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HB 35: "An Act relating to the certificate of need program for health care facilities; and providing for an effective date."

00 HOUSE BILL NO. 35 01 "An Act relating to the certificate of need program for health care facilities; and 02 providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 12.25.030(e) is amended to read: 05 (e) In this section, "health care facility" has the meaning given in 06 AS 12.55.155(c)(36) [AS 18.07.111]. 07 * Sec. 2. AS 12.55.155(c)(36)(A) is repealed and reenacted to read: 08 (A) "health care facility" means a private, municipal, state, or 09 federal hospital, psychiatric hospital, independent diagnostic testing facility, 10 residential psychiatric treatment center as defined in AS 18.20.400(d), 11 tuberculosis hospital, skilled nursing facility, kidney disease treatment center 12 (including freestanding hemodialysis units), intermediate care facility, and 13 ambulatory surgical facility; the term excludes 14 (i) the Alaska Pioneers' Home and the Alaska Veterans'

01 Home administered by the Department of Family and Community 02 Services under AS 47.55; and 03 (ii) the offices of private physicians or dentists whether 04 in individual or group practice; 05 * Sec. 3. AS 18.20.400(c) is amended to read: 06 (c) Subsection (a) of this section does not apply to 07 (1) a nurse who is employed by a health care facility providing 08 services for a school, school district, or other educational institution, when the nurse is 09 on duty for more than 14 consecutive hours during an occasional special event, such as 10 a field trip, that is sponsored by the employer; 11 (2) a nurse voluntarily working overtime on an aircraft in use for 12 medical transport, so long as the shift worked is allowable under regulations adopted 13 by the Board of Nursing based on accreditation standards adopted by the Commission 14 on Accreditation of Medical Transport Systems; 15 (3) a nurse on duty in overtime status 16 (A) who is participating in the performance of a medical 17 procedure or surgery that has begun but has not been completed; 18 (B) because of an unforeseen emergency situation that could 19 jeopardize patient safety; in this subparagraph, "unforeseen emergency 20 situation" means an unusual, unpredictable, or unforeseen situation caused by 21 an act of terrorism, disease outbreak, natural disaster, major disaster as defined 22 in 42 U.S.C. 5122, or disaster emergency under AS 26.23.020 or 26.23.140, 23 but does not include a situation in which a health care facility has reasonable 24 knowledge of increased patient volume or inadequate staffing because of some 25 other cause, if that cause is foreseeable; 26 (C) because the health care facility has a scheduling problem 27 caused by unforeseen weather conditions that prevent a second nurse from 28 arriving at the facility to relieve the nurse on duty; in this subparagraph, 29 "unforeseen weather conditions" means unusual, unpredictable, or unforeseen 30 weather so extreme as to impair travel to the health care facility, but does not 31 include a situation in which the health care facility has knowledge of the

01 weather conditions far enough in advance to act so that a scheduling problem 02 under this subparagraph can reasonably be avoided; or 03 (D) at a health care facility located in a rural community that 04 declares a temporary nurse staffing emergency under AS 18.20.410; 05 (4) a nurse fulfilling on-call time that is agreed on by the nurse and a 06 health care facility before it is scheduled unless fulfilling the on-call time would, in the 07 nurse's judgment, create an unacceptable risk to the physical safety of the nurse, a 08 patient, or an employee of the facility; 09 (5) a nurse voluntarily working overtime so long as the work is 10 consistent with professional standards and safe patient care and does not exceed 14 11 consecutive hours; 12 (6) a nurse voluntarily working beyond 80 hours in a 14-day period so 13 long as the nurse does not work more than 14 consecutive hours without a 10-hour 14 break and the work is consistent with professional standards and safe patient care; 15 (7) a nurse who 16 (A) is employed 17 (i) at a psychiatric treatment hospital that treats only 18 children or at a residential psychiatric treatment center [, AS DEFINED 19 UNDER AS 18.07.111,] that treats only children; in this sub- 20 subparagraph, "children" means persons under 19 years of age who are 21 receiving psychiatric treatment from a hospital or center or who are 22 residing in a center and who were under 18 years of age on the date that 23 the treatment or period of residence commenced; 24 (ii) at a residential psychiatric treatment center as 25 defined in [UNDER] AS 47.32.900; or 26 (iii) at a secure residential psychiatric treatment center 27 as defined in [UNDER] AS 47.12.990; 28 (B) voluntarily agrees to work a 16-hour shift for the period 29 between 5:00 p.m. on a Friday and 8:00 a.m. on the Monday that immediately 30 follows and receives pay and benefits for that work that are equal to or greater 31 than the pay and benefits the nurse would receive for working 20 regular hours

01 in the same position; and 02 (C) during the period described in (B) of this paragraph does 03 not work a 16-hour shift consecutive with another shift of eight hours or more 04 without an intervening break of at least eight hours; 05 (8) the first two hours on overtime status when the health care facility 06 is obtaining another nurse to work in place of the nurse in overtime status, so long as 07 the nurse in overtime status is not on duty for more than 14 consecutive hours. 08 * Sec. 4. AS 18.20.400 is amended by adding a new subsection to read: 09 (d) In (c)(7)(A)(i) of this section, "residential psychiatric treatment center" 10 means a secure or semi-secure psychiatric facility or inpatient program in a psychiatric 11 facility that is licensed by the Department of Family and Community Services and that 12 provides therapeutically appropriate and medically necessary diagnostic, evaluation, 13 and treatment services 14 (1) 24 hours a day for children with severe emotional or behavioral 15 disorders; 16 (2) under the direction of a physician; and 17 (3) under a professionally developed and supervised individual plan of 18 care designed to achieve the recipient's discharge from inpatient status at the earliest 19 possible time that is intensively and collaboratively delivered by an interdisciplinary 20 team involving medical, mental health, educational, and social service components. 21 * Sec. 5. AS 18.20.499(2) is amended to read: 22 (2) "health care facility" means a private, municipal, or state hospital; 23 independent diagnostic testing facility; primary care outpatient facility; skilled nursing 24 facility; kidney disease treatment center, including freestanding hemodialysis units; 25 intermediate care facility; ambulatory surgical facility; Alaska Pioneers' Home or 26 Alaska Veterans' Home administered by the Department of Family and Community 27 Services under AS 47.55; correctional facility owned or administered by the state; 28 private, municipal, or state facility employing one or more public health nurses; long- 29 term care facility; psychiatric hospital; residential psychiatric treatment center [,] as 30 defined in AS 18.20.400(d) [AS 18.07.111] or AS 47.32.900; secure residential 31 psychiatric treatment center as defined in [UNDER] AS 47.12.990; juvenile detention

01 facility or juvenile treatment facility [,] as those terms are defined in AS 47.12.990; or 02 treatment institution as [THAT TERM IS] defined in AS 47.14.990; 03 * Sec. 6. AS 18.26.220 is amended to read: 04 Sec. 18.26.220. Facility compliance with health and safety laws and 05 licensing requirements. A medical facility constructed, acquired, improved, financed, 06 or otherwise under the provisions of this chapter and all actions of the authority are 07 subject to [AS 18.07,] AS 47.32 [,] and any other present or future state licensing 08 requirements for the facilities or services provided under this chapter. [A MEDICAL 09 FACILITY ISSUED A CERTIFICATE OF NEED UNDER SEC. 4, CH. 275, SLA 10 1976, BY VIRTUE OF BEING IN EXISTENCE OR UNDER CONSTRUCTION 11 BEFORE JULY 1, 1976, MUST FULLY MEET THE REQUIREMENTS OF 12 AS 18.07 IN ORDER TO BE ELIGIBLE FOR FUNDING UNDER THIS 13 CHAPTER.] 14 * Sec. 7. AS 18.35.399(9) is amended to read: 15 (9) "health care facility" means an office or institution providing care 16 or treatment for physical, mental, emotional, or other medical, dental, physiological, or 17 psychological diseases or conditions; private, municipal, or state hospital; independent 18 diagnostic testing facility; primary care outpatient facility; skilled nursing facility; 19 kidney disease treatment center, including freestanding hemodialysis units; 20 intermediate care facility; ambulatory surgical facility; Alaska Pioneers' Home or 21 Alaska Veterans' Home administered by the department under AS 47.55; long-term 22 care facility; psychiatric hospital; residential psychiatric treatment center, as defined in 23 AS 18.20.400(d) [AS 18.07.111] or AS 47.32.900; and other facilities, places of 24 employment, or offices operated for use by doctors, nurses, surgeons, chiropractors, 25 physical therapists, physicians, psychiatrists, or dentists or other professional health 26 care providers to provide health care; 27 * Sec. 8. AS 18.07.021, 18.07.031, 18.07.035, 18.07.041, 18.07.043, 18.07.045, 18.07.051, 28 18.07.061, 18.07.071, 18.07.081, 18.07.091, 18.07.101, 18.07.111; AS 21.86.030(c)(1); 29 AS 44.64.030(a)(18); and AS 47.80.140(b) are repealed. 30 * Sec. 9. Section 4, ch. 275, SLA 1976, is repealed. 31 * Sec. 10. The uncodified law of the State of Alaska is amended by adding a new section to

01 read: 02 CERTIFICATES OF NEED; APPLICABILITY. The Department of Family and 03 Community Services may not take action on or after the effective date of this Act to revoke, 04 enforce, or modify a certificate of need issued to a health care facility before the effective date 05 of this Act. 06 * Sec. 11. This Act takes effect July 1, 2024.