Legislature(1999 - 2000)

02/11/1999 08:08 AM STA

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
HB 2 REGISTRATION PLATES FOR DISABLED                                                                                           
                                                                                                                                
CHAIR JAMES announced the first order of business is HB 2," An Act                                                              
relating to issuance of a motor vehicle registration plate to or                                                                
parking permit for a person who is disabled."                                                                                   
                                                                                                                                
Number 0019                                                                                                                     
                                                                                                                                
BARBARA COTTING, Legislative Aide to Representative James, Alaska                                                               
State Legislature, read the following sponsor statement:                                                                        
                                                                                                                                
     House Bill 2, which is an Act relating to issuance of a motor                                                              
     vehicle registration plate to, or a parking permit for a                                                                   
     person who is disabled, is very short and very simple.  It                                                                 
     makes one simple change to Title 28, Vehicle Registration and                                                              
     Title, allowing licensed nurse practitioners to provide proof                                                              
     of disability for veterans to receive specially designed                                                                   
     license plates.                                                                                                            
                                                                                                                                
     Currently, only licensed physicians are authorized in our                                                                  
     Alaska Statutes to provide proof of disability.  Alaska has                                                                
     many medical facilities in both rural and urban settings where                                                             
     a nurse practitioner is the only licensed medical person                                                                   
     available, and this bill would allow much-needed flexibility.                                                              
                                                                                                                                
MS. COTTING mentioned HB 2 was previously heard in the House                                                                    
Transportation Standing Committee and then referred to a letter of                                                              
support from Anne Lilley, a nurse practitioner in Fairbanks.  She                                                               
pointed out Ms. Lilley's veterans center requested the introduction                                                             
of HB 2 which details why nurse practitioners in the state of                                                                   
Alaska need this flexibility.                                                                                                   
                                                                                                                                
MS. COTTING read Juanita Hensley's, Chief, Driver Services,                                                                     
Division of Motor Vehicles, message that the Department of                                                                      
Administration has no objection to HB 2 in its current form.                                                                    
                                                                                                                                
REPRESENTATIVE OGAN asked, "What was the purpose of -- I mean I can                                                             
understand the licensed physician and maybe at best nurse                                                                       
practioners in some parts of the state act like a physician in                                                                  
those areas.  But, how would one get one before?"                                                                               
                                                                                                                                
Number 0071                                                                                                                     
                                                                                                                                
MS. COTTING explained that the patients had to go through a series                                                              
of tests with a licensed physician.  At the present time, that's                                                                
the only way they can be certified.  Whereas, these nurse                                                                       
practitioners are usually very familiar with their disabilities                                                                 
because they're the ones that work with them most frequently.  This                                                             
applies to all disabled people, not just veterans - there is a list                                                             
of requirements in federal statute that qualifies a person as                                                                   
disabled.  And we follow those statutes in Alaska that is our                                                                   
criteria.  It has to do with how far the person can walk without                                                                
assistance and other such things that a nurse practitioner can very                                                             
easily verify.                                                                                                                  
                                                                                                                                
REPRESENTATIVE KERTTULA asked if this could be broadened to include                                                             
other people that might need this type of certification by a nurse                                                              
practitioner.                                                                                                                   
                                                                                                                                
MS. COTTING replied, Mike Ford, Legal Services, drafter of HB 2,                                                                
assured her that this applies to all disabilities, to all disabled                                                              
people, not just veterans.                                                                                                      
                                                                                                                                
CHAIR JAMES further explained that vehicles owned by disabled                                                                   
veterans, including persons disabled in the line of duty, and other                                                             
persons with disabilities is in existing law.  The only change is                                                               
adding the advanced nurse practitioners as authorized to make those                                                             
determinations for any person who is disabled.                                                                                  
                                                                                                                                
     For purposes of this subsection, proof of disability may be                                                                
     provided by a person licensed as a physician under AS 08.64 or                                                             
     as an advanced nurse practitioner under AS 08.68.                                                                          
                                                                                                                                
Number 0118                                                                                                                     
                                                                                                                                
REPRESENTATIVE SMALLEY indicated he could support HB 2 and stated,                                                              
"In looking at the criteria, it says a disabled veteran who is not                                                              
- and it is in the regulation - is not otherwise qualified under                                                                
this section, but he presents the department written proof that                                                                 
this person is at least 70 percent disabled.  So they would have to                                                             
bring that criteria to the nurse practitioner, and then the nurse                                                               
practitioner verifies it, is that correct?"                                                                                     
                                                                                                                                
MS. COTTING replied she believes the nurse practitioner is the one                                                              
who verifies it, and then the form is taken to the Division of                                                                  
Motor Vehicles.                                                                                                                 
                                                                                                                                
CHAIR JAMES pointed out the only difference is that they can take                                                               
the form to a nurse practitioner or a doctor.  Currently the                                                                    
disabled can only take the form to a doctor and it's not                                                                        
necessarily presumed that that's going to be the doctor that's                                                                  
going to make the determination.  She reiterated the requirements                                                               
to determine the 70 percent disability doesn't change, it only                                                                  
allows a nurse practitioner to do the same thing a doctor would do                                                              
in verifying the documentation.                                                                                                 
                                                                                                                                
REPRESENTATIVE OGAN said, "The bill suggests that an advanced nurse                                                             
practitioner, under AS 08.68, and then it doesn't define it past                                                                
that.  Alaska Statute 08.68 is the whole title of the Board of                                                                  
Nursing.  Might I suggest we tighten it down - and I'm looking for                                                              
the section under 'advanced nurse practitioner' - I'm not sure                                                                  
exactly where it is."                                                                                                           
                                                                                                                                
CHAIR JAMES noted the legislature has been working on adding                                                                    
language throughout the past few years.  She reiterated that this                                                               
was required to allow nurse practitioners to operate in the rural                                                               
areas where a physician isn't available.  They can contact a                                                                    
physician and are able to pass on that authority given to them by                                                               
phone.  Chair James said, "To me that's a separate issue, if you                                                                
really want to know what the difference is, we need to find that in                                                             
the statute where it is defined, it probably is also in                                                                         
regulation."                                                                                                                    
                                                                                                                                
Number 0183                                                                                                                     
                                                                                                                                
REPRESENTATIVE OGAN expressed his concern that it could be                                                                      
interpreted broadly. He indicated, for example a nurse's aid can                                                                
issue a certificate if it's just under AS 08.68.                                                                                
                                                                                                                                
CHAIR JAMES informed Representative Ogan that is not true and                                                                   
explained "advanced nurse practitioner" is a title, a person has to                                                             
qualify for that certification.                                                                                                 
                                                                                                                                
REPRESENTATIVE HUDSON mentioned HB 2 amends AS 28.10.181, which is                                                              
licensing and making reference to the advanced nurse practitioner                                                               
under AS 08.68.  He said, "Typically speaking, that's what we do.                                                               
We just draw reference to that which is the nurse practitioner.                                                                 
That's the nurse practitioner's section within the statutes."                                                                   
                                                                                                                                
CHAIR JAMES said she agrees, but believes what Representative Ogan                                                              
is asking what you have to do to qualify for certification.                                                                     
                                                                                                                                
REPRESENTATIVE HUDSON indicated it doesn't matter for this purpose.                                                             
                                                                                                                                
REPRESENTATIVE OGAN stated, "I think we could clear it up by                                                                    
amending the bill to say [AS] 08.68 -- that 410 - there's a                                                                     
definition of advanced nurse practitioner in the bill and I would                                                               
move that as an amendment, just as a technical amendment."                                                                      
                                                                                                                                
MS. COTTING noted the bill drafter didn't think it was necessary.                                                               
                                                                                                                                
CHAIR JAMES asked Ms. Cotting to contact Mr. Ford since she isn't                                                               
aware of another reference to nurse practitioners under AS 08.68                                                                
and in 410.  If that's the only place it is, then that would be                                                                 
perfectly okay there.                                                                                                           
                                                                                                                                
Number 0235                                                                                                                     
                                                                                                                                
REPRESENTATIVE SMALLEY asked Representative Ogan, "In the 410                                                                   
section, is it defining only nurse practitioner, or is it specific                                                              
to advanced nurse practitioner?"  He also said he is wondering if                                                               
it's even necessary.                                                                                                            
                                                                                                                                
REPRESENTATIVE OGAN replied that he didn't know if it was necessary                                                             
or not.  He indicated, under AS 08.68, a certified nurse's aid                                                                  
could issue one of these.  You may leave a loophole.                                                                            
                                                                                                                                
CHAIR JAMES said she doesn't feel uncomfortable with this and                                                                   
referred to Anne Lilley's title, "Advanced Nurse Practitioner" is                                                               
capitalized in her letter.  Chair James explained that it's a title                                                             
not a definition.                                                                                                               
                                                                                                                                
CHAIR JAMES called an at-ease at 8:20 a.m. and called the meeting                                                               
back to order at approximately 8:21 a.m.                                                                                        
                                                                                                                                
MS. COTTING, after speaking with Mr. Ford, said the bill as written                                                             
would be referring to the whole chapter which regards licensing as                                                              
a whole procedure, not just a definition of a nurse practitioner.                                                               
                                                                                                                                
REPRESENTATIVE OGAN removed his motion for the amendment.                                                                       
                                                                                                                                
Number 0284                                                                                                                     
                                                                                                                                
REPRESENTATIVE HUDSON made a motion to move HB 2 out of the House                                                               
State Affairs Standing Committee with individual recommendations                                                                
and the accompanying zero fiscal note.  There being no objection,                                                               
it was so ordered.                                                                                                              
                                                                                                                                

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