00CS FOR HOUSE BILL NO. 217(L&C)                                                                                          
01 "An Act relating to certified nurse aides; and providing for an effective date."                                        
02 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
03    * Section 1.  AS 08.01.087 is amended by adding a new subsection to read:                                            
04  (c)  Under procedures and standards of operation established by the department                                        
05 by regulation, and with the agreement of the appropriate agency, the department may                                     
06 designate appropriate state or municipal agencies to investigate reports of abuse,                                      
07 neglect, or misappropriation of property by certified nurse aides.                                                      
08    * Sec. 2.  AS 08.01.090 is amended to read:                                                                          
09  Sec. 08.01.090.  Applicability of the Administrative Procedure Act.  The                                              
10 Administrative Procedure Act (AS 44.62) applies to regulations adopted and                                              
11 proceedings held under this chapter, except those under AS 08.01.087(b) and                                            
12 AS 08.68.333.                                                                                                          
13    * Sec. 3.  AS 08.68.100(a) is amended to read:                                                                       
14  (a)  The board shall                                                                                                  

01   (1)  adopt regulations necessary to implement this chapter, including                                                
02 regulations pertaining to practice as an advanced nurse practitioner and a nurse                                        
03 anesthetist, and regulations necessary to implement AS 08.68.331 - 08.68.336                                           
04 relating to certified nurse aides in order to protect the health, safety, and welfare                                   
05 of clients served by nurse aides;                                                                                      
06   (2)  approve curricula and adopt standards for basic education programs                                              
07 that prepare persons for licensing under AS 08.68.190;                                                                  
08   (3)  provide for surveys of the basic nursing education programs in the                                              
09 state at the times it considers necessary;                                                                              
10   (4)  approve education programs that meet the requirements of this                                                   
11 chapter and of the board, and deny, revoke, or suspend approval of education programs                                   
12 for failure to meet the requirements;                                                                                   
13   (5)  examine, license, and renew the licenses of qualified applicants;                                               
14   (6)  prescribe requirements for competence before a former nurse may                                                 
15 resume the practice of nursing under this chapter;                                                                      
16   (7)  keep a record of its proceedings, and submit annual reports to the                                              
17 governor and legislature;                                                                                               
18   (8)  define by regulation the qualifications and duties of the executive                                             
19 secretary and delegate authority to the executive secretary that is necessary to conduct                                
20 board business;                                                                                                         
21   (9)  develop reasonable and uniform standards for nursing practice;                                                  
22   (10)  publish advisory opinions regarding whether nursing practice                                                   
23 procedures or policies comply with acceptable standards of nursing practice as defined                                  
24 under this chapter.                                                                                                     
25    * Sec. 4.  AS 08.68.140 is amended to read:                                                                          
26  Sec. 08.68.140.  Applicability of Administrative Procedure Act.  Except as                                           
27 specified in AS 08.68.333(f), the [THE] board shall comply with the Administrative                                     
28 Procedure Act (AS 44.62).                                                                                               
29    * Sec. 5.  AS 08.68 is amended by adding new sections to read:                                                       
30 Article 3A.  Certified Nurse Aides.                                                                                     
31  Sec. 08.68.331.  Certification of nurse aides.  (a)  The board or the                                                 

01 Department of Commerce and Economic Development, as designated by the board,                                            
02 may issue certification as a nurse aide to qualified applicants.  The board, after                                      
03 consultation with affected agencies, may adopt regulations regarding the certification                                  
04 of nurse aides, including                                                                                               
05   (1)  the training, educational, and other qualifications for certification                                           
06 that will ensure that the nurse aides are competent to perform the tasks of their                                       
07 occupation;                                                                                                             
08   (2)  application, certification, renewal, and revocation procedures; and                                             
09   (3)  maintenance of a registry of certified nurse aides.                                                             
10  (b)  The board may                                                                                                    
11   (1)  conduct hearings upon charges of alleged violations of this chapter                                             
12 or regulations adopted under it; and                                                                                    
13   (2)  invoke, or request the department to invoke, disciplinary action                                                
14 under AS 08.01.075 against a certified nurse aide.                                                                      
15  Sec. 08.68.332.  Use of title.  (a)  A person may not use the title "certified                                        
16 nurse aide" or the abbreviation "C.N.A." unless the person is certified under this                                      
17 chapter.                                                                                                                
18  (b)  A person who knowingly violates this section is guilty of a class B                                              
19 misdemeanor.  In this subsection, "knowingly" has the meaning given in                                                  
20 AS 11.81.900(a).                                                                                                        
21  Sec. 08.68.333.  Registry of certified nurse aides.  (a)  The board shall                                             
22 maintain a registry of certified nurse aides.  At a minimum, this registry must include                                 
23 the information required under federal regulations that are applicable to nurse aides                                   
24 found to have committed abuse, neglect, or misappropriation of property in connection                                   
25 with their employment by a facility participating in the Medicaid or Medicare program.                                  
26  (b)  If the board finds that a certified nurse aide has committed abuse, neglect,                                     
27 or misappropriation of property in connection with employment as a nurse aide, the                                      
28 board shall revoke the nurse aide's certification and enter the finding in the registry.                                
29  (c)  Upon receiving a notice of a finding under AS 47.05.055 that a certified                                         
30 nurse aide has committed abuse, neglect, or misappropriation of property, the board                                     
31 shall immediately revoke the nurse aide's certification without a hearing, enter the                                    

01 finding in the registry, and notify the nurse aide of the revocation and entry of the                                   
02 finding.  Notice is considered given when delivered personally to the nurse aide or                                     
03 when mailed by certified mail addressed to the nurse aide's last known mailing address                                  
04 on file with the board.                                                                                                 
05  (d)  If the certified nurse aide is employed in a skilled nursing facility or a                                       
06 nursing facility, other than an intermediate care facility for the mentally retarded, that                              
07 is participating in the Medicaid or Medicare program, only the state survey and                                         
08 certification agency may make, and report to the Board of Nursing, a finding that the                                   
09 certified nurse aide has committed abuse, neglect, or misappropriation of property in                                   
10 connection with the nurse aide's employment at the facility.                                                            
11  (e)  The board shall establish procedures under which a finding under                                                 
12 AS 47.05.055 that a certified nurse aide has committed abuse, neglect, or                                               
13 misappropriation of property and the resulting revocation of certification will be                                      
14 removed from the registry if the certified nurse aide requests a hearing and can                                        
15 establish mistaken identity or the finding has been set aside by the reporting agency                                   
16 or by a court of competent jurisdiction.                                                                                
17  (f)  AS 44.62.330 - 44.62.630 do not apply to hearings held or the procedures                                         
18 established under this section.                                                                                         
19  Sec. 08.68.334.  Grounds for denial, suspension, or revocation of certificate.                                        
20 The board may deny a certification to, or impose a disciplinary sanction authorized                                     
21 under AS 08.01.075 against, a person who                                                                                
22   (1)  has obtained or attempted to obtain certification as a nurse aide by                                            
23 fraud, deceit, or intentional misrepresentation;                                                                        
24   (2)  has been convicted of a crime substantially related to the                                                      
25 qualifications, functions, or duties of a certified nurse aide;                                                         
26   (3)  has impersonated a registered or practical nurse or other licensed                                              
27 health care provider;                                                                                                   
28   (4)  has intentionally or negligently engaged in conduct that has resulted                                           
29 in a significant risk to the health or safety of a client or in injury to a client;                                     
30   (5)  is incapable of working as a certified nurse aide with reasonable                                               
31 skill, competence, and safety for the public because of                                                                 

01   (A)  professional incompetence;                                                                                     
02   (B)  addiction or severe dependency on alcohol or a drug that                                                       
03 impairs the licensee's ability to practice safely;                                                                      
04   (C)  physical or mental disability; or                                                                              
05   (D)  other factors determined by the board;                                                                         
06   (6)  has knowingly or repeatedly failed to comply with this chapter, a                                               
07 regulation adopted under this chapter, or with an order of the board; or                                                
08   (7)  has misappropriated the property of, abused, or neglected a client.                                             
09  Sec. 08.68.335.  Immunity for certain reports to the board.  A person who,                                            
10 in good faith, reports information to the board relating to alleged incidents of                                        
11 incompetent, unprofessional, or unlawful conduct of a certified nurse aide is not liable                                
12 in a civil action for damages resulting from the reporting of the information.                                          
13  Sec. 08.68.336.  Fees.  The Department of Commerce and Economic                                                       
14 Development shall set fees under AS 08.01.065 for certified nurse aides for each of                                     
15 the following:                                                                                                          
16   (1)  application;                                                                                                    
17   (2)  examination;                                                                                                    
18   (3)  certification; and                                                                                              
19   (4)  renewal of certification.                                                                                       
20    * Sec. 6.  AS 08.68.410 is amended by adding a new paragraph to read:                                                
21   (9) "certified nurse aide" is a person who is certified as a nurse aide by                                           
22 the board.                                                                                                              
23    * Sec. 7.  AS 44.62.330(a)(10) is amended to read:                                                                   
24   (10)  Board of Nursing functions, except those related to findings of                                               
25 abuse, neglect, or misappropriation of property contained in the registry of                                            
26 certified nurse aides under AS 08.68.333;                                                                              
27    * Sec. 8.  AS 47.05.010 is amended by adding a new paragraph to read:                                                
28   (15)  investigate reports of abuse, neglect, or misappropriation of                                                  
29 property by certified nurse aides in facilities licensed by the department under                                        
30 AS 18.20.                                                                                                               
31    * Sec. 9.  AS 47.05.017(b) is amended to read:                                                                       

01  (b)  The department shall adopt regulations identifying actions that it will take,                                    
02 in addition to those otherwise required under AS 47.17 and AS 47.24, when a report                                      
03 of harm is made under AS 47.17 or AS 47.24 that might relate to harm caused by                                          
04 actions or inactions of a public home care provider. The regulations must                                               
05   (1)  address circumstances under which the department will, or will                                                  
06 require a contractor or grantee to, reassign, suspend, or terminate a person alleged to                                 
07 have perpetrated harm; [AND]                                                                                            
08   (2)  include appropriate procedural safeguards to protect the due process                                            
09 rights of public home care providers who may be reassigned, suspended, or terminated                                    
10 under the circumstances described in (1) of this subsection; and                                                       
11   (3)  if the home care provider is a certified nurse aide, include                                                    
12 procedures under which the department shall notify the Board of Nursing if the                                          
13 nurse aide is suspected of abuse, neglect, or misappropriation of property.                                            
14    * Sec. 10.  AS 47.05 is amended by adding a new section to read:                                                     
15  Sec. 47.05.055.  Certified nurse aides.  (a)  If the department has reason to                                         
16 believe that a certified nurse aide employed in a facility licensed by the department                                   
17 under AS 18.20 has committed abuse, neglect, or misappropriation of property in                                         
18 connection with the person's duties as a certified nurse aide at the facility, the                                      
19 department shall investigate the matter.  The department shall conduct proceedings to                                   
20 determine if a finding of abuse, neglect, or misappropriation of property should be                                     
21 made.  These proceedings shall be conducted under regulations adopted by the                                            
22 department and are exempt from AS 44.62.330 - 44.62.630.  A finding under this                                          
23 subsection that a certified nurse aide has committed abuse, neglect, or misappropriation                                
24 of property shall be reported by the department to the Board of Nursing.                                                
25  (b)  If the certified nurse aide is employed in a skilled nursing facility or                                         
26 nursing facility, other than an intermediate care facility for the mentally retarded, that                              
27 is participating in the Medicaid or Medicare program, only the state survey and                                         
28 certification agency may make, and report to the Board of Nursing, a finding that a                                     
29 certified nurse aide has committed abuse, neglect, or misappropriation of property in                                   
30 connection with the nurse aide's employment at the facility.                                                            
31    * Sec. 11.  AS 47.17.030 is amended by adding a new subsection to read:                                              

01  (f)  If an investigation under this section shows reasonable cause to believe that                                    
02 a certified nurse aide has committed abuse, neglect, or misappropriation of property,                                   
03 the department shall report the matter to the Board of Nursing.                                                         
04    * Sec. 12.  AS 47.17.290(13) is amended to read:                                                                     
05   (13)  "practitioner of the healing arts" includes chiropractors, mental                                              
06 health counselors, dental hygienists, dentists, health aides, nurses, nurse practitioners,                             
07 certified nurse aides, occupational therapists, occupational therapy assistants,                                       
08 optometrists, osteopaths, naturopaths, physical therapists, physical therapy assistants,                                
09 physicians, physician's assistants, psychiatrists, psychologists, psychological associates,                             
10 audiologists licensed under AS 08.11, hearing aid dealers licensed under AS 08.55,                                      
11 marital and family therapists licensed under AS 08.63, religious healing practitioners,                                 
12 acupuncturists, and surgeons;                                                                                           
13    * Sec. 13.  AS 47.24.010(a) is amended by adding a new paragraph to read:                                            
14   (15)  a certified nurse aide.                                                                                        
15    * Sec. 14.  AS 47.24.013 is amended by adding a new subsection to read:                                              
16  (f)  If an investigation conducted by an agency under this section shows                                              
17 reasonable cause to believe that a certified nurse aide has committed abuse, neglect,                                   
18 or misappropriation of property, the agency shall report the matter to the Board of                                     
19 Nursing.                                                                                                                
20    * Sec. 15.  AS 47.24.015 is amended by adding a new subsection to read:                                              
21  (g)  If an investigation under this section shows reasonable cause to believe that                                    
22 a certified nurse aide has committed abuse, neglect, or misappropriation of property,                                   
23 the department shall report the matter to the Board of Nursing.                                                         
24    * Sec. 16.  AS 47.33.520 is amended by adding a new subsection to read:                                              
25  (f)  If the licensing agency's investigation shows reasonable cause to believe                                        
26 that a certified nurse aide has committed abuse, neglect, or misappropriation of                                        
27 property, the licensing agency shall report the matter to the Board of Nursing.                                         
28    * Sec. 17.  TRANSITION:  REGULATIONS.  A state agency affected by this Act may                                       
29 proceed to adopt regulations necessary to implement changes affecting the state agency that                             
30 are enacted by this Act.  The regulations take effect under AS 44.62 (Administrative                                    
31 Procedure Act), but not before the effective date of the changes in law in this Act.                                    

01    * Sec. 18.  TRANSITION:  CERTIFICATIONS.  (a)  A person who holds a current, valid                                   
02 certification from the Board of Nursing as a nurse aide on the day before the effective date                            
03 of this bill section, subject to continued eligibility under AS 08.68 and regulations adopted                           
04 under that chapter, is entitled to retain a renewable certification as a nurse aide.                                    
05  (b)  A person who, on the day before the effective date of this bill section, holds a                                  
06 certification from the Board of Nursing as a nurse aide that has been expired for less than two                         
07 years may apply for renewal of that certification under standards to be established by the                              
08 board.  A certification may not be renewed under this subsection unless the person applies for                          
09 the renewal before September 1, 1998.                                                                                   
10    * Sec. 19.  Section 17 of this Act takes effect immediately under AS 01.10.070(c).