Legislature(2015 - 2016)SENATE FINANCE 532
04/14/2015 09:00 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB82 | |
| SB53 | |
| HB146 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 53 | TELECONFERENCED | |
| + | HB 146 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 82 | TELECONFERENCED | |
SENATE BILL NO. 53
"An Act relating to advanced practice registered
nursing; relating to certified direct-entry midwifery;
and providing for an effective date."
9:22:36 AM
AT EASE
9:22:43 AM
RECONVENED
Co-Chair MacKinnon introduced SB 53.
9:23:09 AM
SENATOR CATHY GIESSEL, SPONSOR, directed the committee to a
chart from the Advanced Practice Registered Nurse (APRN)
Alliance (copy on file). She said that over the past 34
years that the state had authorized the practice for
advanced nurse practitioners and nurse anesthetists
additional nursing specialties in advance practice had
evolved. She said that the advanced categories of Advanced
Nurse Practitioner (ANP); Nurse Anesthetist (NA); Certified
Nurse Midwife (CNM); and Clinical Nurse Specialist (CNS),
had been brought under the single title of APRN. She shared
that 11 states had completed the transition to the single
title and 13 were working on the transition. She relayed
that there were approximately 1000 APRN's in the state.
9:26:24 AM
Senator Giessel addressed the fiscal note, which reflected
a cost of $7,500 in FY 16. She spoke to the analysis on
Page 2:
SB 53 was requested by the advanced practice
registered nurses (APRN) in Alaska through the APRN
Alliance to reduce confusion about titling for
consumers and payers. It brings Alaska into alignment
with the APRN Consensus Model, a national best
practices act.
It is anticipated that the Board of Nursing, Medical
Board, and Board of Professional Counselors would each
need to replace outdated terminology that conforms to
this statutory change. The division estimates that
the cost to each of these licensing programs could be
up to $2.5 per program for attorney review,
regulations specialist time, printing, and postage to
affected licensees. As required by AS 08.01.065, the
cost of promulgating regulations will be recovered
through license fee receipts.
If the bill passes the division will require $7.5 to
cover legal costs to amend regulations, printing, and
postage.
Professional licensing programs within the Division of
Corporations, Business and Professional Licensing are
funded by Receipt Supported Services, fund source 1156
Rcpt Svcs (DGF). Licensing fees for each occupation
are set per AS 08.01.065 so the total amount of
revenue collected approximately equals the
occupation's actual regulatory costs.
9:27:08 AM
JANE CONWAY, STAFF TO SENATOR CATHY GIESSEL, gave an
overview of the sectional summary (copy on file). She
explained that 12 sections in the bill were related to
conforming amendments:
Section 1 amends AS 08.02.010 by adding advanced
practice registered nurses to the list of professions
required to use their professional titles or initials
on stationery, signs, or other advertising.
Sections 2 - 4 are conforming amendments that change a
statutory reference from "advanced nurse practitioner"
to "advance practice registered nurse" and make other
related technical amendments.
Section 5 amends AS 08.68.1 OO(a) by requiring that
the Board of Nursing's regulations pertaining to
advanced practice registered nursing include the
practices of advanced practice registered nurses who
practice as certified registered nurse anesthetists,
certified clinical nurse specialists, certified nurse
practitioners, or certified nurse midwives and makes
conforming amendments.
Section 6 amends AS 08.68.160 by adding advanced
practice registered nursing to the licenses issued
under AS 08.68 and changes the term "professional
nursing" to "registered nursing."
Section 7 adds a new subsection to AS 08.68.170 that
sets out the qualifications for an advanced practice
registered nursing license.
Section 8 repeals and reenacts AS 08.68.190 concerning
license examinations and adds an advanced practice
registered nursing examination to the licensing
examinations conducted under AS 08.68.
Section 9 is a conforming amendment that changes a
statutory reference from "advanced nurse practitioner"
to "advance practice registered nurse."
Section 10 amends AS 08.68.220 by adding a paragraph
requiring the Department of
Commerce, Community and Economic Development to set
fees related to advanced practice registered nursing
and deletes "vocational" nursing.
Section 11 amends AS 08.68.230(a) by removing
"licensed professional nurse" from the titles
authorized for persons licensed under AS 08.68.
Section 12 amends AS 08.68.230 by adding new
subsections authorizing the use of the titles
"advanced practice registered nurse", "certified
registered nurse anesthetist", "certified clinical
nurse specialist", "certified nurse practitioner", or
"certified nurse midwife" and associated initials.
Section 13 amends AS 08.68.265 to acid advanced
practice registered nurses to the persons authorized
to supervise a practical nurse.
Section 14 adds impersonation of an advanced practice
registered nurse as a grounds for denial, suspension,
or revocation of a nursing license.
Section 15 requires institutions that are applying for
accreditation of advanced practice registered nurse
training to provide certain information to the Board
of Nursing.
Section 16 adds impersonation of an advanced practice
registered nurse as a grounds for denial, suspension,
or revocation of a certificate to practice as a nurse
aide.
9:30:40 AM
Ms. Conway continued:
Sections 17 - 19 add advanced practice registered
nursing to the licenses issued by the board, and
change the term "professional nursing" to "registered
nursing" in
AS 08.68.360 - 08.68.390, which declare the unlicensed
practice of nursing a public nuisance and provide for
injunctive relief.
Section 20 adds advanced practice registered nurses to
the licensees who may delegate certain nursing duties.
Section 21 is a conforming amendment that changes a
statutory reference from "advanced nurse practitioner"
to "advance practice registered nurse" and makes a
related technical change.
Section 22 defines the practice of advanced practice
registered nursing.
9:30:59 AM
Co-Chair MacKinnon asked whether the definition in Section
22 was a new or existing definition.
9:31:24 AM
AT EASE
9:32:00 AM
RECONVENED
Co-Chair MacKinnon repeated her question.
Senator Giessel related that the legislation corrected the
title of advanced practice registered nurse. She noted that
the scope of practice would remain the same.
9:32:50 AM
Ms. Conway continued with the sectional analysis:
Sections 23 - 25 are conforming amendments that change
a statutory reference from "advanced nurse
practitioner" to "advance practice registered nurse"
and make other related technical amendments.
Section 26 adds advanced practice registered nurses to
persons who are considered justified in conduct that
would otherwise be considered the use of force when
delivering emergency medical care.
Sections 27 and 28 are conforming amendments that
change a statutory reference from "advanced nurse
practitioner" to "advance practice registered nurse."
Section 29 adds advanced practice registered nurses to
those licensees immune from civil liability for an act
or omission in delivering patient case services while
escorting an injured or sick person whose life is in
danger in a conveyance that is not an ambulance.
Section 30 is a conforming amendment that changes a
statutory reference from "advanced nurse practitioner"
to "advance practice registered nurse."
Section 31 adds advanced practice registered nurses to
those practitioners authorized to draw blood for tests
of persons charged with sex offenses.
Sections 32 and 33 are conforming amendments that
change a statutory reference from "advanced nurse
practitioner" to "advance practice registered nurse."
Section 34 clarifies that nurse-midwives and direct
entry midwives are certified.
Sections 35 - 38 are conforming amendments that change
a statutory reference from "advanced nurse
practitioner" to "advance practice registered nurse"
and make other related technical amendments.
Section 39 changes the term "registered professional
nursing" to "registered nursing."
Section 40 clarifies that nurse-midwives must be
certified to be a provider under AS21.87.
Section 41 is a conforming amendment that changes a
statutory reference from "advanced nurse practitioner"
to "advance practice registered nurse."
Sections 42 - 43 clarifies that nurse-midwives are
certified and makes other technical amendments.
Sections 44 - 46 are conforming amendments that change
a statutory reference from "advanced nurse
practitioner" to "advance practice registered nurse."
Section 47 adds advanced practice registered nurses to
the definition of health care provider in statutory
provisions concerning prisons.
Section 48 is a conforming amendment that changes a
statutory reference from "advanced nurse practitioner"
to "advance practice registered nurse."
Section 49 adds advanced practice registered nurses to
licensees with particular training who may assess a
child with respect to the waiver under a statutory
provision concerning home and community based medical
assistance.
9:35:25 AM
Ms. Conway continued to Section 50 of the sectional
analysis:
Section 50 is a conforming amendment that changes a
statutory reference from "advanced nurse practitioner"
to "advance practice registered nurse" and makes a
related technical change.
Sections 51 adds advanced practice registered nurses
to practitioners who are not liable for providing
information to the Department of Health and Social
Services for the purpose of providing services to
certain children and makes a related technical change.
9:35:52 AM
Co-Chair MacKinnon asked for further explanation of Section
51.
Senator Giessel elucidated that newborns were assessed for
hearing loss; the section clarified that not only
registered nursed could administer the test, but also
advance practice registered nurses.
9:36:32 AM
Ms. Conway continued with the sectional analysis:
Sections 52 - 54 add advanced practice registered
nurses to practitioners who may under statutory
provisions concerning mental health commitment,
determine if a person may be administered psychotropic
medication without the person's consent, and add
advanced practice registered nurses with particular
training to the definition of mental health
professional for those statutory provisions.
9:37:00 AM
AT EASE
9:37:52 AM
RECONVENED
Ms. Conway continued with the sectional analysis:
Sections 55 adds advanced practice registered nurses
to practitioners who may review a health care plan for
an assisted living home resident.
Sections 56 - 59 are conforming amendments that change
a statutory reference from "advanced nurse
practitioner" to "advance practice registered nurse."
Section 60 repeals specific statutes.
Section 61 sets July 1, 2015, as the effective date
for the bill.
9:38:49 AM
Vice-Chair Micciche asked why the nurse anesthetists had
been outside of the supervised practical nurse structure.
Senator Giessel explained that a licensed practical nurse
had a two year degree; certified registered nurse
anesthetists had their own section in nursing statue, which
the bill would correct.
9:39:54 AM
Senator Olson interjected that nurse anesthetists operated
under the supervision of an anesthesiologist.
9:40:18 AM
Vice-Chair Micciche repeated his question.
Senator Giessel contended that it had been decades since
nurse anesthetists had been under the supervision of
anesthesiologists.
9:41:03 AM
Co-Chair MacKinnon OPENED public testimony.
LAURA SARCONE, CO-CHAIR, APRN ALLIANCE, ANCHORAGE (via
teleconference), testified in support of SB 53. She relayed
that the APRN consensus model was a National Best Practice
Act that put consumers, employers, APRNs, the Board of
Nursing, insurance companies and the legislature on the
same page by standardizing licensing, accreditation,
certification and educational requirements for APRNs. She
said that the APRN Alliance had reviewed the fiscal note
and was comfortable with the cost, which would be recovered
through licensing fees.
9:42:56 AM
CARRIE DOYLE, AK CLINICAL NURSE SPECIALIST ASSOCIATION,
ANCHORAGE (via teleconference), testified in support of SB
53. She gave a brief history of the consensus model. She
stated that the uniformity would expedite insurance
reimbursement by eliminating confusion about service
providers and would allow APRN's from other states to more
easily obtain Alaska licensure. She said that under the
legislation, advance nurse practitioners and anesthetists
would still provide high quality, safe, accessible care,
but under a new title.
9:44:40 AM
Co-Chair MacKinnon CLOSED public testimony.
9:45:02 AM
Senator Bishop felt that anything that could be done to
expedite payments to hospitals and medical providers was a
good idea. He asked whether an individual would more easily
find reciprocity when seeking nursing licensure in Alaska
under the legislation.
Senator Giessel answered in the affirmative.
9:47:01 AM
Senator Olson asked about Section 29, he wondered who was
on the current list of licensees that were immune from
civil liability.
Senator Giessel replied registered nurses and licensed
practical nurses were on the list.
Senator Olson asked whether health corporations supported
the legislation.
Senator Giessel replied that she had not heard from any
health corporations.
9:48:07 AM
Senator Dunleavy reminded the sponsor of the state's fiscal
situation. He requested justification for the fiscal impact
of the fiscal note attached to the bill.
Senator Giessel responded that the fiscal note reflected
that the fiscal impact of the note would be paid for by
licensees.
Senator Dunleavy understood that no general funds would be
used for the legislation.
Senator Giessel replied in the affirmative.
9:49:12 AM
SB 53 was HEARD and HELD in committee for further
consideration.