Legislature(1999 - 2000)
02/11/1999 08:08 AM STA
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
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.