04/22/2019 03:15 PM House LABOR & COMMERCE

                 SB 36-EXTEND BOARD OF NURSING                                                                              
                                                                                                                                
3:32:45 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL announced that the  next order of business would be                                                               
SENATE BILL  NO. 36,  "An Act extending  the termination  date of                                                               
the Board of Nursing; and providing for an effective date."                                                                     
                                                                                                                                
3:33:10 PM                                                                                                                    
                                                                                                                                
SENATOR  CATHY  GIESSEL,  Alaska   State  Legislature,  as  prime                                                               
sponsor of  SB 36, introduced  the bill and paraphrased  parts of                                                               
the sponsor  statement [included in the  committee packet], which                                                               
read in its entirety as follows [original punctuation provided]:                                                                
                                                                                                                                
     In accordance  with AS  08.03.010(c)(14,) the  Board of                                                                    
     Nursing  is  scheduled  to  terminate  June  30,  2019.                                                                    
     Senate  Bill 36  extends the  board's termination  date                                                                    
     six years to June 30, 2025.                                                                                                
                                                                                                                                
     The Board of Nursing is  established under AS 08.68 for                                                                    
     the purpose of controlling  and regulating the practice                                                                    
     of  nursing,   including  APRNs,   nurse  anesthetists,                                                                    
     registered nurses, LPNs and CNAs.                                                                                          
                                                                                                                                
     The board's  mission statement 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 audit of the Board  demonstrated that it is meeting                                                                    
     this mission.                                                                                                              
                                                                                                                                
SENATOR GIESSEL  addressed the Board  of Nursing's  sunset audit,                                                               
which was  conducted by the  Division of Legislative  Audit (DLA)                                                               
to determine the  need for the board's continued  existence.  She                                                               
noted that the  DLA made four recommendations, all  of which have                                                               
been agreed to  by the board.  She directed  attention to page 11                                                               
of  the audit  and  addressed the  337,422-dollar  deficit.   She                                                               
pointed  out  that the  board's  revenues  and expenditures  have                                                               
since been updated  to reflect the license  renewals from October                                                               
and November  2018.  She  assured the committee  that, currently,                                                               
"the cash box is full."                                                                                                         
                                                                                                                                
3:36:43 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  LEDOUX  asked  why  the   DLA  recommended  a  six-year                                                               
extension as opposed to three or four years.                                                                                    
                                                                                                                                
SENATOR  GIESSEL offered  her understanding  that the  DLA wanted                                                               
the ability  to follow up  and ensure that  prior recommendations                                                               
will be resolved.                                                                                                               
                                                                                                                                
3:37:48 PM                                                                                                                    
                                                                                                                                
KAREN BUCHKOSKI,  Audit Manager,  Division of  Legislative Audit,                                                               
Legislative  Affairs  Agency,  explained that  the  reduction  in                                                               
extension time was due to the repeat findings.                                                                                  
                                                                                                                                
3:40:52 PM                                                                                                                    
                                                                                                                                
SARAH CHAMBERS, Director, Division  of Corporations, Business and                                                               
Professional  Licensing,  Department  of  Commerce,  Community  &                                                               
Economic   Development,   in   response  to   a   question   from                                                               
Representative Hannan, said  that the audit was one  of the first                                                               
things  that the  new board  addressed.   She  revealed that  the                                                               
board recently approved  two sets of regulations  to be forwarded                                                               
for public notice once they are through the legal process.                                                                      
                                                                                                                                
3:41:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HANNAN  mentioned the opioid crisis  and expressed                                                               
concern   that   notifications   of   license   suspensions   for                                                               
prescriptive  authority  weren't being  dealt  with  in a  timely                                                               
matter.   She asked how  soon the  regulations would be  in place                                                               
and wondered if they would adequately address the problem.                                                                      
                                                                                                                                
MS.  CHAMBERS  explained  that the  division  views  the  audit's                                                               
recommendation   as  an   extra   safeguard.     She  said   that                                                               
administrative measures were established  6 months ago to address                                                               
the problem.   She said the  board created the regulations  as an                                                               
extra  step  and  to  "make  sure   that  it  was  a  mandate  on                                                               
themselves."                                                                                                                    
                                                                                                                                
3:46:09 PM                                                                                                                    
                                                                                                                                
CO-CHAIR LEDOUX pointed  out that the board is  still missing one                                                               
member  because  one  of  the   appointees  didn't  meet  certain                                                               
requirements.                                                                                                                   
                                                                                                                                
REPRESENTATIVE FIELDS requested  that the DCCED follow  up on the                                                               
review of CNA programs and report back to the committee.                                                                        
                                                                                                                                
MS.  CHAMBERS offered  to give  the committee  a current  update.                                                               
She  said that  timeframe of  lookback  for the  audit covered  a                                                               
period  when   the  board  was  switching   from  an  independent                                                               
contractor  to a  permanent  position, which  went  vacant for  a                                                               
period of time.  During  that time, she said, "programs approvals                                                               
fell by  the wayside  and the  board itself  didn't pick  up that                                                               
activity."  She said once  the position was filled, they returned                                                               
to a  regular schedule  and a  full update on  the status  of CNA                                                               
program  reviews was  reported to  the new  board at  their first                                                               
meeting.  She stated that it is no longer a deficiency.                                                                         
                                                                                                                                
REPRESENTATIVE FIELDS questioned whether  all 22 CNA programs are                                                               
getting inspected.                                                                                                              
                                                                                                                                
MS. CHAMBERS confirmed that they  are all inspected on a biennial                                                               
basis.  She noted that they  received a federal grant through the                                                               
Department of  Health and  Social Services  (DHSS) to  offset the                                                               
cost and ensure that it doesn't  fall on the certified nurse aids                                                               
themselves.                                                                                                                     
                                                                                                                                
3:48:49 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL  questioned whether the 22  CNA [training] programs                                                               
are mostly affiliated with hospitals or if they are educational.                                                                
                                                                                                                                
MS. CHAMBERS replied  that there is a variety;  for example, some                                                               
are private,  and some are  affiliated with  university programs.                                                               
Nonetheless, she pointed out that all  of them must meet the same                                                               
standards.                                                                                                                      
                                                                                                                                
3:49:33 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL announced that SB 36 was held over.