Legislature(2007 - 2008)SENATE FINANCE 532
03/04/2008 09:00 AM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB176 | |
| SB28 |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 176 | TELECONFERENCED | |
| += | SB 170 | TELECONFERENCED | |
| + | SB 28 | TELECONFERENCED | |
| += | SB 249 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE BILL NO. 28
"An Act relating to limitations on mandatory overtime
for registered nurses and licensed practical nurses in
health care facilities; and providing for an effective
date."
9:42:43 AM
SENATOR BETTYE DAVIS, SPONSOR, introduced SB 28.
TOM OBERMEYER, STAFF, SENATOR DAVIS, observed that SB 28 was
modeled after Congressional Resolution #791. He read from
the sponsor statement:
SB 28, hereafter also to be known as "The Alaska Safe
Nursing and Patient Care Act," prevents Alaska
registered and licensed practical nurses from being
forced to work mandatory overtime, i.e., compulsory as
opposed to voluntary work in excess of an agreed to,
predetermined, regularly scheduled shift, and it
protects patients from the dangers caused by overworked
nurses. Too often Alaska's nurses are overworked,
underpaid, and undervalued. This bill will improve the
lives of nurses and their families and enhance the
quality of patient care in communities across the
state. It will let nurses decide if they can provide
their same quality care while working overtime. SB 28
strictly limits the use of mandatory overtime for
nurses to situations in which an official state of
emergency is declared by federal, state or a local
government, or other stated exceptions. It does,
however, allow nurses to work overtime voluntarily when
they feel they can continue to provide safe, quality
care. This legislation also protects nurses from
discrimination and retaliation by employers who
continue to force them into working hours beyond what
they believe safe for quality care. SB 28 requires
that health care facilities monitor, document, and
report overtime semiannually and face penalties for
knowing violations. Faced with nursing shortages
nationwide, Alaska needs to encourage and support
nurses to enter and stay in the profession. SB 28 is a
long overdue step in that direction.
9:49:18 AM
Senator Olson asked if the provision effected all nurses
regardless of classification. Mr. Obermeyer clarified that
the bill includes all licensed practical nurses and all
registered nurses with some exceptions.
Senator Olson asked if rural hospitals had expressed
concerns regarding mandatory overtime. Mr. Obermeyer said
he had not heard from rural areas. He commented that there
were members of nurse's organizations in the audience that
could respond to the question. Senator Davis observed that
there had been no testifiers from rural communities in any
of the previous committee hearings.
Senator Olson stressed that unanticipated delays can happen
in rural areas. He described situations that would not
allow for the 10 hour rest requirement, specifically medical
airlift situations. Mr. Obermeyer explained that there were
changes made to SB 28 to accommodate emergency situations,
specifically medical airlift situations.
Co-Chair Stedman asked if the legislation would provide a
management tool to reduce the nursing gap. Senator Davis
differed to the nurses association.
Co-Chair Stedman asked if the mandatory overtime is a
negotiated labor issue.
Senator Davis said the issue should be worked out between
employer and employee, but acknowledged that this was not
happening. Nurses maintain that they are putting in more
hours than is appropriate, hence the need for legislation.
9:53:03 AM
Co-Chair Stedman asked if the provision would alleviate the
nursing shortage. Senator Davis responded that, though it
might not alleviate the situation, it may promote retention
of nurses in Alaska.
Senator Steadman asked who opposes SB 28. Senator Davis
observed that that the Alaska State and Hospital and Nursing
Home Association (ASHNHA) would be testifying in opposition
to the bill.
Senator Steadman questioned the Department of Labor and
Workforce Development's fiscal note for $97.2 thousand for a
new wage and hour investigator. He expected that the
Committee would look at zeroing out the fiscal note.
GREY MITCHELL, DIRECTOR, DIVISION OF LABOR STANDARDS &
SAFETY, DEPARTMENT OF LABOR & WORK FORCE DEVELOPMENT,
addressed the $97.2 thousand fiscal note. He explained the
fiscal note represents the cost of one investigator to deal
with complaints from nurses regarding mandatory overtime and
discrimination issues. He said, as of February 28, 2008,
there are potentially 10,000 complainants. He maintained
that the fiscal note is conservative in view of the
potential amount of complaints.
9:55:21 AM
Co-Chair Stedman asked if the Department supports SB 28.
Mr. Mitchell said the Department has no position on the
bill.
Senator Huggins asked if the provision is precedent setting.
He further inquired if there are other mechanisms available
to the Department to address the issue of mandatory
overtime.
9:59:54 AM
Mr. Mitchell said he could not suggest another mechanism.
He explained that if the provision is enacted the burden of
enforcement falls on the Department of Labor and Workforce
Development, as outlined in the provision.
Senator Huggins asked if there are any innovative ideas for
addressing the issue.
Co-Chair Hoffman addressed the fiscal note and asked what
the $19.1 thousand under contractual represented.
10:01:58 AM
Mr. Mitchell explained that the contractual line represents
a wide range of overhead costs. He clarified that the
Department is not contracting with any entity.
Senator Olson asked how many complaint actions have been
brought to the Department. Mr. Mitchell said there were
approximately 500 wage claims filed per year.
Senator Elton asked how many wage and hour investigators
were employed by the Department. Mr. Mitchell said there
are 10 wage and hour investigators statewide.
Senator Elton reasoned that additional responsibilities
added to the position would result in a 10 percent increase
in the work load. Mr. Mitchell said that was a reasonable
approximation.
Senator Elton surmised that if investigators were located
around the State and no position was added, the travel and
contractual component would be unnecessary. Mr. Mitchell
said the travel component would be necessary as
investigators need to travel to investigate complaints.
Discrimination cases in particular require travel to the
place where the complaint initiates.
Senator Elton ascertained that if there are investigators
available around the state it would preclude the need for
travel funds. Mr. Mitchell agreed that was a fair
assessment.
10:05:13 AM
Senator Thomas asked if the fines imposed in SB 28 are
standard for wage violations.
Mr. Mitchell said the fines proposed in SB 28 are civil
fines. There are no civil fines pursued by the Wage and
Hour Division under the wage enforcement requirements. In
cases where an employee does not get paid overtime or
minimum wage, the statute provides for liquidated damages to
be paid to the employee. The difference in SB 28 is that
civil penalties would be applied to those in violation of
the provision to be paid to the state.
10:06:49 AM
RON ADLER, CHIEF EXECUTIVE OFFICER, ALASKA PSYCHIATRIC
INSTITUTE, (API), testified via teleconference. He noted
that API is neutral on the bill. He explained that if the
provision passed there would be ramifications for the
hospital. He informed the Committee that prospective
employees are notified that mandatory overtime is used.
There have been not had a grievances filed to date.
SUSAN JOHNSTON, DIRECTOR FOR COMPENSATION AND BENEFITS,
PROVIDENCE HOSPITAL, testified via teleconference, in
opposition to SB 28. She stated that the hospital would
rather work with the management team to address nurse's
concerns. She informed the Committee that the hospital has
provisions within the collective bargaining agreement to
minimize overtime.
Senator Elton asked if the hospital had nurses who are
working more than 14 hours without a 10 hour break between
shifts. Ms. Johnston explained that the hospital does have
nurses working overtime. She explained that there is a
provision within the contract that provides premium pay for
those with less than an eight hour break between shifts.
There is no mandatory overtime at Providence Hospital.
Senator Elton asked for an explanation of mandatory overtime
and questioned if it differs from mandatory call. Ms.
Johnston replied that only three units in their largest
hospital have mandatory call. Mandatory call requires nurses
to be available "on call". Nurses are paid for that time.
Nurses within that group understand the requirement when
they are hired for the position.
Senator Elton asked if mandatory call can be applied even
after a nurse has had a fourteen hour shift. Ms. Johnston
confirmed that there is potential for that circumstance.
REBECCA BOLLING, ALASKA NURSES ASSOCIATION, KETCHIKAN,
testified via teleconference, in support of SB 28. She
explained the challenges and difficulties of working
overtime. She said if a nurse is on call they can, after
working a 12 hour shift, return five hours later and still
work the regularly scheduled shift the next day. She added
that mandatory overtime is frequently used in the operating
room and poses a safety risk to both patients and staff. She
further noted that the present conditions are not conducive
for recruitment of new staff.
Senator Olson asked Ms. Bolling if there is equity in the
request when considering some registered nurses serve in
administrative positions, rather than direct patient care.
Ms. Bolling said that administrative staff is not called in
for mandatory overtime. Mandatory overtime is generally
used for nurses in direct patient care.
10:15:21 AM
Senator Thomas asked if nurses work beyond a 12 hour shift
within a 14 day period. Ms. Bolling said that it is routine
with approximately 20 nurses working more than 80 hours in a
week.
PAMELA REID, REGISTERED NURSE, testified via teleconference,
in opposition to SB 28. She disagreed with the provision
for three reasons: 10 hours rest required between shifts,
restricted work hours to 14 hours, and no provision for
bailor nurses. She explained that bailor nurseswork a
reduced number of hours, during inconvenient times, and are
paid for working a full shift. She said there is no
mandatory on call or overtime at North Star. She pointed
out that the provision does not preclude nurses from putting
in extra shifts at another facility. She recommended a
change in Sec. 18.20.400 (c),6: delete "14 consecutive hours
without a 10 hour break" insert "16 hours with 7.5 hour
break". She concluded by requesting that language be added
to address bailor nurses.
DEBBIE THOMPSON, PRESIDENT, ALASKA NURSES ASSOCIATION,
ANCHORAGE, testified via teleconference, in support of SB
28. She outlined her history in the field. She noted the
danger of overworked nurses and opined that nurses coming
into the profession would not want to work in the current
environment.
10:25:12 AM
TOM RENKES, EXECUTIVE DIRECTOR, ALASKA NURSES ASSOCIATION,
testified via teleconference, testified in support of SB 28.
He outlined his extensive work history in the nursing field
and read from statement (copy on file).
In the last 5 months I have personally visited and
spoke with nurses in Fairbanks Valdez, Anchorage,
Wrangell, Ketchikan, Juneau, and Wasilla, as well as
several groups of nursing students from UAA and their
faculty. One hundred of those nurses interviewed said
mandatory overtime is a problem in their career, while
the students indicated they would not work at a
facility where overtime was the rule and mandatory
overtime was a policy.
There is major arbitration occurring as we speak for
one facility's inability to offer meals and breaks to
nurses during the course of a work day. There is
th
another facility that has on RN on her 7 12 hour shift
in 8 days, which is why she cannot be here today.
Finally, one nurse at a Southeast facility indicated it
was just expected they take mandatory call because they
always work short.
Mr. Renkes continued his testimony with a quote from the
National Academy of Science, Institute of Medicine, Authored
by John Howard MD: Report section 6.1 "To reduce error
producing fatigue, state regulatory bodies should prohibit
nursing staff from providing patient care in any combination
of scheduled shift, mandatory overtime, volunteer overtime
in excess of 12 hours in any given 24 hour period, in an
excess of 60 hours in a seven day period". By 2002, eight
states prohibited mandatory overtime, after the reports five
other states immediately enacted legislation.
There is similar legislation nationally that covers airline
pilots, railroad engineers, police officers, firefighters,
maritime personnel, physicians and pilots in military
combat. He referenced an editorial on fatigue from February
27, 2008, Anchorage Daily News. The article mentioned
several cases of fatigue among nursing staff and determined
that by increasing nursing staff to reduce fatigue,
hospitals could save money. He informed the Committee that
there are 9,000 registered nurses licensed in the state. Six
thousand registered nurses live in Alaska: 4,500 work in
acute care. It has been proven by the Board of Nursing that
newly licensed nurses are leaving Alaska due to the work
environment.
Senator Elton asked if patients have the right to request a
nurse that has worked only four hours that day. Mr. Renkes
said a patient does not have that right.
10:30:16 AM
NANCY DAVIS, VICE PRESIDENT, ALASKA NURSES ASSOCIATION,
testified in support of SB 28 and outlined her history in
the nursing field. She provided some information on the
Bailor plan explaining that originally the intent was to
establish two, 12 hour nursing shifts to cover weekends. The
plan has changed considerably from its original intent. She
maintained that extending the shifts creates a safety risk
to patients as well as to the nursing staff. She informed
the Committee that in the Gallup poll nurses have been rated
as the number one profession for professional honesty and
ethics. As an extension of that, patients expect that
nurses speak for patient safety. She asked the Committee to
support nurses and patient safety by passing SB 28.
ROD BETIT, PRESIDENT, CEO, ALASKA STATE HOSPITAL AND NURSING
HOME ASSOCIATION (ASHNHA), testified in opposition to SB 28.
He presented a chart, ASHNHA 2004 and 2005 Nurse Overtime
Survey Results - Version 'D', 2/03/06 (copy on file). He
clarified that 10 of the facilities represented in the chart
have negotiated labor agreements governing mandatory
overtime. The other 21 facilities deal with overtime issues
among staff. The survey reveled that there is no
significant use of mandatory overtime other than at the
Alaska Psychiatric Institute. He explained that the
psychiatric facilities have unique circumstances that
require the need for mandatory overtime. He further
clarified that there is an expectation that nurses be on
call in certain units. He pointed out that the mandatory
overtime for Bartlett Hospital is a result of excess hours
of nurses in surgery. He further explained that there is a
pattern of temporary nurse hours purchased to fill the gap
in nursing hours.
Mr. Betit reported that ASHNA has been working with the
University Of Alaska Anchorage to improve the nursing
shortage. Members of ASHNHA contribute financially to the
expanded nursing program, which is now producing 200 nurses
a year with 93% of the nurses continuing to work in Alaska.
ASHNHA has not seen supportive documentation that mandatory
overtime is a problem and does not support SB 28.
Senator Elton referenced earlier comments regarding Bartlett
Regional Hospital mandatory overtime for operating room (OR)
nurses. He asked if mandatory overtime for OR nurses is an
issue for other facilities. Mr. Betit said at other
facilities OR nurses have worked out the issue through labor
agreements.
Senator Elton referenced the chart and asked if "on-call"
represents mandatory overtime. Mr. Betit confirmed that was
correct.
Senator Elton asked who had been surveyed. Mr. Betit said
the survey went to each CEO of the facilities to give to
their personnel department to collect the information.
Senator Thomas asked what hospitals consider a safe amount
of hours for someone to work in acute care. Mr. Betit said
the facilities consider that with staff when scheduling.
10:38:41 AM
Senator Thomas asked if the hours are based on a five day
work week. Mr. Betit explained that if you are working a 12
hour shift, typically that would be a three day week.
Senator Thomas asked why Providence Hospital was not
represented in the temporary nursing hour's column. Mr.
Betit said they do have temporary nurses, but their data was
not collected in that specific detail.
10:39:50 AM
Senator Olson asked how many lawsuits have been filed
against any of the institutions due to mistakes made by
nurses. Mr. Betit said he is unaware of any lawsuits and
referenced the chart.
Senator Elton asked if the grievances are filed by nurses or
patients. Mr. Betit said the chart represents grievances
filed by nurses.
In response to Senator Elton's question, Mr. Betit said a
grievance can be filed any time a person feels they have
been treated inappropriately by an employer.
Senator Elton asked if patients can request a nurse that is
not on overtime.
10:41:35 AM
Mr. Betit said he did not think that was possible at any
facility. He offered to follow up on the question.
Senator Olson asked if physicians have commented on the
provision. Senator Davis said that there is one letter of
support from Dr. Patrick Nolan in the packets.
SB 28 was HEARD and HELD in Committee for further
consideration.
AT EASE: 10:43:44 AM
RECONVIENE: 10:44:15 AM
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