04/16/2007 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB28 | |
| Overview: Sound Families Initiative | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 28 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
April 16, 2007
1:40 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Thomas, Vice Chair
Senator John Cowdery
Senator Kim Elton
Senator Fred Dyson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 28
"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."
MOVED CSSB 28 (HES) OUT OF COMMITTEE
Overview: Sound Families Initiative
PREVIOUS COMMITTEE ACTION
BILL: SB 28
SHORT TITLE: LIMIT OVERTIME FOR REGISTERED NURSES
SPONSOR(s): SENATOR(s) DAVIS
01/16/07 (S) PREFILE RELEASED 1/5/07
01/16/07 (S) READ THE FIRST TIME - REFERRALS
01/16/07 (S) HES, L&C, FIN
04/04/07 (S) HES AT 2:45 PM BUTROVICH 205
04/04/07 (S) Heard & Held
04/04/07 (S) MINUTE(HES)
04/16/07 (S) HES AT 1:30 PM BELTZ 211
WITNESS REGISTER
Ray South, representing himself
Nikiski, AK
POSITION STATEMENT: Testified on SB 28
Tom Obermeyer, aide to Senator Davis
Juneau, AK
POSITION STATEMENT: Presented SB 28
Jeff Jesse, CEO
Alaska Mental Health Trust Authority
Anchorage, AK
POSITION STATEMENT: Presented overview
David Wertheimer, Senior Program Officer
Bill and Melinda Gates Foundation
Seattle, WA
POSITION STATEMENT: Presented overview
ACTION NARRATIVE
CHAIR BETTYE DAVIS called the Senate Health, Education and
Social Services Standing Committee meeting to order at 1:43:29
PM. All members were present at the call to order.
SB 28-LIMIT OVERTIME FOR REGISTERED NURSES
CHAIR DAVIS announced SB 28 to be under consideration.
1:46:47 PM
RAY SOUTHWELL, representing himself, said that SB 28 is needed
to make hospitals do the right thing is terms of not forcing
overtime. He referenced several studies regarding the high
numbers of deaths caused by medical error, and said that patient
safety is an important issue in the medical field. He talked
about his work history and personal experience with work
fatigue, and said that hospitals refuse to discuss the problem;
legislation will force this discussion and will help to
recognize the issue.
SENATOR DYSON asked why nurses don't look for better jobs, when
they're in such demand.
1:51:51 PM
MR. SOUTHWELL replied that some nurses do that, and such
preferable hospitals are referred to as "magnet hospitals", but
they are sometimes hard to find. There are often waiting lists
at these hospitals for nurses who wait to work there.
1:53:28 PM
SENATOR DYSON said that some nurses do prefer longer shifts, and
asked if shifts over eight hours should be outlawed.
MR. SOUTHWELL said that each individual nurse has a preferred
schedule, and not everyone gets fatigued at the same time.
Shifts longer than eight hours shouldn't necessarily be
outlawed.
SENATOR DYSON asked if each nurse should be able to give their
own parameters for shift length.
MR. SOUTHWELL said that that shouldn't necessarily happen;
nurses need a regular schedule.
SENATOR COWDERY asked if there could be any alternative to the
bill, and if a union could negotiate the issue.
1:56:53 PM
MR. SOUTHWELL said that the issue has been previously brought
up, and money was given to nurses rather than a real solution
being offered. Striking isn't a popular option for most nurses.
There being no further public testimony, Chair Davis asked her
aide to present the bill before committee.
1:58:49 PM
TOM OBERMEYER, aide to Chair Davis, sponsor of SB 28, said that
the bill is primarily a patient safety issue. Additionally, the
nursing shortage wouldn't be such a problem if unreasonable
hours didn't force nurses out of the profession. He explained
how the bill would allow nurses to be able to gain control over
their work lives. He said that there was a committee substitute
available for the bill, and cited several small changes.
SENATOR THOMAS said that the 12-hour shift seems to be the
easiest length to manage.
2:01:47 PM
MR. OBERMEYER said that the 12-hour shift was initially
integrated due to nursing shortages; now, required sign-up for
on-call on top of these shifts means incredible long work-weeks.
There is overtime in all areas of hospitals, including intensive
and emergency care, that leads to medical mistakes and resulting
death and litigation.
SENATOR THOMAS said that using 8-, 10-, or 12-hour shifts is the
easiest ways to divide shifts, and in his opinion 12-hour shifts
are the simplest for nursing.
MR. OBERMEYER said that a nurse told him that if additional
nurses were available to spread work time out over, 12-hour
shifts wouldn't be an issue. Some nurses don't even take breaks
during their long shifts because there's no one to cover them.
SENATOR THOMAS asked what the response from the hospital
association is to the idea of hiring more staff.
2:07:42 PM
MR. OBERMEYER said that the Fair Labor Standards Act, enacted in
1938, prevents overworking of individuals and encourages
adequate employment. The shortage is self-created because nurses
often are driven out of the profession.
2:09:19 PM
ROD BEATTY, President of Alaska State Hospital and Nursing Home
Association (ASHNHA), explained how overtime works in the state,
and said that nurse scheduling is done without requiring
mandatory overtime; temporary nurses are used to fill the gaps.
There isn't information that supports some of the negative
comments made about hospitals and overtime in the meeting.
SENATOR DYSON asked for the definition of mandatory overtime.
MR. BEATTY said that that's time worked that's not scheduled,
against a nurse's wishes.
SENATOR DYSON asked what happens if a nurse refuses to do so.
2:11:49 PM
MR. BEATTY replied that there are rules that protect nurses from
such situations in bargaining agreements; Alaska doesn't use
mandatory overtime.
SENATOR DYSON said that many nurses would stay voluntarily
overtime to help people, but it seems strange that there would
be any repercussions for an employee who's asked to stay over
and refuses.
2:13:11 PM
MR. BEATTY said that many hospitals have varied shifts, and so
nurses can be flexible.
SENATOR DYSON said that apparently some nurses can't leave their
jobs for better ones because they would lose their benefits.
MR. BEATTY replied that some people do get trapped in their
jobs; health care and retirements are often non-transferable.
2:14:50 PM
SENATOR ELTON commented that many nurses are not covered by
collective bargaining agreements, and referenced a study about
work fatigue.
MR. BEATTY said that Alaska's scheduling methods are not
inconsistent with other states'; hospitals know best how to
schedule the shifts.
SENATOR ELTON asked if a caveat could be added to the bill
regarding work hour maximums allowing for collective bargaining
agreement adjustments.
MR. BEATTY said that he couldn't answer that question.
2:19:35 PM
SENATOR THOMAS said that there seems to be little indication of
mandatory overtime being used, yet he gets a lot of comments
complaining about it. He said that required documentation of
overtime wouldn't be as difficult as some say; a written comment
from a nurse would be the only documentation needed.
2:18:17 PM
MR. BEATTY said that ASHNHA has offered to track mandatory
overtime in the past; it's a considerable effort, and there's
nothing on the same scale in other states.
CHAIR DAVIS commented that the committee substitute (CS) at the
last meeting was adopted, and has not changed. The nurses
associations have said they're happy with the bill; there's been
ample time to make changes, and if they haven't been made by
this time then they'll have to be addressed in another
committee. Almost every comment she's received has been in
support of the bill. Many times nurses don't feel comfortable
speaking up for themselves; her recommendation is that the bill
be moved out of committee.
2:25:28 PM
SENATOR ELTON moved to report CSSB 28(HES), referred to as
Version K, from committee with individual recommendations and
accompanying fiscal notes. There being no objection, the motion
carried.
CHAIR DAVIS announced a brief at-ease.
^OVERVIEW: SOUND FAMILIES INITIATIVE
2:26:47 PM
CHAIR BETTY DAVIS invited Mr. Jesse to present his overview on
the sound families initiative.
JEFF JESSE, CEO for the Alaska Mental Health Trust Authority
(AMHTA), said that the state's relationship with the Bill and
Melinda Gates Foundation (BMGF) began when the previous governor
commissioned a report examining homelessness in Alaska. The
BMFG's actions in the Seattle area were a clear example for
other states, and they've since presented their strategies for
addressing homelessness. He then introduced David Wertheimer,
with the BMFG.
2:29:03 PM
DAVID WERTHEIMER, Senior Program Officer with the BMFG,
explained that the foundation looks for ways to address sets of
problems and create partnerships to address issues from malaria
in Africa to homelessness in Washington. No one system on its
own can end issues like family homelessness, so the foundation
works with various partners.
He explained the areas of involvement of the foundation, and
said that the Sound Families Initiative was launched in 2000 on
a $40 million investment with the goal of creating 1,500
homeless family housing units. The goal was to create a cohesive
system where there was none; the three levels of goals were the
system, organization, and families. The launch phase began with
the signing of an agreement between all the government and
housing authority partners. The foundation's incentives included
$20,000 per unit in capital expenses and $1,500 yearly for
service costs. While the money didn't cover all costs, it helped
leverage other dollars from various donors.
He said that there were many partners in the program; the state
offered tax credits, housing trust funds pitched in, and other
resources leveraged by the foundation reached almost $200
million. Housing authorities also helped provide access to
Section 8 allocations and vouchers. Also, the assurance of
guaranteed capital funds led to private housing landlords
offering their units for rental. By 2004, preliminary evaluation
results showed housing stability and movement towards economic
self-sufficiency. The model of the Seattle program was then co-
opted for a state-wide effort which leverages private and public
funds for housing aide across the state.
2:41:50 PM
He cited the historical expenditures of the program to date, and
said that the evaluations have shown that many of the program
participants remain dependent on rental assistance, but the gap
between their income and housing affordability is closing. The
families have increased their incomes and daily wages, but they
need to be further helped with workforce development resources.
He explained that the evaluations are also showing a decreased
reliance on Temporary Assistance for Needy Families (TANF)
funding, and the participants have shown improved support from
families and friends and stabilized schooling for children.
2:47:47 PM
He concluded by saying that housing assistance is important to
improving many aspects of life, and some families require more
intensive services than others; oftentimes homeless families
have co-occurring issues like mental illness and substance abuse
as well. Families typically need assistance to transfer to
market housing, so the program is looking into ways to aid
further. The program has learned that case managers are
essential to success, and integrated care is essential. The
program will require several adjustments and further alignment
of the involved systems. While current funding won't necessarily
be available long-term, up-front, multi-year commitments by
partners are necessary for stability in the program. The
foundation is currently looking at how to continue its work with
homelessness and share its work with others.
2:54:50 PM
CHAIR DAVIS asked for clarification on the people who didn't
make it through the program, and asked what could be done to
lower that number.
MR. WERTHEIMER replied that public health systems have very
categorized funding, that doesn't allow for the possibility co-
occurring illnesses. Many people have more than one mental
health issue, which often leads to homelessness; in the absence
of an integrated response, they won't be able to remain in the
housing program. The initiative didn't do an adequate initial
job of addressing this problem.
2:58:20 PM
CHAIR DAVIS said that there's a high transient student
population in Alaska, not necessarily due to homelessness. She
asked what the foundation has done in Alaska.
MR. JESSE said that there was information available to the
committee about a proposed program much like the Washington
initiative.
CHAIR DAVIS asked how much the BMGF foundation would give to the
Alaskan program.
MR. JESSE clarified that the BMGF would not be contributing to
the effort in Alaska.
CHAIR DAVIS said that the BMGF did help with education and
libraries in Alaska, and clarified that the members of the
committee who left during the presentation had already heard it
earlier that morning.
There being no further business to come before the committee,
she adjourned the meeting at 3:00:21 PM.
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