where this
should be." Second, he noted that there is no differentiation
in the bill regarding the number of nurses in a facility.
Third, he said he wants to know the reach of the bill. For
example, page 4, line 7, refers to a "primary care outpatient
facility", which he said sounds like a doctor's office. Page 4,
line 2, refers to an "intermediate care facility", which he said
he wants defined. He noted the language refers to "federal",
"state", and "private" facilities, and inquired as to whether
that includes Native health service within the State of Alaska.
9:04:15 AM
CHAIR WILSON said she doesn't know if nurses have much say
regarding collective bargaining. She indicated that there will
time to research these questions for answers by next session.
Regarding large and small facilities, she said she knows a
distinction was made regarding critical access hospitals,
because most of them are in areas where there is not access to
any other hospital, but she said the issue has not been brought
forward when there is more than one hospital in an area.
9:05:49 AM
REPRESENTATIVE SEATON directed attention to page 4, which refers
to a "primary care outpatient facility" and "long-term care
facility". He requested that the committee obtain a definition
of the scope of the bill from "the department" and if the
current definition covers doctors' offices.
9:08:03 AM
CHAIR WILSON reiterated wanting feedback between now and the
start of session in January 2006. She said that in the Lower
48, some states require that there be so many nurses per
patient; they've gone much further than this bill. Chair Wilson
stated that she doesn't want to go any further than necessary.
9:08:45 AM
REPRESENTATIVE CARL GATTO, Alaska State Legislature, indicated
that he would like to know what the situation is regarding
school nurses.
9:09:16 AM
CHAIR WILSON revealed that she is a nationally certified school
nurse and knows that some schools require a nurse for so many
students.
9:10:04 AM
REPRESENTATIVE GATTO, in response to a comment from
Representative Anderson, said his wife is currently at work as a
school nurse. He noted, "In the first week of school she is
being paid for one day, but in order to get the work done has to
show up for all five." He questioned whether that would be
considered uncompensated overtime.
9:10:41 AM
CHAIR WILSON said when she was a nurse in North Carolina she was
the only nurse at the school. The law was changed just as she
was leaving to require more than one nurse at the school.
9:11:28 AM
REPRESENTATIVE ANDERSON suggested that various hospitals around
the state could send in suggestions to the committee.
9:11:53 AM
REPRESENTATIVE GATTO indicated that a new hospital would be
opening in the [Matanuska/Susitna] Valley, which will increase
the need for new nurses. He suggested he may contact the
director to give him a "head's up" regarding the bill.
9:12:47 AM
CHAIR WILSON encouraged written testimony for those who don't
want to testify in person.
9:13:02 AM
REPRESENTATIVE GATTO stated that although he is not on the
committee, he would "appreciate being kept in the line up."
CHAIR WILSON commented that she had expected to hear from more
nurses at today's meeting.
[HB 271 was held over.]
9:13:13 AM
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 9:13:41 AM.
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