04/29/1997 09:40 AM Senate FIN

       CS FOR SENATE BILL NO. 152(L&C)                                         
                                                                               
       "An  Act  relating   to  certified  nurse   aides;  and                 
  providing for  an effective date."                                           
                                                                               
  Co-chair Sharp introduced SB 152.  Annette Kritzer, staff to                 
  Senator Leman  was  invited  to join  the  committee.    She                 
  explained the sections outlined in the CS.  Page 4 indicated                 
  the  grounds for denial  or suspension.   Section  6 defined                 
  nurse's   aide.    She  also  explained  the  administrative                 
  procedure act.   Senator Adams asked  why section 16 of  the                 
  original bill had been deleted  and Ms. Kritzer advised that                 
  it had  been deleted  at the  request of  the Department  of                 
  Health and  Social Services.   Senator  Parnell asked  about                 
  sections on page 6 and 7 and Ms.  Kritzer advised those were                 
  two different sections.                                                      
                                                                               
  Senator Phillips asked what problems had arisen  in the past                 
  that the  Alaska Nurses' Association could not  handle.  Ms.                 
  Kritzer said that there would be  no recourse if a certified                 
  nurse's aide committed abuse or neglect.                                     
                                                                               
  Mr. Ron Cowan, Division of Medical Assistance, Department of                 
  Health and Social Services testified via teleconference from                 
  Anchorage.    He  explained  the   abuse  problems  for  the                 
  committee.  Senator Adams asked the department's position on                 
  amendment #1.  Mr. Cowan  responded indicating there usually                 
  would  be one or two  witnesses to an  aide being accused of                 
  neglect or abuse.                                                            
                                                                               
  Senator Parnell moved amendment #1  and without objection it                 
  was adopted.                                                                 
                                                                               
  Dorothy   Fulton,   Executive   Director,   Alaska   Nurses'                 
  Association  testified  via  teleconference from  Anchorage.                 
  She  explained  the  process  of   action  taken  against  a                 
  certified  nurses'  aide.   A  full  investigation  would be                 
  undertaken.  Senator  Phillips asked when the  accused could                 
  defend themselves.  Ms. Fulton  explained the accused worked                 
  with  the  investigator and  could hire  an attorney  at any                 
  time.                                                                        
                                                                               
  Catherine  Reardon,  Director,   Division  of   Occupational                 
  licensing, Department  of Commerce and  Economic Development                 
  was invited to  join the committee.   She said the  Attorney                 
  General must approve the filing of  an accusation letter.  A                 
  hearing office  would be then  appointed to hear  the matter                 
  and  make recommendations.   In  response to  a question  by                 
  Senator Phillips she noted there were only three suspensions                 
  in the last two years.                                                       
                                                                               
                                                                               
  Co-chair  Sharp  asked  if  there  would  be  any  increased                 
  liability  to  medicaid or  medicare.   Ms.  Kritzer advised                 
  there would not.                                                             
                                                                               
  Senator Donley asked  the duties of certified  nurses' aides                 
  and who  set the standards.   Ms. Kritzer said the  board of                 
  the  Nurses'  Association  set  the  standards  and  duties.                 
  Senator  Donley asked  the difference  between  nurse, nurse                 
  Physician/Practitioner  and   nurses'  aide.     Ms.  Fulton                 
  outlined the  duties of  each.   Senator Donley  asked if  a                 
  nurses'  aide  was  allowed  to  draw  blood.    Ms.  Fulton                 
  explained that was the  duty of a phlebotomist.   However, a                 
  nurses' aide  could or could not be  a trained phlebotomist.                 
  She   said   there  were   no   standards  for   training  a                 
  phlebotomist.  Senator Donley  voiced his concern  regarding                 
  this situation.  Ms.  Fulton agreed saying this had  been an                 
  on-going  problem at least forty years  that she knew about.                 
  Senator Donley said he was also  concerned that a new status                 
  was  being created,  replacing  real  nurses with  certified                 
  aides.  Mr.  Cowan said this  would fall into his  licensing                 
  category.  Nurses' aides were relatively  new to Alaska.  At                 
  present  only  certified nurses'  aides  could be  hired and                 
  there was no  specific staff ratio.  It was felt that if the                 
  needs of patients were  being met then there was  no concern                 
  for the nurse/patient ratio.   The situation had  been dealt                 
  with appropriately and he  specifically asked Senator Donley                 
  or anyone else to  report any misuse they  may be aware  of.                 
  Ms. Reardon said there  was no mandatory license law  but it                 
  was a  federal requirement  for nursing  homes that  nurses'                 
  aides be certified.                                                          
                                                                               
  Senator  Parnell   moved  CSSB   152(FIN)  with   individual                 
  recommendations  and accompanying  fiscal notes  and without                 
  objection it was reported out.