SB 1: "An Act repealing the certificate of need program for health care facilities; making conforming amendments; and providing for an effective date."

00 SENATE BILL NO. 1 01 "An Act repealing the certificate of need program for health care facilities; making 02 conforming amendments; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 18.20.400(c) is amended to read: 05 (c) Subsection (a) of this section does not apply to 06 (1) a nurse who is employed by a health care facility providing 07 services for a school, school district, or other educational institution, when the nurse is 08 on duty for more than 14 consecutive hours during an occasional special event, such as 09 a field trip, that is sponsored by the employer; 10 (2) a nurse voluntarily working overtime on an aircraft in use for 11 medical transport, so long as the shift worked is allowable under regulations adopted 12 by the Board of Nursing based on accreditation standards adopted by the Commission 13 on Accreditation of Medical Transport Systems; 14 (3) a nurse on duty in overtime status

01 (A) who is participating in the performance of a medical 02 procedure or surgery that has begun but has not been completed; 03 (B) because of an unforeseen emergency situation that could 04 jeopardize patient safety; in this subparagraph, "unforeseen emergency 05 situation" means an unusual, unpredictable, or unforeseen situation caused by 06 an act of terrorism, disease outbreak, natural disaster, major disaster as defined 07 in 42 U.S.C. 5122, or disaster emergency under AS 26.23.020 or 26.23.140, 08 but does not include a situation in which a health care facility has reasonable 09 knowledge of increased patient volume or inadequate staffing because of some 10 other cause, if that cause is foreseeable; 11 (C) because the health care facility has a scheduling problem 12 caused by unforeseen weather conditions that prevent a second nurse from 13 arriving at the facility to relieve the nurse on duty; in this subparagraph, 14 "unforeseen weather conditions" means unusual, unpredictable, or unforeseen 15 weather so extreme as to impair travel to the health care facility, but does not 16 include a situation in which the health care facility has knowledge of the 17 weather conditions far enough in advance to act so that a scheduling problem 18 under this subparagraph can reasonably be avoided; or 19 (D) at a health care facility located in a rural community that 20 declares a temporary nurse staffing emergency under AS 18.20.410; 21 (4) a nurse fulfilling on-call time that is agreed on by the nurse and a 22 health care facility before it is scheduled unless fulfilling the on-call time would, in the 23 nurse's judgment, create an unacceptable risk to the physical safety of the nurse, a 24 patient, or an employee of the facility; 25 (5) a nurse voluntarily working overtime so long as the work is 26 consistent with professional standards and safe patient care and does not exceed 14 27 consecutive hours; 28 (6) a nurse voluntarily working beyond 80 hours in a 14-day period so 29 long as the nurse does not work more than 14 consecutive hours without a 10-hour 30 break and the work is consistent with professional standards and safe patient care; 31 (7) a nurse who

01 (A) is employed 02 (i) at a psychiatric treatment hospital that treats only 03 children or at a residential psychiatric treatment center, as defined in 04 (d) of this section [UNDER AS 18.07.111], that treats only children; in 05 this sub-subparagraph, "children" means persons under 19 years of age 06 who are receiving psychiatric treatment from a hospital or center or 07 who are residing in a center and who were under 18 years of age on the 08 date that the treatment or period of residence commenced; 09 (ii) at a residential psychiatric treatment center as 10 defined in [UNDER] AS 47.32.900; or 11 (iii) at a secure residential psychiatric treatment center 12 as defined in [UNDER] AS 47.12.990; 13 (B) voluntarily agrees to work a 16-hour shift for the period 14 between 5:00 p.m. on a Friday and 8:00 a.m. on the Monday that immediately 15 follows and receives pay and benefits for that work that are equal to or greater 16 than the pay and benefits the nurse would receive for working 20 regular hours 17 in the same position; and 18 (C) during the period described in (B) of this paragraph does 19 not work a 16-hour shift consecutive with another shift of eight hours or more 20 without an intervening break of at least eight hours; 21 (8) the first two hours on overtime status when the health care facility 22 is obtaining another nurse to work in place of the nurse in overtime status, so long as 23 the nurse in overtime status is not on duty for more than 14 consecutive hours. 24 * Sec. 2. AS 18.20.400 is amended by adding a new subsection to read: 25 (d) In (c)(7)(A)(i) of this section, "residential psychiatric treatment center" 26 means a secure or semi-secure psychiatric facility or inpatient program in a psychiatric 27 facility that is licensed by the Department of Health and Social Services and that 28 provides therapeutically appropriate and medically necessary diagnostic, evaluation, 29 and treatment services 30 (1) 24 hours a day for children with severe emotional or behavioral 31 disorders;

01 (2) under the direction of a physician; and 02 (3) under a professionally developed and supervised individual plan of 03 care designed to achieve the recipient's discharge from inpatient status at the earliest 04 possible time that is intensively and collaboratively delivered by an interdisciplinary 05 team involving medical, mental health, educational, and social service components. 06 * Sec. 3. AS 18.20.499(2) is amended to read: 07 (2) "health care facility" means a private, municipal, or state hospital; 08 independent diagnostic testing facility; primary care outpatient facility; skilled nursing 09 facility; kidney disease treatment center, including freestanding hemodialysis units; 10 intermediate care facility; ambulatory surgical facility; Alaska Pioneers' Home or 11 Alaska Veterans' Home administered by the Department of Health and Social Services 12 under AS 47.55; correctional facility owned or administered by the state; private, 13 municipal, or state facility employing one or more public health nurses; long-term care 14 facility; psychiatric hospital; residential psychiatric treatment center, as defined in 15 AS 18.20.400(d) [AS 18.07.111] or AS 47.32.900; secure residential psychiatric 16 treatment center as defined in [UNDER] AS 47.12.990; juvenile detention facility; 17 juvenile detention home, juvenile work camp, or treatment facility as defined in 18 AS 47.12.990; 19 * Sec. 4. AS 18.26.220 is amended to read: 20 Sec. 18.26.220. Facility compliance with health and safety laws and 21 licensing requirements. A medical facility constructed, acquired, improved, financed, 22 or otherwise under the provisions of this chapter and all actions of the authority are 23 subject to [AS 18.07,] AS 47.32 [,] and any other present or future state licensing 24 requirements for the facilities or services provided under this chapter. [A MEDICAL 25 FACILITY ISSUED A CERTIFICATE OF NEED UNDER SEC. 4, CH. 275, SLA 26 1976, BY VIRTUE OF BEING IN EXISTENCE OR UNDER CONSTRUCTION 27 BEFORE JULY 1, 1976, MUST FULLY MEET THE REQUIREMENTS OF 28 AS 18.07 IN ORDER TO BE ELIGIBLE FOR FUNDING UNDER THIS 29 CHAPTER.] 30 * Sec. 5. AS 18.07.021, 18.07.031, 18.07.035, 18.07.041, 18.07.043, 18.07.045, 18.07.051, 31 18.07.061, 18.07.071, 18.07.081, 18.07.091, 18.07.101, 18.07.111; AS 21.86.030(c)(1);

01 AS 44.64.030(a)(18); and AS 47.80.140(b) are repealed. 02 * Sec. 6. Section 4, ch. 275, SLA 1976, is repealed. 03 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 04 read: 05 CERTIFICATES OF NEED; APPLICABILITY. The Department of Health and 06 Social Services may not take action on or after the effective date of this Act to revoke, 07 enforce, or modify a certificate of need issued to a health care facility before the effective date 08 of this Act. 09 * Sec. 8. This Act takes effect July 1, 2020.