MINUTES SENATE FINANCE COMMITTEE 29 April 1997 9:40 a.m. TAPES SFC-97, #132, Side 1 (000 - 591) Side 2 (591 - 142) CALL TO ORDER Senator Bert Sharp, Co-chairman, convened the meeting at approximately 9:40 a.m. PRESENT In addition to Co-chairman Sharp, Senators Phillips, Donley, Parnell and Adams were present when the meeting convened. Senators Pearce and Torgerson arrived shortly thereafter. ALSO ATTENDING: Annette Kritzer, staff to Senator Leman; Catherine Reardon, Director, Division of Occupational Licensing, Department of Commerce and Economic Development; Representative Pete Kelly; Walter Majoros, Executive Director, Alaska Mental Health Board, Department of Health and Social Services; Margot Knuth, Assistant Attorney General, Department of Law; James Baldwin, Assistant Attorney General, Civil Division, Department of Law; aides to committee members and other legislators. via teleconference: Ron Cowan, Division of Medical Assistance, Department of Health and Social Services; Dorothy Fulton, Executive Director, Alaska Nurses' Association SUMMARY INFORMATION CS FOR SENATE BILL NO. 103(STA) am "An Act relating to hearings before and fees for the State Commission for Human Rights; and providing for an effective date." Co-chair Sharp convened the session. He introduced SB 103 and noted receipt of revised fiscal note from the Human Rights Commission. Senator Parnell moved CSSB 103(STA) with individual recommendations and accompanying fiscal note and without objection it was reported out. CS FOR SENATE BILL NO. 152(L&C) "An Act relating to certified nurse aides; and providing for an effective date." Co-chair Sharp introduced SB 152. Annette Kritzer, staff to Senator Leman was invited to join the committee. She explained the sections outlined in the CS. Page 4 indicated the grounds for denial or suspension. Section 6 defined nurse's aide. She also explained the administrative procedure act. Senator Adams asked why section 16 of the original bill had been deleted and Ms. Kritzer advised that it had been deleted at the request of the Department of Health and Social Services. Senator Parnell asked about sections on page 6 and 7 and Ms. Kritzer advised those were two different sections. Senator Phillips asked what problems had arisen in the past that the Alaska Nurses' Association could not handle. Ms. Kritzer said that there would be no recourse if a certified nurse's aide committed abuse or neglect. Mr. Ron Cowan, Division of Medical Assistance, Department of Health and Social Services testified via teleconference from Anchorage. He explained the abuse problems for the committee. Senator Adams asked the department's position on amendment #1. Mr. Cowan responded indicating there usually would be one or two witnesses to an aide being accused of neglect or abuse. Senator Parnell moved amendment #1 and without objection it was adopted. Dorothy Fulton, Executive Director, Alaska Nurses' Association testified via teleconference from Anchorage. She explained the process of action taken against a certified nurses' aide. A full investigation would be undertaken. Senator Phillips asked when the accused could defend themselves. Ms. Fulton explained the accused worked with the investigator and could hire an attorney at any time. Catherine Reardon, Director, Division of Occupational licensing, Department of Commerce and Economic Development was invited to join the committee. She said the Attorney General must approve the filing of an accusation letter. A hearing office would be then appointed to hear the matter and make recommendations. In response to a question by Senator Phillips she noted there were only three suspensions in the last two years. Co-chair Sharp asked if there would be any increased liability to medicaid or medicare. Ms. Kritzer advised there would not. Senator Donley asked the duties of certified nurses' aides and who set the standards. Ms. Kritzer said the board of the Nurses' Association set the standards and duties. Senator Donley asked the difference between nurse, nurse Physician/Practitioner and nurses' aide. Ms. Fulton outlined the duties of each. Senator Donley asked if a nurses' aide was allowed to draw blood. Ms. Fulton explained that was the duty of a phlebotomist. However, a nurses' aide could or could not be a trained phlebotomist. She said there were no standards for training a phlebotomist. Senator Donley voiced his concern regarding this situation. Ms. Fulton agreed saying this had been an on-going problem at least forty years that she knew about. Senator Donley said he was also concerned that a new status was being created, replacing real nurses with certified aides. Mr. Cowan said this would fall into his licensing category. Nurses' aides were relatively new to Alaska. At present only certified nurses' aides could be hired and there was no specific staff ratio. It was felt that if the needs of patients were being met then there was no concern for the nurse/patient ratio. The situation had been dealt with appropriately and he specifically asked Senator Donley or anyone else to report any misuse they may be aware of. Ms. Reardon said there was no mandatory license law but it was a federal requirement for nursing homes that nurses' aides be certified. Senator Parnell moved CSSB 152(FIN) with individual recommendations and accompanying fiscal notes and without objection it was reported out. SENATE CS FOR CS FOR HOUSE BILL NO. 6(JUD) "An Act relating to minors and amending laws relating to the disclosure of information relating to certain minors; and amending Rule 3(c), Alaska Delinquency Rules." Representative Pete Kelly, sponsor of the bill, was invited to join the committee. He provided a brief explanation of the bill. He referred to a chart reflecting formal and informal handling procedures for juvenile charges. He said it was important to try and encourage youth to work with their family and the department to resolve the matter. The bill would allow release of names of youth involved in crimes for a second felony and was for the more dangerous, repeat offenders. The provision would also allow court proceedings to be open to the public. In response to Senator Parnell's comments, Representative Kelly said it was important to try and avoid a petition being filed, which was the formal adjudication of the petition. He went on to explain a particular Fairbanks case in which a juvenile released on one charge later shot an unsuspecting trooper. Juveniles should not be released at the discretion of the department on an unsuspecting public. He also referred to the case of teenagers breaking into a home to steal marijuana, a scuffle ensued and one juvenile was shot. Senator Adams asked how this bill would protect the innocent. Rural Alaska still believed one innocent until proven guilty. Representative Kelly said this was disclosure and not punishment. Protection of the public was a top priority. Senator Donley moved amendment #1 and without objection it was adopted. Co-chair Sharp advised at this point that he would continue to take testimony but would hold the bill pending receipt of new fiscal note. Walter Majoros, Executive Director, Alaska Mental Health Board, Department of Health and Social Services was invited to join the committee. He said the board had serious conflict with HB 6. There needs to be a sharing of information regarding disclosure. Mental Health needed to be present in both juvenile and adult matters. These individuals needed to be moved from the correctional system to the mental health system. He suggested amendments be made that would identify mental health needs before time of adjudication. He further suggested the amendments might be as follows: 1. limited to the older adolescent; 2. no disclosure until the adjudication. Senator Donley said no other states release information or disclosure regarding juveniles, but juveniles are tried as adults. Mr. Majoros said he had no information regarding this matter. Senator Parnell said there was a concern for the protection of the public. Mr. Majoros responded that there should be a balance for rehabilitation. Disclosure would be appropriate at the time of adjudication. Representative Kelly said the victim would also be protected because they have the option of not having their name released. Margot Knuth, Assistant Attorney General, Department of Law was invited to join the committee. She said the main issue was to try and avoid formal prosecution and bring the juvenile back in to the fold. Senator Parnell explained amendment #2, page 1, line 9 to delete "petition" and insert "motion". Ms. Knuth continued answering questions of the committee. She said that use of a deadly weapon not against a person was a property offense. She further advised that at this time the State was not concerned about a log jam of cases. The department appreciated the efforts of Representative Kelly and said they concurred in the matter of public safety. Senator Parnell moved his amendment #2 and without objection it was adopted. Co-chair Sharp requested any written testimony be faxed into the committee and requested any revised fiscal notes be submitted. He set aside HB 6 until tomorrow. CS FOR SENATE BILL NO. 42(STA) "An Act relating to the fiscal operations of the Alaska Railroad Corporation; and providing for an effective date." Senator Phillips moved work draft CSSB 42 (O-LS0182\K, Utermohle, 4/26/97) for working purposes. Senator Adams objected that the title was too tight. Senator Pearce asked if it affected the land and Senator Phillips said no. Senator Phillips moved CSSB 42(FIN). Senator Parnell objected and asked for a legal analysis regarding the debt service. Senator Donley asked if time was of the essence and if not more information would be needed. Jim Baldwin, Assistant Attorney General, Civil Division, Department of Law was invited to join the committee. He said he would need at least until the end of the day to provide a legal analysis as requested. Senator Phillips said he would hold his motion until tomorrow. Co-chair Sharp so ordered SB 42 held until tomorrow. ADJOURNMENT Co-chair Sharp adjourned the meeting until 8:00 a.m. tomorrow.