Legislature(2009 - 2010)HOUSE FINANCE 519
03/23/2010 09:00 AM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB50 |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 50 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 369 | TELECONFERENCED | |
HOUSE BILL NO. 50
"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."
9:08:31 AM
Co-Chair Stoltze went over the morning itinerary.
9:09:18 AM
REPRESENTATIVE PEGGY WILSON indicated that she would
present a general introduction to the bill.
Co-Chair Hawker MOVED CSHB 50 (FIN), 26-LS0274\U,
Chenoweth/Wayne, 3/22/10 as a working document.
Co-Chair Stoltze OBJECTED for discussion.
Representative Wilson reported on the excessive working
hours for nurses in Alaska. She did not believe this
provides a safe working environment for patients or nurses.
She explained that the purpose of the bill is to promote
better patient safety by making sure nurses receive enough
rest. There are fifteen other states that have adopted
similar requirements. Most of the other state versions
restrict nurses to twelve consecutive hours with the
mandated rest period of twelve hours. House Bill 50 will
set a fourteen hour limit with a ten hour rest period to
provide additional flexibility to hospitals. There are
eleven additional states that are in the process of passing
a similar bill. Representative Wilson alleged that there
will be testimony from some hospitals insisting there is no
need for this bill. Hospitals in Alaska do not use the
practice of mandatory overtime. Representative Wilson
believed that nurses in Alaska are working excessive
overtime without adequate rest at these hospitals. She
stated that nurses are often mandated or bullied into
working the overtime hours. Nurses across Alaska have
provided considerable testimony and written communications
that there are serious problems occurring with these long
shifts. Nurses are working beyond the twelve hour shifts on
a frequent basis and then returning to work without enough
rest. She stressed the lack of safety in this practice.
Nurses often work twelve hour shift over multiple
consecutive days. Representative Wilson disclosed that
nurses often leave the state or retire early. She urged
consideration and action on this bill.
9:13:24 AM
BEN MULLIGAN, STAFF, CO-CHAIR STOLTZE, explained the new
Committee Substitute. He began on page 4, line 2,
subsection (i) which needed further clarification of the
intent coming out of the Health and Social Services
Committee. In subsection (ii) and (iii) the statute
references needed to be clarified. Mr. Mulligan continued
to page 6 that removed Section 18.20.450 which brought the
Department of Law into the situation of retaliation against
the nurses by health care facilities. The co-chair removed
that section. He also mentioned that the Applicability
sections needed to be updated.
Co-Chair Stoltze remarked that the change was brought
through the committee substitute rather than amendments. He
voiced a concern about a state agency being involved in a
litigation issue. Those opposed to the bill did not like
this section.
Co-Chair Stoltze WITHDREW his OBJECTION. There being NO
further OBJECTION, CSHB 50 (FIN) 26-LS0274\U,
Chenoweth/Wayne, 3/22/10 was adopted as a working document.
BECKY ROONEY, STAFF, REPRESENTATIVE WILSON commented that
the new Committee Substitute changed was acceptable.
9:17:04 AM
Representative Austerman asked for an explanation of the
change on page six. Mr. Mulligan stated that the co-chair
removed the Department of Law in retaliation cases for the
representation of the nurses.
Representative Austerman reiterated his question. Co-Chair
Stoltze interjected that the section was removed. It
provided for the Department of Law to be the legal services
for the nurses. Representative Austerman commented that it
appeared to be added back in.
9:18:38 AM
Mr. Mulligan explained that the numbers on the bill have
just been changed.
Representative Wilson expressed that she was comfortable
with the changes.
9:19:10 AM
Representative Doogan noted the section that has been
deleted. One requirement of the Commissioner of the
Department of Labor is investigate the allegations and
then, if there is a violation, the Department of Law
prosecutes. He inquired if the states requirement to
investigate complaints has been removed. Mr. Mulligan
replied yes.
9:20:26 AM
Representative Fairclough furthered that if anyone violates
the law in the state of Alaska they still have recourse,
but it has just been removed from this specific document.
Representative Doogan noted that the Commissioner's
positive duty to investigate every complaint alleging a
violation has been removed in this bill. He inquired on how
complaint investigations would now occur. Co-Chair Stoltze
agreed that needed to be looked at again.
9:22:32 AM
Vice-Chair Thomas asked how many nurses are in Alaska.
Representative Wilson did not know the exact numbers, but
estimated in the thousands. Vice-Chair Thomas requested the
exact number of nurses.
9:23:41 AM
NANCY DAVIS, PRESIDENT, ALASKA NURSES ASSOCIATION supported
HB 50. She informed that she has been a Registered Nurse
for over 40 years in public health and hospice
associations. She indicated that nurses have been seeking
basic protection for themselves and patients. The patient
depends on the nurses for their health and safety, which is
especially important for those who cannot make good
determination for themselves. The patient should be
protected against mistakes or errors. Nurses are ethically
required to guard and protect the patient, but often feel
the fear of retaliation if they refuse to work all the
overtime hours. The bill reduces the practice of the nurses
having to work these excessive overtime hours. It also
protects against the retaliation practices. Nurses often
fear their job is in danger. She would like to see Alaska
join other states in passing this bill.
9:29:59 AM
Vice-Chair Thomas inquired on the number of nurses in
Alaska being affected. Ms. Davis replied that there are
eight thousand practicing nurses in Alaska, but some of
them only practice a minimum amount of hours. She indicated
that approximately 85 percent of nurses work in 24-hour
institutional care facilities. She noted that 15 percent to
20 percent work outside in community or public health.
Vice-Chair Thomas asked for the average age of the nurses
in Alaska.
Ms. Davis responded that Alaska's working nurses are older
than the national average. She estimated close to fifty
years old for the average nurse.
Vice-Chair Thomas inquired if nurses must update their
nursing licenses. Ms. Davis informed that nurses must renew
their licenses every two years. They must demonstrate work
as a nurse and complete thirty hours of continuing
education.
Vice-Chair Thomas asked who pays for this recertification
training. Ms. Davis noted that it depends on where the
nurses worked; many hospitals have continuing training
available in-house for the nurses, but there are some
nurses who pay it themselves.
Vice-Chair Thomas noted that some nurses belong to unions
and wondered if those nurses have the same problems under
union contracts. Ms. Davis replied that labor contracts do
not always address excessive overtime hours. She estimated
that about half of Alaska's facilities have collective
bargaining agreements. She believed that the first issue is
patient safety.
Vice-Chair Thomas commented that he thought the unions
would speak to this issue for patient safety. Ms. Davis
declared that she wished there was no reason to have to set
a limit, but there has been no other way to solve this.
9:34:31 AM
Representative Fairclough asked if Registered Nurses and
Licensed Practical Nurses cover all aspects of nursing. Ms.
Davis replied yes, although there are Certified Nursing
Assistants covered under the Board of Nursing, but they are
not considered professional nursing staff. They do not have
independent responsibility for patient care.
Representative Fairclough asked if agencies would turn to a
Certified Nursing Assistant in seeking additional hours.
She wondered if that class of nurses would be covered under
this bill. Ms. Davis replied that she did not believe a 24-
hour facility could only run with nursing assistants. A
registered nurse must oversee and be responsible for the
work of the nursing assistants.
9:36:53 AM
ROD BETIT, PRESIDENT, ALASKA HOSPITAL & NURSING HOME
ASSOCIATION spoke on behalf of the associations twenty
seven members that represent private, federal, state, and
tribal facilities. Although he respected Representative
Wilson for her efforts, he did not support the bill. He
indicated that mandatory overtime has been tracked for a
number of years and it is minimal in the state (ASHNHA 2007
and 2008 Nurse Overtime Survey Results, March 13, 2009,
copy on file). Mandatory overtime has only been used in
four facilities, mostly at state operated psychiatric
institutes. The chart indicates that vacancies are
improving; 11 percent in 2007 to 9 percent in 2008. Mr.
Betit referred to the blue highlighted column that showed
the temporary nursing hours purchased by the facilities
from various companies throughout Alaska. It reflected over
one quarter of a million hours were purchased. This is a
more expensive approach to the facilities since temporary
staff time is more expensive. The final column shows that a
zero number of grievances were filed in 2008. Mr. Betit
believed that this issue belongs in the bargaining table.
He noted there is a there is a 12 hour basic nursing shift
which means they pay for a fulltime nurse to produce 36
hours of work in any given week to protect a three day work
for a nurse. There is a 10 percent loss of working time of
each nurse employed by a facility. This is one of factor
that contributes to the nursing shortage.
Mr. Betit continued that a third issue is quality of
service and 90 percent of Alaskans responded always or
usually positive. He proved further statistics of positive
patient response. He believed the real question is the
storage of nurses throughout the state. He provided ways
that his organization has tried to deal with this storage.
He also referred to several bills to bring already trained
and ready to work nurses from around the country. Finally,
he believed this bill would require a new mandatory
recording burden that could hurt smaller facilities. He
understood the purpose, but believed the facilities were
meeting the intent of the bill and much was being done to
move forward in a positive way.
9:43:31 AM
Representative Foster wanted clarification on the tracking
burden because it seemed like the tracking mechanism was
already in place. Mr. Betit explained that the report only
tracked mandatory overtime and on-call time. The reporting
requirement in the bill would be for all overtime by the
nurses. All facilities in the state use voluntary overtime,
therefore every facility in the state would have to keep
these records and report them on a quarterly basis.
Representative Fairclough inquired if there was a payroll
system in place in each of the facilities. Mr. Betit
replied that was true, but it was his understanding that
the depth of detail is not routinely put out by those
personal systems.
Representative Fairclough commended that every time she has
worked overtime it is tracked on her payroll checks. She
did not understand how that information could not be linked
up for the required reporting.
9:45:18 AM
Representative Doogan that some of the numbers show a
variety of symbols under "length of shift in hours." He
wondered what these numbers refer to.
Mr. Betit agreed there was an inconsistent use of commas
and periods, but basically it states the variety of shifts
available in each of the facilities.
9:46:23 AM
DR. PATRICK NOLAN, ENDOCRINOLOGIST, ANCHORAGE (via
teleconference) voiced his concern about nurses working
long hours. He believed that even the fourteen hours
specified in the bill was excessive. Many hospital nurses
have quit because of long hours and overtime requirements.
Nursing is a stressful job and mistakes can be made when
someone is tired.
9:49:09 AM
PATTIE ARTHUR, NORTH STAR HOSPITAL (via teleconference),
testified in support of the bill. She referenced Article 4,
Section 18.20.400 Limitations on nursing overtime and
applauded this inclusion. She also referred to page 3,
number 7 (A, B, C) (CS HB 50 (HSS). This allowed her to get
her nursing degree and opened other opportunities for
nurses to pursue their master's degree or nursing degree.
She was in favor of passing this legislation.
9:51:02 AM
SCOTT JUNGWIRTH, CHIEF HUMAN RESOURCES OFFICER, PROVIDENCE
HOSPITAL & HEALTH SERVICES OF ALASKA (via teleconference),
indicated that Providence Hospital does not support this
legislation. He believed that collective bargaining should
be used to reach solutions on staffing issues. His hospital
does not require mandatory overtime, but allows the nurses
to bid on overtime should they choose. The on-call language
in this legislation is vague and would create
misinterpretations. On-call teams are often necessary in
cases such as emergency operating rooms. For most part
nurses are allowed to schedule their on-call time which is
a practice preferred by many nurses.
Co-Chair Stoltze asked for a faxed copy of his testimony.
9:53:24 AM
Representative Gara commented that nurses, by being on-
call, alter their lives in significant ways on behalf of
their patients. He wished to hear some credit offered to
these nurses.
Vice-Chair Thomas inquired about collective bargaining
units and pondered retuning of this bill to those
facilities that do not have collective bargaining units.
9:54:43 AM
BARBARA LANDER, ICU NURSE, KETCHIKAN GENERAL HOSPITAL,
supported the bill. She believed this would put the
hospital on call with more realistic hiring techniques. The
facilities count on nurses to work overtime to fill in the
time. She gave a personal experience when dealing with an
emergency and the resulting mistakes made by some overtired
nurses. She indicated there are many examples like this and
it is a widespread problem that other states have dealt
with. She disagrees with the collective bargaining
technique because some nurses are not covered by labor. She
explained a situation of excessive hours for herself. There
are some nurses that oppose this bill and enjoy the
overtime hours. Ms. Lander stressed that this bill is not
about the nurses, but for the safety of the patients.
Hospital administrators use overtime as a staffing tool.
10:01:10 AM
DR. CHRISTIE ARTUSO, DIRECTOR OF NEUROSCIENCE SERVICES,
PROVIDENCE ALASKA MEDICAL CENTER presented her
qualifications. She expressed that she was unaware of any
instance when nurses were required to work overtime. She
testified against the bill. Dr. Artuso argued that there
was no need for legislation to regulate nurses. Mandatory
overtime is not the way to staff a hospital, but sometimes
it is required and many nurses like this. She elaborated
that sometimes nurses are often sent home due to lack of
work. She asserted that when a nurse is paid, then patient
safety does not seem to be the issue. Why is it necessary
to have this bill, but a battle of power and money and not
patient safety? She asked where is the current research on
this situation. She challenged them to check the data.
Demographics of nurses have changed with better educated
nurses and workforce has aged but research is lacking.
Nurse patient ratio has improved but no data. Do not
support this legislation.
10:07:19 AM
Representative Gara on the data how is it data.
Ms. Artuso patient data did not include any current
delivery that is present today. None of some particulars
were included. Patients looked at differently in the past
based on new techniques in medical profession. Has not seen
current studies.
10:09:05 AM
DEBBIE THOMPSON, EXECUTIVE DIRECTOR, ALASKA NURSES
ASSOCIATION supported this bill. She is responsible for
hearing many of the nurses regarding this bill. She did not
believe this to be a union issue - no one party has the
best. She believed that working through a grievance. Often
in negotiation session told it would be handled of
legislation. It is a patient safety issue. The nurses were
tired but often no one to call and they dealt with the
pressures. The people and patients of Alaska need this
bill.
10:12:52 AM
DOUG CARSON, BUSINESS AGENT, ALASKA STATE EMPLOYEES
ASSOCIATION (via teleconference) supported this legislation
and supported nurses. He spoke of the psychiatric institute
overtime situation. Many required working too much overtime
and results in injury and safety.
DONNA PHILLIPS, REGISTERED NURSE, TURNAGAIN ARM HEALTH
BOARD OF DIRECTORS (via teleconference) supported the
legislation. Patients should not be concerned about long
hours of the nurses. Nurses can only last so long because
of long hours. UAA doing great job of training new nurses
for Alaska. Too many people rely on them, especially
doctors who rely on their monitoring. She urged for patient
safety.
10:17:21 AM
EVANGELYN DOTOMAIN, PRESIDENT & CEO, ALASKA NATIVE HEALTH
BOARD (via teleconference) named her issue is that it has
not been proved it is a problem in Alaska. The data does
not support this and their needs to be more study on this.
All facilities have risk managers dealing with this issue.
Main concern is that is presents a market challenge. Tribal
health care have harder time recruiting nurses and this
legislation will make it harder. In tight labor market the
nurse there can make their own deals. These are agreed to
in labor agreements. This will provide a hardship. Also not
sure how certain issues will be handled under this bill.
How will they know if people working in several facilities
be directed under this bill.
10:21:23 AM
Representative Foster understood rural Alaska has unique
challenges, and he believed tribal facilities were exempted
in this bill and wondered if Ms. Dotomain was aware of
that. Ms. Dotomain responded that she was aware. She
believed the whole market is changes and made it more
difficult to recruit and retain good nurses.
10:22:15 AM
JOHN BRINGHURST, CEO, PETERSBURG MEDICAL CENTER (via
teleconference) voiced his opposition to the bill. He has
never required overtime at his facility, it is always
voluntary. There will be a burden that would require more
tracking. This would go beyond just tracking overtime, but
many other features. There is only one person tracking
human resources and does many other jobs which would add
much to her already overburdened scheduled. He did not
believe a 16 hour shift was unsafe. This should be labor
negotiation. Nurses often spend time on paperwork and
patient care. This would inflict more regulation.
STACY ALLEN, REGISTERED NURSE, LABORERS LOCAL 341, PALMER
(via teleconference) supported this bill and gave her
reasons. She spoke to the mistakes made when nurses are
tired. She wondered how it can be believed that a nurse can
work safely after 14 hours. She spoke of a personal
situation where she patients and family were happy that the
nurse was not in 15th hour when dealing with them.
Collective bargaining is when two groups agree on something
or if they don't, then try to agree with what they can.
10:28:45 AM
JOEY MERRICK, PRESIDENT OF DISTRICT COUNCIL OF LABORERS,
EAGLE RIVER (via teleconference) supported this bill. He
contended the support of safety in all industries. It has
been proved that when working longer hours, more mistakes
can happen.
10:30:19 AM
BARBARA HUFF TUCKNESS, DIRECTOR OF LEGISLATIVE & GOVERNMENT
AFFAIRS, GENERAL TEAMSTERS LOCAL 959 spoke to the
collective bargaining situation. She indicated that safety
has been a big issue as well as the number of hours. She
indicated that a new management may have a different
attitude, but the importance deals with patient safety. Ms.
Huff supported the passage of the bill.
10:33:00 AM
Co-Chair Stoltze closed public testimony.
10:33:40 AM
CSHB 50 (FIN) was HEARD and HELD in Committee for further
consideration.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Averting Errors WSJ Article HB 50.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| CSHB 50 Sectional Revised Ver N.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| hb 50 sponsor.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| Hours of Service Limitations on Other Professions (3).pdf |
HFIN 3/23/2010 9:00:00 AM |
|
| HSS50-1.PDF |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| HSS50-2.PDF |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| HSS50-3.PDF |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| scanned fiscal notes.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| States the prohibit RN OT Map HB 50.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| Studies Relating to Effects of Excessive Overtime by Nurses (2).pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| WORK DRAFT CS HB 50 26-LS0274 U.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| CSHB369 (FIN)-OOG-EO-03-23-10.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 369 |
| HB050CS(HSS)-DOLWD-WH-03-22-10.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| HB050CS(HSS)-DHSS-N-03-19-10.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| HB050CS(HSS)-DHSS-API-03-19-10.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| HB050CS(HSS)-DHSS-APH-03-19-10.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| HB 50 support letters.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 50 |
| CSHB 369 _FIN_ fiscal analysis-ALL _2_.pdf |
HFIN 3/23/2010 9:00:00 AM |
HB 369 |