Legislature(2001 - 2002)
04/15/2002 01:50 PM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
REPRESENTATIVE PEGGY WILSON, sponsor of HB 276, informed members
that the measure is a clean-up bill that aligns the nursing
statutes with current practice in three ways:
· It gives licensed nurses the authority to delegate nursing
duties to other personnel;
· It increases the length of time available for a temporary
nursing certificate from four to six months to accommodate
the length of time it takes to get a criminal background
check done;
· It changes the wording regarding licensure by endorsement
and aligns the statute with what is already being done.
· The Labor and Commerce Committee added a definition of
"unlicensed assistive personnel" so there would be no
question of who is covered.
CHAIRWOMAN GREEN asked for clarification.
REPRESENTATIVE WILSON said it specifies who a nurse can delegate
duties to in Section 6. She also pointed out the bill has a zero
fiscal note.
CHAIRWOMAN GREEN noted the term "unlicensed assistive personnel"
first appears in the bill on page 2, line 10.
REPRESENTATIVE WILSON said she has letters of support for HB 276
from the Alaska State Hospital and Nursing Home Association, the
Alaska Nurses Association, the Alaska School Nurses Association,
and the Alaska Board of Nursing, and the Division of Public
Health also support the measure. She indicated that she does not
know of anyone who opposes the bill.
SENATOR WILKEN stated support for HB 276 but noted that concerns
were expressed on behalf of the physicians. He asked if those
concerns have been addressed and whether any outstanding issues
remain.
REPRESENTATIVE WILSON said that adding the definition of
unlicensed assistive personnel raised the physicians' comfort
level. She said that as far as she knows, they are not opposed to
the measure.
CHAIRWOMAN GREEN asked what physicians Senator Wilken was
referring to.
SENATOR WILKEN said the Alaska Medical Association and private
physicians.
The committee took public testimony.
MS. LYNN HARTZ, a member of the Board of Nursing, said she will
only address amendments made to HB 276 in the Senate Labor and
Commerce Committee since she testified before the committee on SB
283, the companion bill to HB 276. The amendment, which is the
only change from the bill passed from committee, SB 283, puts the
term "unlicensed assistive personnel" into statute and defines
that term. It is a broad definition but a broad one is required
since UAPs work under many different job titles and new job
titles are created regularly. She emphasized the importance of
passing this bill because current nursing practice is to delegate
to unlicensed assistants daily and has been an accepted part of
the health care system for years. However, that practice is not
legally authorized in Alaska according to the assistant attorney
general. The board realizes this is going on and does not intend
to discipline nurses who currently delegate to unlicensed
personnel since enforcement would literally risk bringing health
facilities to a halt. Until this bill has passed, the board will
be unable to write or enforce any safety regulations regarding
delegation to UAPs. The board is advising nurses to abide by the
delegation guidelines, described in its 1993 position statement
on delegation, but that is not satisfactory since guidelines in
the position statement do not have the weight of regulation. The
board of nursing appreciates passage of SB 283 and CSHB 276(L&C)
with equal speed.
The committee took a brief at-ease.
MS. PATRICIA SENNER, Alaska Nurses Association, stated support
for CSHB 276(L&C). The Alaska Nurses Association is in agreement
with the definition of UAPs. She asked the committee to support
the bill and pass it out quickly.
MS. MARY WEYMILLER, Board of Nursing, told members the Board is
charged with the protection of the public for safe medical
practice. CSHB 276(L&C) will provide the legal authority needed
to write regulations to provide for safe delegation of nursing
tasks. One way that delegation is used in this changing health
care environment is for people who choose to stay in their homes
for as long as their conditions permit. Often these people do not
need skilled nursing care on a continuous basis but assistance
with their care if their condition is stable and long term. Those
delegating and being delegated to depend on the guidance of
statutes and regulations to set standards for safe practice. She
urged members to pass CSHB 276(L&C) so the Board of Nursing has
the authority to protect both the public and practitioners in the
delegation process.
MS. NANCY DAVIS, Chief of Public Health Nursing for the Alaska
Division of Public Health, stated support for CSHB 276(L&C) and
appreciates the language changes that clarify the endorsement
licensure process. The division especially appreciates the
attention given to the delegation of authority issue and the
definition of UAPs. Public health nurses work throughout rural
Alaska in villages and, in order to accomplish health care across
Alaska, it is essential to be able to delegate.
SENATOR WARD moved CSHB 276(L&C) and its accompanying fiscal
notes from committee with individual recommendations.
CHAIRWOMAN GREEN announced that with no objection, the motion
carried. The committee then took up HB 209.
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