02/02/2011 01:30 PM Senate HEALTH & SOCIAL SERVICES

                 SB 12-EXTEND BOARD OF NURSING                                                                              
                                                                                                                                
1:33:37 PM                                                                                                                    
SENATOR EGAN announced the consideration of SB 12.                                                                              
                                                                                                                                
CELESTE  HODGE,  staff to  Senator  Davis,  explained  that SB  12                                                              
extends  the  termination date  of  the  Alaska Board  of  Nursing                                                              
(BON) for  eight years  to June  30, 2019,  as recommended  by the                                                              
Legislative Budget  and Audit Committee in its  report of December                                                              
2010. The  mission of the Alaska  Board of Nursing is  to actively                                                              
promote and protect  the health of the citizens  of Alaska through                                                              
the safe  and effective  practice  of nursing  as defined  by law.                                                              
The BON plays an important role in public health and safety.                                                                    
                                                                                                                                
NANCY SANDERS,  Executive Administrator, Alaska Board  of Nursing,                                                              
stated she was available to answer questions.                                                                                   
                                                                                                                                
SENATOR  DYSON  asked if  the  BON  deals with  licensing  censure                                                              
issues.                                                                                                                         
                                                                                                                                
MS.  SANDERS responded  yes,  if  there is  a  complaint from  the                                                              
public or  from another  licensee, it is  investigated, and  if it                                                              
is founded, the BON acts to discipline the person's license                                                                     
                                                                                                                                
1:35:26 PM                                                                                                                    
SENATOR DYSON  said he  was specifically  referring to  complaints                                                              
having to  do with poor  medical practice,  and asked in  the last                                                              
five  years how  many complaints  have  they heard  per year,  and                                                              
what percentage of those resulted in disciplinary actions?                                                                      
                                                                                                                                
MS. SANDERS  replied  that she did  not have  specific numbers  in                                                              
front of her.                                                                                                                   
                                                                                                                                
SENATOR DYSON asked if she could give him a general idea.                                                                       
                                                                                                                                
MS.  SANDERS   replied  the  board   acts  on  several   types  of                                                              
complaints, such  as competency audits, inaccurate  information on                                                              
an  application,  and  unprofessional  conduct.  If  there  was  a                                                              
violation  of  unprofessional  conduct   regulations,  the  person                                                              
would be disciplined.                                                                                                           
                                                                                                                                
SENATOR  DYSON  asked  if they  see  unprofessional  conduct  that                                                              
affects patients.                                                                                                               
                                                                                                                                
MS. SANDERS said  they do see those types of  complaints, but they                                                              
are not the majority;  probably five to eight  per quarterly board                                                              
meeting.                                                                                                                        
                                                                                                                                
SENATOR DYSON responded  that he would like to  see statistics for                                                              
the last four or five years.                                                                                                    
                                                                                                                                
MS. SANDERS  said the  investigations unit  would have  the number                                                              
of complaints,  but she would only  know the number  that resulted                                                              
in actions.                                                                                                                     
                                                                                                                                
1:39:52 PM                                                                                                                    
SENATOR DYSON said  there was no hurry to receive  the statistics,                                                              
and then asked which groups of nurses can write prescriptions.                                                                  
                                                                                                                                
MS.  SANDERS  said  that  nurse   practitioners,  certified  nurse                                                              
midwives,   and    certified   nurse   anesthetists    can   write                                                              
prescriptions.                                                                                                                  
                                                                                                                                
SENATOR DYSON  asked if licensed  nurses in Alaska are  ever under                                                              
any pressure to not report unprofessional conduct.                                                                              
                                                                                                                                
MS. SANDERS replied not that she was aware of.                                                                                  
                                                                                                                                
1:43:48 PM                                                                                                                    
PAT  DAVIDSON,   Legislative  Auditor,  Division   of  Legislative                                                              
Audit, Alaska  State Legislature,  said she  performed the  sunset                                                              
review of  the Board  of Nursing (BON),  and recommended  that the                                                              
termination date be  extended until June 30, 2019.  She noted that                                                              
she also made four recommendations to the BON, as follows:                                                                      
                                                                                                                                
   · The BON should take action to insure that appropriate                                                                      
     people and agencies are notified when a nurse's                                                                            
     prescriptive authority is revoked.                                                                                         
   · The BON needs to improve oversight of the CNA training                                                                     
    program, especially in terms of the evaluation process.                                                                     
   · The current LPN member on the BON does not meet statutory                                                                  
     qualifications,  which require that  member to be  working in                                                              
     an institutional  nursing  situation. The  member who  was on                                                              
     the  Board  during  the  review  was an  LPN  working  as  an                                                              
     Emergency Medical Technician.                                                                                              
   · Fourth, the Division of Corporate, Professional and                                                                        
     Business Licenses  needs to  do more timely  investigation of                                                              
     complaints made against licensees.                                                                                         
                                                                                                                                
1:44:04 PM                                                                                                                    
SENATOR DYSON  asked if the  BON has a  plan of action  to address                                                              
the Audit Division's recommendations.                                                                                           
                                                                                                                                
MS. SANDERS responded  that they are aware of  the recommendations                                                              
and are taking steps to address them, as follows:                                                                               
                                                                                                                                
   · The BON has instituted policies to notify the federal Drug                                                                 
     Enforcement  Administration on  the first  day after  a board                                                              
     meeting  in which the  board took action  to suspend  a nurse                                                              
     practitioner's authority to write prescriptions.                                                                           
   · The BON is submitting those names to the Board of Pharmacy,                                                                
     and  if there  is  an employer  they  are  letting them  know                                                              
     about the  suspension or revocation.  They are  also updating                                                              
     the  disciplinary  database  on  their web  site  within  two                                                              
     weeks of the revocation.                                                                                                   
   · The division is aware that the CNA training program review                                                                 
     is  a federal  mandate  that is  also  in their  regulations.                                                              
     There have been  personnel issues, resulting  in the position                                                              
     reviewing  the programs  being unfilled.  The current  person                                                              
     is on  a two-year  contract. Eighty-five  percent of  the CNA                                                              
     programs have  been recently  reviewed and reapproved  or not                                                              
     by the BON.                                                                                                                
   · The current LPN term on the board expires at the end of                                                                    
     February  and a  new person  has been appointed  to board  in                                                              
     the LPN position.                                                                                                          
                                                                                                                                
1:45:36 PM                                                                                                                    
MS SANDERS  further explained  that the  suspension or  revocation                                                              
of  a  licensed  nurse  practitioner's  license  is  a  very  rare                                                              
occurrence,  and that  in four years  it has  only happened  three                                                              
times.                                                                                                                          
                                                                                                                                
1:47:45 PM                                                                                                                    
SENATOR  MEYER  moved   to  report  SB  12  from   committee  with                                                              
individual  recommendations  and  attached fiscal  note(s).  There                                                              
being  no  objection, SB  12  moved  from  the Senate  Health  and                                                              
Social Services Standing Committee.