03/25/2009 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB139 | |
| SB12 | |
| SB101 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 101 | TELECONFERENCED | |
| *+ | SB 139 | TELECONFERENCED | |
| += | SB 12 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 25, 2009
1:31 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Paskvan, Vice Chair
Senator Johnny Ellis
Senator Joe Thomas
Senator Fred Dyson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 139
"An Act establishing a loan repayment program and employment
incentive program for certain health care professionals employed
in the state; and providing for an effective date."
HEARD AND HELD
SENATE BILL NO. 12
"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 SB 12 OUT OF COMMITTEE
SENATE BILL NO. 101
"An Act relating to questionnaires and surveys administered in
the public schools."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 139
SHORT TITLE: INCENTIVES FOR CERTAIN MEDICAL PROVIDERS
SPONSOR(s): SENATOR(s) OLSON
03/09/09 (S) READ THE FIRST TIME - REFERRALS
03/09/09 (S) HSS, FIN
03/25/09 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 12
SHORT TITLE: LIMIT OVERTIME FOR REGISTERED NURSES
SPONSOR(s): SENATOR(s) DAVIS
01/21/09 (S) PREFILE RELEASED 1/9/09
01/21/09 (S) READ THE FIRST TIME - REFERRALS
01/21/09 (S) HSS, L&C, FIN
03/09/09 (S) HSS AT 1:30 PM BUTROVICH 205
03/09/09 (S) Heard & Held
03/09/09 (S) MINUTE(HSS)
03/25/09 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 101
SHORT TITLE: STUDENT QUESTIONNAIRES AND SURVEYS
SPONSOR(s): SENATOR(s) DAVIS
02/06/09 (S) READ THE FIRST TIME - REFERRALS
02/06/09 (S) EDC, HSS
03/11/09 (S) EDC AT 8:00 AM BELTZ 211
03/11/09 (S) Heard & Held
03/11/09 (S) MINUTE(EDC)
03/18/09 (S) EDC RPT 1DP 2NR
03/18/09 (S) DP: DAVIS
03/18/09 (S) NR: OLSON, HUGGINS
03/18/09 (S) EDC AT 8:00 AM BELTZ 211
03/18/09 (S) Moved SB 101 Out of Committee
03/18/09 (S) MINUTE(EDC)
03/25/09 (S) HSS AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
SENATOR DONNY OLSON
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Sponsor of SB 139.
KENDRI CESAR
Staff to Senator Olson
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Commented on SB 139 for the sponsor.
PAT CARR
Health Program Manager
Department of Health and Social Services
POSITION STATEMENT: Opposed SB 139.
DIANE BERHENDS, Executive Director
Alaska Commission on Postsecondary Education
Department of Education
POSITION STATEMENT: Supported SB 139.
SUZANNA TRICK
Washington, Wyoming, Alaska, Montana, Idaho Medical Education
Program (WWAMI)
POSITION STATEMENT: Available to answer questions on SB 139.
DELISSA CULPEPPER, CEO
Alaska Mental Health Trust Authority
POSITION STATEMENT: Supported SB 139.
MARIE DARLIN
Capital City Task Force
AARP
POSITION STATEMENT: Supported SB 139.
BETH SIRLES, Director
School of Social Work
University of Alaska Anchorage (UAA) and
Co-chair, Mental Health Trust Authority Workforce Development
Focus Area Education and Training Committee
POSITION STATEMENT: Supported SB 139.
TRACY TURLEY, full-time nurse practitioner student
POSITION STATEMENT: Supported SB 139.
MARY LOEB, Family Physician
Sunshine Community Health Center
POSITION STATEMENT: Supported SB 139.
ROD BETIT
Alaska State Hospital and Nursing Home Association (ASHNHA)
POSITION STATEMENT: Supported SB 139.
SHELLEY HUGHES
Alaska Primary Care Association
POSITION STATEMENT: Supported SB 139.
MARK HICKEY
Alaska Nurses Association
POSITION STATEMENT: Supported SB 12.
RYAN SMITH, CEO
Central Peninsula Hospital
Soldotna, AK
POSITION STATEMENT: Opposed SB 12.
TAMMY McCUTCHEON
Human Resources Director
Alaska Regional Hospital
POSITION STATEMENT: Opposed SB 12.
BRANDY PROCTOR, RN
North Star Behavioral Health
POSITION STATEMENT: Opposed SB 12.
TRACY CURLEE, RN
North Star Hospital
POSITION STATEMENT: Opposed SB 12.
DIEDRA JOSEPH, RN
North Star Hospital
POSITION STATEMENT: Opposed SB 12.
LEVI WASHINGTON, RN Manager
North Star Hospital
POSITION STATEMENT: Opposed SB 12.
ROBIN RICHARDSON, Director
Critical Care Services
Alaska Regional Hospital
POSITION STATEMENT: Opposed SB 12.
TOM OBERMEYER
Staff to Senator Davis
State Capital
Juneau, AK.
POSITION STATEMENT: Commented on SB 101 for the sponsor.
JENNIFER SCHMIDT, representing herself
Fairbanks, AK.
POSITION STATEMENT: Supported SB 101.
JOAN DIAMOND
Alaska Public Health Association
POSITION STATEMENT: Supported SB 101.
PAULA EASLEY, Trustee
Alaska Mental Health Trust Authority (AMHTA) and
Chair, Trust Planning Committee
POSITION STATEMENT: Supported SB 101.
ACTION NARRATIVE
1:31:16 PM
CHAIR BETTYE DAVIS called the Senate Health and Social Services
Standing Committee meeting to order at 1:31 p.m. Present at the
call to order were Senators Paskvan, Dyson and Davis.
SB 139-INCENTIVES FOR CERTAIN MEDICAL PROVIDERS
1:31:34 PM
CHAIR DAVIS announced consideration of SB 139.
1:31:57 PM
SENATOR OLSON, sponsor of SB 139, said it establishes a loan
repayment and incentive program that is essential to induce
people to come to Alaska to serve as health care professionals.
Two years ago the Health Commission estimated that over 400 more
medical doctors are needed to provide the same level of care as
is available elsewhere in the country. SB 139 will play an
important role in the overall solution by establishing this
program now. Forty-four states already have a similar loan
program, so competition is fierce. Alaska offers unique
lifestyle opportunities, but a program such as this will make us
competitive with other areas. Rural Alaska faces an acute
shortage of doctors.
1:34:28 PM
KENDRI CESAR, staff to Senator Olson, said SB 139 establishes
the Health Care Profession's Loan Repayment and Incentive
Program to make health care employment more attractive to
practitioners who both originate from Alaska, but who are also
from the Outside. Particularly in hard-to-fill localities,
people face obstacles such as limited financial resources,
cultural barriers and geographical hindrances to health care
access. This program would mirror similar loan repayment
incentives in the Lower 48 that have been substantially
successful as cost effective strategies in addressing workforce
shortages both for health care and other professions.
The program would be overseen by the Department of Health and
Social Services (DHSS) and the commissioner would appoint an
advisory council to communicate between program administrators
and providers and would make recommendations back to the
commissioner regarding program administration. The commissioner
would use the data and input of the advisory council to annually
prioritize 10 eligible practitioner-types according to relative
need in Alaska. These 10 practitioner types would be further
prioritized into two categories - Tier 1 and Tier 2. The Tier 1
category would include pharmacists, dentists and physicians with
either an M.D. or a D.O., the types of practitioners that are in
highest demand in Alaska. These types of practitioners often
come out of medical school with the highest amount of loans.
Tier 2 practitioners would initially include dental hygienists,
nurse practitioners, registered nurses, physical therapists,
physician assistants, clinical psychologists, and clinical
social workers. These practitioners are also in high demand in
Alaska, but to a lesser extent than the Tier 1 practitioners.
MS. CESAR explained that each of the 10 practitioner types would
be allocated 8-9 slots in the program, so the total number of
program participants each year would be 90. She said 60 program
slots would be allocated to regular site positions and the other
30 slots will go to the very hard-to-fill slots in areas that
are labeled so by the commissioner.
Current federally defined health care shortage areas are
referred to as health profession shortage areas (HPSA) and these
would help to guide the commissioner in defining very hard-to-
fill slots, but he would not be confined to those and preference
would be given to sites that serve individuals who have
difficulty paying.
She explained that eligible program participants must commit to
three years, no more and no less, in exchange for either loan
repayment support; or if they have no student loans owing, they
could participate in the incentive payment component of the
program.
A Tier 1 practitioner serving in a regular site could receive up
to $35,000/yr.; or if they choose to serve in a very hard-to-
fill site, they could receive $47,000/yr. A Tier 2 practitioner
serving in a regular site could receive up to $20,000/yr. or up
to $27,000/yr. for a very hard-to-fill site. These figures are
the same regardless of whether they are participating in the
loan repayment component or the incentive payment.
A participant in the loan repayment component who completes
their three years of service can opt to work for up to a total
of six years. Employers might be required to pay a matching
amount at the commissioner's discretion, but that would be based
on the employer's ability to pay. The Alaska Commission on
Postsecondary Education would serve as payment agent for the
loan payments.
1:41:01 PM
She said that a $7.4 million price tag might seem high, but
because 44 other states already offer such programs, Alaska is
at a distinct disadvantage in hiring health care professionals.
1:42:03 PM
SENATOR OLSON urged that if they are going to take advantage of
existing residency programs, they end in July. Maybe those first
graduates can come up here.
1:43:28 PM
PAT CARR, Health Program Manager, Department of Health and
Social Services (DHSS), said she was available to answer
questions and that the administration does not support this bill
due to the price tag.
CHAIR DAVIS asked if she agreed that this program should be
within the Department of Health and Social Services and if they
have problems with anything other than the money.
MS. CARR replied that they have been monitoring the healthcare
work force for some time, and it is in the purview of
responsibilities of the department. The concerns about the price
tag and needing to add staff to manage the program are of
concern.
1:44:33 PM
CHAIR DAVIS said she didn't have a fiscal note from the
department, and asked where it was.
MS. CARR replied that the fiscal note went to the Governor's
office.
CHAIR DAVIS stated that they did not have it even though the
administration knew this bill was up today. She asked if she had
already told Senator Olson that the department didn't support
this bill.
MS. CARR replied that information should have reached him
yesterday.
1:45:30 PM
SENATOR DYSON pointed out a zero fiscal note from the Department
of Education.
1:46:06 PM
DIANE BERHENDS, Executive Director, Alaska Commission on
Postsecondary Education, Department of Education, explained the
reason they were asked to participate in the discussion around
this program was their familiarity with education loans, and
they agreed they were equipped to play the part of a disbursing
agent on the loan repayment piece.
1:46:39 PM
SENATOR DYSON said he was not aware of a shortage of physical
therapists in this state, and asked where that information came
from.
MS. BEHRENDS said their packets contain the 2007 Alaska Health
Workforce Vacancy Study, which gives that information. Physical
therapists were chosen in consultation with the working group
that helped to outline the proposed program.
1:48:18 PM
SENATOR DYSON said he was particularly concerned that the state
has had a long standing turf war between various levels of
counselors and he sees that social workers are included here but
other counselors are not, particularly counselors who deal with
sexually abused children. He wanted to know why they are not
listed and social workers are. He has heard it is because social
workers have the best lobbyists.
1:49:50 PM
CHAIR DAVIS recognized that Senator Ellis arrived at the meeting
some time ago.
1:50:09 PM
SUZANNA TRICK, WWAMI, said she was available to answer
questions.
1:51:00 PM
DELISSA CULPEPPER, CEO, Alaska Mental Health Trust Authority,
said she has been working on health care workforce issues for
some years and helped produce the Vacancy Study. All workforce
areas that serve their beneficiaries have shortages across
Alaska, both rural and urban. So three years ago, they began
putting money into a larger workforce development issue. Loan
repayment rose to the top as one strategy that could be used.
So, for the last two years they have crafted a small
demonstration project around master's level or higher behavioral
health positions across the state to help with loan repayment
and recruiting. Therefore, they have been involved as part of
the coalition that crafted the details of this bill believing
that incentives will help them compete with other states. She
urged the committee to pass SB 139.
1:53:02 PM
CHAIR DAVIS advised that they just received the fiscal note from
the department.
1:53:51 PM
SENATOR DYSON said he had the Health Workforce Vacancy Summary
before him and on page 2, Table 1 showed a 17.7 percent vacancy
rate of professions and therapists and a 13.9 percent vacancy
rate for behavioral health professionals. Those are the highest
rates of vacancy next to physician assistants. He said he
thought they "missed it" by not including those mental health
professionals and therapists and that someone "bluffed you" into
putting the social workers in there instead.
1:56:14 PM
MARIE DARLIN, Capital City Task Force, AARP, supported SB 139.
She said that Alaska is going to have to do something like this
if it is going to compete in recruitment and retention of
providers. The cost of our inability to provide care to our
people is greater than the cost of the program.
1:57:20 PM
BETH SIRLES, Director, School of Social Work, University of
Alaska Anchorage (UAA), said she is also co-chair of the Mental
Health Trust Authority Workforce Development Focus Area
Education and Training Committee, and supported SB 139. The
Committee has been working for years to identify key workforce
shortage areas in the state, and health care workers are at the
top of the list. Their providers tell them regularly that their
top priority is the recruitment and retention of health care
providers. Several workforce studies show there is no question
that Alaska has serious shortages of health providers, both Tier
1 and Tier 2.
1:59:03 PM
TRACY TURLEY, full-time nurse practitioner student, said she
when she gets out of school she will have over $95,000 in
student loans, and that makes it very hard to pay for a mortgage
at the same time.
1:59:51 PM
MARY LOEB, Family Physician, Sunshine Community Health Center,
said she has experienced the distress of unmet medical and
dental needs in her community. One and a half years ago their
community was down from five to two providers to staff two
clinics. At that time she interviewed a lot of providers and
administrators and she often heard that they would have to give
up so much financially to work for the Center.
2:02:24 PM
ROD BETIT, Alaska State Hospital and Nursing Home Association
(ASHNHA), supported SB 139, because it addresses this critical
hole in the health care workforce in Alaska. He hears stories
first hand every day from Alaskans who can't obtain health care
services. The investments made in the WWAMI program are great,
but the fruits from that program won't be seen for many years;
SB 139 will address the short term need.
2:04:45 PM
MR. BETIT continued that he sees this as a rural bill primarily,
but the problem exists in some urban areas, as well. "If we
don't go after these work-ready health care professionals more
aggressively, more competitively, with the limited number
available, we're going to look worse rather than better five
years from now." To do that they need funding and this bill
wasn't premised on the notion that there would be any
diminishment of funding by those who are going after health care
professional.
He said that urban hospitals and big clinics will continue to
hire the available professionals, because they have the
financial capacity to do so. This bill is aimed at the "safety
net providers" who are willing to serve Medicaid/Medicare and
uninsured patients, but don't have the discretionary income or
the balance sheet to get professionals to their area.
ASHNHA conducted a statewide survey in 2007 about health care
attitudes. It clearly showed that the public feels that
hospitals are in a position to make the workforce needs known
and to champion some solutions to address those needs, even if
the most pressing needs aren't hospital-based. This area has
been selected by his board as a way to give back to the
community in terms of trying to get that message out and develop
some strategies for putting the solutions together.
2:07:34 PM
He said that ASHNHA has been working with the Alaska Primary
Care Association, the Alaska Native Health Board, the Alaska
State Medical Association, the Alaska Dental Society, the Alaska
Nurses Association, the Alaska Mental Health Trust Authority,
the Alaska Commission on Postsecondary Education, the Alaska
Pharmacists Association, and the Alaska Native Tribal Health
Consortium. The Department of Health and Social Services (DHSS)
has provided some staff support and he is sorry it can't support
the bill due to its financial requirements.
Even so, Mr. Betit said, he wants to put this before them as a
good solution. The bill does not mandate a funding level each
year. The fiscal note for $7 million provides a half million to
the department to run the program annually, but the idea for the
rest is to fund 90 health care professionals to come work in the
state. If only half the money is available, then they could fund
45. It seems to be an excellent way to put something in place
that can be used when funds are available.
2:09:15 PM
MR. BETIT said he doesn't have all the details pinned down even
though they've worked on this for 10 months. This legislation
leaves a lot of discretion to the department, but the bill says
that the Advisory Committee, once it makes a recommendation to
the commissioner, wants it to be honored. Having been a state
official, he has seen a lot of advisory committee's input not
used. If the commissioner doesn't use the input, he needs to put
in writing why not. He is very supportive of this legislation
and he feels if this issue isn't dealt with now, it will be an
even bigger problem in the future.
2:11:07 PM
SENATOR DYSON asked if ASHNHA had input on which professionals
would be included.
MR. BETIT replied yes; they wrestled with this question at many
meetings, and the reason they went with the master's level
social worker is that those professionals could fill in other
areas as well. However, they are open to discussion on this
issue.
SENATOR DYSON said the supporting documentation doesn't talk
about a shortage of social workers, but does mention behavioral
and mental health workers.
MR. BETIT responded that it was felt that the social worker
would be the stronger health profession to put in that package,
but that was open to discussion.
2:13:44 PM
CHAIR DAVIS said she supported this bill; it requires some money
up front, but it would save in the long run, and it is not an
unusual amount of money to put forward on something like this.
2:14:33 PM
SENATOR PASKVAN asked if the department recognizes that it needs
to attract health care workers or do they reject that need. Does
the administration want to reject certain fields under the bill
or limit the number, or is it a situation where, regardless of
need they don't want to spend the money?
MS. CARR replied that she would have to go back to the
administration for answers.
CHAIR DAVIS said she would appreciate that.
MS. CARR said her department knows there are workforce
shortages. On the other questions, she would get prepared
responses for the committee.
2:18:13 PM
SHELLEY HUGHES, Alaska Primary Care Association, said she worked
with Mr. Betit and a number of others to craft this bill. They
started by looking at what other states were doing and found
that loan repayment and incentive programs were most effective.
They found that only 2 percent of medical students are currently
going into primary care. They hear from the 141 clinics in the
state that are part of the Association, that they will have a
candidate lined up and when they learn Alaska doesn't have an
incentive program, and the candidate moves on.
She clarified that the $7.5 million fiscal note is the
encumbrance for 3 years and 90 participants. She also wanted to
mention that, as they looked at the workforce study data, they
found that recruiting physical therapists has been very hard. As
for behavioral health, both psychologists and licensed clinical
social workers are included. She explained that in order to keep
a clinic's doors open you have to have providers who can bill to
Medicaid and both psychologists and licensed clinical social
workers are reimbursable through Medicaid. She didn't think that
some of the other positions were billable like RNs.
2:22:12 PM
CHAIR DAVIS closed public testimony and held SB 139 in
committee.
SB 12-LIMIT OVERTIME FOR REGISTERED NURSES
2:22:56 PM
CHAIR DAVIS announced consideration of SB 12. She said this bill
had come before them previously and a couple of changes had been
made since then. The committee also had a couple of amendments
to ponder.
CHAIR DAVIS said she would like someone from the Nurses
Associate to tell her if they want them. One has to do with a
program that is like the Baylor Plan and that language was in
last year's bill.
2:25:22 PM
MARK HICKEY, Alaska Nurses Association, said the exemption that
was in the bill last year has been referred to as the Baylor
Plan although it really isn't. It allows weekend back-to-back
eight-hour shifts followed by an eight-hour break and an
additional 16-hour shift at residential psychiatric treatment
centers. They are still looking for a solution to the present
language which they don't support.
The reason it was added last year is that the nature of the care
at this facility was different than an acute care 24-hour
facility. Their concern was about nurses being overly tired and
possibly making mistakes. He suggested to the sponsor that the
bill start out without this language while the issue was
researched. A compromise provision already allows hospitals to
get up to 14 hours of consecutive work to come up with adequate
staff and balance that with not having nurses' excessive numbers
of hours without adequate rest. However, he repeated the Nurse's
Association does not support the amended language today.
CHAIR DAVIS asked if he was saying is that the bill is fine in
its present form.
MR. HICKEY replied yes.
2:28:48 PM
CHAIR DAVIS asked Senator Dyson if he would have a problem
moving this bill, and he indicated no.
2:29:13 PM
RYAN SMITH, CEO, Central Peninsula Hospital, Soldotna, AK,
supplemented the ASHNHA data saying that nurses at their
hospital worked approximately 14,000 shifts last year and 44 of
them were greater than 14 hours; 21 of the 44 were 14.25 hours;
so about 23 out of 14,000 shifts were over 14 hours. He said he
was unaware of any Alaska studies that show mandatory overtime
is causing any patient safety problems. His hospital does not
use on-call and mandatory overtime to supplement a nursing
shortage. In fact, the Peninsula doesn't actually have a nursing
shortage, because they make a significant contribution to the
UAA Kenai Peninsula College Nursing Program to help subsidize an
instructor position that has hired approximately 50 nurses from
the prior two graduating classes.
This bill also creates another mandatory reporting requirement
which will raise operating costs for both them and the state. As
a participant of the Health Care Commission, they have taken an
interest in lowering the cost of health care. And, finally, he
said they are currently in contract negotiations with their RNs
and have always been able to negotiate shift issues with their
nurses.
2:32:45 PM
TAMMY McCUTCHEON, Human Resources Director, Alaska Regional
Hospital, said they have a "weekend flex program" that allows
nurses in certain areas of the hospital to work two shifts per
week and receive payment as well as benefits as a full-time
employee. The current language would limit those nurses' ability
to be with their families during the week. They also they hire a
lot of snowbirds who enjoy being able to work and make a living
when they come to Alaska.
2:34:08 PM
SENATOR DYSON asked how many hours the nurses work on the
weekend to be considered full time.
MS. MCCUTCHEON replied that they work two 12-hour shifts with 12
hours between them.
2:35:01 PM
BRANDY PROCTOR, Registered Nurse (RN), North Star Behavioral
Health, supported continuing the Baylor plan at their hospitals
throughout the state. They allow two consecutive 16-hour shifts
on Saturday and Sunday only. North Star doesn't have mandatory
overtime and she chooses to work the 16 hour shifts voluntarily.
If she were to feel impaired for any reason, she could ask to be
relieved. It works for her because she can stay home during the
week and be with her family - which decreases her child care
costs as a side benefit.
TRACY CURLEE, Registered Nurse (RN), North Star Hospital, said
she works the same modified Baylor plan with two 16-hour shifts
on the weekend and an 8-hour break in-between. Without this
shift opportunity she couldn't finish her education. Also, she
said North Star has a very unstable and sometimes very acute
population and during the week they have school and other
activities that bring them off the unit. But on the weekends
most of their time is spent "on unit" it helps them to have one
RN available during their waking hours - which is for their
safety.
2:37:51 PM
DIEDRA JOSEPH, Registered Nurse (RN), North Star Hospital, said
she also works the 16-hour "Baylor Plan" on Friday/Saturday. She
was a nursing student when she started working this shift and
this schedule helped her finish school. Now it helps her because
she can pick up another job during the week which helps her to
pay for debt incurred due to moving her family after Hurricane
Katrina. It provides opportunities and options for nurses, she
said, and she didn't feel that the patients were at risk as a
result of this plan.
2:39:52 PM
LEVI WASHINGTON, RN Manager, North Star Hospital, said they have
not incurred any issues related to the nurses on the Baylor
Plan, and he felt it actually enhanced the quality of care. It
provides continuity to the kids in the plan. They are always
tracking patient safety. It also allows him the time to be a
great dad to his kids.
MR. WASHINGTON said he thinks there is a genetic factor that
makes it possible for some people to recover quickly enough to
work these shifts. It doesn't work for everyone, but some people
can do it and do it well. He doesn't see how the language in
this bill addresses patient safety or the needs of the nurses.
He asked the committee to put the exemption language back in and
continue research to determine whether it is a problem.{
2:44:00 PM
ROBIN RICHARDSON, Director, Critical Care Services, Alaska
Regional Hospital, said their nurses don't have mandatory
overtime, but they have the weekend flex program (Baylor Plan)
with two 12-hour shifts on Fri/Sat or Sat/Sun. At least 50
percent of her critical care staff, whether on the Baylor plan
or not, also work at another facility. So she didn't feel nurses
would be any more tired because they worked Baylor versus other
shifts in other facilities. She has had no increase in reports
of errors during the year they have had the Baylor plan and it
has hugely benefited the nurses. It has also helped to bring
nurses up from the Lower 48 to Alaska.
2:46:36 PM
CHAIR DAVIS recognized that Senator Thomas arrived earlier.
SENATOR THOMAS asked how the 16-hour shifts work on weekends and
what the average hourly wage of a nurse is.
MS. CURLEE responded that those who work the 16-hour weekend
shifts do not work during the week at North Star. They work 32
hours on the weekend and are paid for 40 hours with full
benefits.
MS. RICHARDSON added that the Alaska Regional nurses work two
12-hour shifts and get paid for 36 hours with full benefits. The
average wage is based on years of experience.
SENATOR THOMAS asked what that the range of average wages is.
MS. RICHARDSON replied that at least two years of experience is
required to get into the ICU, so those nurses average $28 per
hour.
CHAIR DAVIS closed public testimony on SB 12.
2:50:34 PM
SENATOR PASKVAN moved to report SB 12 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
SB 101-STUDENT QUESTIONNAIRES AND SURVEYS
2:51:36 PM
CHAIR DAVIS announced consideration of SB 101.
TOM OBERMEYER, staff to Senator Davis, sponsor of SB 101, said
the primary reason for SB 101 is to allow the Youth Risk
Behavior Survey to be administered in the schools with passive
parental consent. That means that if parents are given adequate
notice and an opportunity to review the survey and don't want
their children to take it, they can notify the school in writing
that they do not want their children to participate. In
addition, an exception in the bill allows a child who is sitting
to take the survey to refuse to answer some or all questions. He
added that this survey is important to all of the school
districts and the centers for disease control, to help them find
out what activities are most affecting the health and welfare of
children in the public school system.
CHAIR DAVIS commented that another reason for the change is that
the districts and non-profit organizations have been having
problems getting enough people to take the survey.
2:53:24 PM
JENNIFER SCHMIDT, representing herself, Fairbanks, AK, supported
SB 101. As well as being a parent, she said she has been a nurse
since 1972 and served for 12 years as a school board member. She
supports this issue because the standard risk assessment is an
important tool; it is anonymous and provides guidelines that
protect students and families that are from small communities.
It also doesn't use language that students haven't already heard
in the media. It doesn't address just sex, drugs and rock 'n'
roll, but the use of seat belts, diet, activity and other
important health issues.
While on the school board, she served on the Curriculum and
Wellness Committees, and found that in order to make good
decisions about programs and curriculum, good data is needed.
One year the Program Planning and Evaluation Department made a
huge effort to get families to participate. And even though they
had good turn out locally, the state still didn't have enough
data to validate, so they could only compare it to federal data.
She said that other providers and agencies that address
adolescent health issues need to know what the trends are
affecting them - for instance seat belt use has increased while
tobacco use has decreased. Also as a parent, Ms. Schmidt said,
she thinks it is important to know what's going on so they know
what issues to discuss with their kids.
2:57:36 PM
JOAN DIAMOND, Alaska Public Health Association, supported SB
101. The state spends a lot of money trying to get the consent
forms back; it's incredibly labor intensive trying to get enough
participation to make this data valid. She has been in public
health since this assessment began, and parents have always been
concerned whether this takes class time away from the students,
but it does not take enough time away to overshadow the amount
of value the data provides. Alaska is only one of three states
still using active consent.
3:00:26 PM
SENATOR THOMAS asked if she believes this is a pro-active step
in finding out what kids are doing in their lives in order to
help prepare them better.
MS. DIAMOND responded that using this data, kids can be provided
with an environment that will help them succeed rather than
reacting to the negative things they do.
3:02:24 PM
PAULA EASLEY, Trustee, Alaska Mental Health Trust Authority
(AMHTA), said she is also chair of the Trust Planning Committee.
She supported SB 101. She said it will significantly increase
participation in this important survey, and that in the past
years the state has not been able to get the 60 percent
participation needed to validate the data. Getting sufficient
participation has been expensive and this will do it at much
less cost. The data is used to identify risky behaviors and to
compare it to that of other states. She mentioned the attempted
suicide rate here, which is about 12 percent, is about 4 percent
higher than the rest of the U.S.
3:05:10 PM
CHAIR DAVIS closed public testimony.
SENATOR DYSON commented that he was the author of the original
legislation requiring active consent and that Alaska's
constitution is one of the few states with privacy in it. It is
his view that the state does not have a right to know these
details about families and kids. People want to get more studies
so they can get more money to do good things, but found
districts are always able to get active participation for
inoculations and field trips. So, he didn't think the issue was
that parents are accidentally failing to provide permission. The
questions are very invasive and young children should not even
be exposed to them. He is talking about the fundamental rights
of parents' and children's privacy.
[SB 101 was held in committee.]
3:11:15 PM
There being no further business to come before the committee,
Senator Davis adjourned the meeting at 3:11 p.m.
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