Legislature(2001 - 2002)

04/15/2002 01:50 PM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                                                                                                                                
REPRESENTATIVE PEGGY  WILSON, sponsor of HB 276,  informed members                                                              
that  the measure  is  a clean-up  bill  that  aligns the  nursing                                                              
statutes with current practice in three ways:                                                                                   
                                                                                                                                
   · It gives licensed nurses the authority to delegate nursing                                                                 
     duties to other personnel;                                                                                                 
   · It increases the length of time available for a temporary                                                                  
     nursing certificate from four to six months to accommodate                                                                 
     the length of time it takes to get a criminal background                                                                   
     check done;                                                                                                                
   · It changes the wording regarding licensure by endorsement                                                                  
     and aligns the statute with what is already being done.                                                                    
   · The Labor and Commerce Committee added a definition of                                                                     
     "unlicensed assistive personnel" so there would be no                                                                      
     question of who is covered.                                                                                                
                                                                                                                                
CHAIRWOMAN GREEN asked for clarification.                                                                                       
                                                                                                                                
REPRESENTATIVE WILSON  said it specifies who a  nurse can delegate                                                              
duties to in Section 6.  She also  pointed out the bill has a zero                                                              
fiscal note.                                                                                                                    
                                                                                                                                
CHAIRWOMAN GREEN  noted the term "unlicensed  assistive personnel"                                                              
first appears in the bill on page 2, line 10.                                                                                   
                                                                                                                                
REPRESENTATIVE WILSON  said she has letters of support  for HB 276                                                              
from the Alaska  State Hospital and Nursing Home  Association, the                                                              
Alaska Nurses  Association, the Alaska School  Nurses Association,                                                              
and  the Alaska  Board  of Nursing,  and  the  Division of  Public                                                              
Health also support  the measure. She indicated that  she does not                                                              
know of anyone who opposes the bill.                                                                                            
                                                                                                                                
SENATOR WILKEN stated  support for HB 276 but  noted that concerns                                                              
were expressed  on behalf  of the  physicians.  He asked if  those                                                              
concerns have  been addressed and  whether any outstanding  issues                                                              
remain.                                                                                                                         
                                                                                                                                
REPRESENTATIVE   WILSON  said  that   adding  the  definition   of                                                              
unlicensed  assistive  personnel  raised the  physicians'  comfort                                                              
level. She said that as far as she  knows, they are not opposed to                                                              
the measure.                                                                                                                    
                                                                                                                                
CHAIRWOMAN  GREEN   asked  what  physicians  Senator   Wilken  was                                                              
referring to.                                                                                                                   
                                                                                                                                
SENATOR  WILKEN said the  Alaska Medical  Association and  private                                                              
physicians.                                                                                                                     
                                                                                                                                
The committee took public testimony.                                                                                            
                                                                                                                                
MS. LYNN HARTZ,  a member of the  Board of Nursing, said  she will                                                              
only address  amendments made  to HB 276  in the Senate  Labor and                                                              
Commerce Committee since she testified  before the committee on SB
283, the companion  bill to HB 276.   The amendment, which  is the                                                              
only change from the bill passed  from committee, SB 283, puts the                                                              
term  "unlicensed assistive  personnel" into  statute and  defines                                                              
that term.  It is a broad definition  but a broad one  is required                                                              
since  UAPs work  under  many different  job  titles  and new  job                                                              
titles are  created regularly.  She emphasized  the importance  of                                                              
passing this bill because current  nursing practice is to delegate                                                              
to unlicensed  assistants daily and  has been an accepted  part of                                                              
the health  care system for years.  However, that practice  is not                                                              
legally authorized  in Alaska according to the  assistant attorney                                                              
general. The board  realizes this is going on and  does not intend                                                              
to  discipline   nurses  who  currently  delegate   to  unlicensed                                                              
personnel since  enforcement would literally risk  bringing health                                                              
facilities to a  halt. Until this bill has passed,  the board will                                                              
be unable  to write  or enforce any  safety regulations  regarding                                                              
delegation to UAPs.  The board is advising nurses  to abide by the                                                              
delegation guidelines,  described in  its 1993 position  statement                                                              
on delegation,  but that is  not satisfactory since  guidelines in                                                              
the position statement  do not have the weight  of regulation. The                                                              
board of nursing  appreciates passage of SB 283  and CSHB 276(L&C)                                                              
with equal speed.                                                                                                               
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
MS.  PATRICIA SENNER,  Alaska Nurses  Association, stated  support                                                              
for CSHB 276(L&C).  The Alaska Nurses Association  is in agreement                                                              
with the  definition of UAPs. She  asked the committee  to support                                                              
the bill and pass it out quickly.                                                                                               
                                                                                                                                
MS. MARY  WEYMILLER, Board of Nursing,  told members the  Board is                                                              
charged  with  the  protection  of the  public  for  safe  medical                                                              
practice. CSHB  276(L&C) will provide  the legal  authority needed                                                              
to write  regulations to  provide for  safe delegation  of nursing                                                              
tasks. One  way that  delegation is used  in this changing  health                                                              
care environment is  for people who choose to stay  in their homes                                                              
for as long as their conditions permit.  Often these people do not                                                              
need skilled  nursing care  on a  continuous basis but  assistance                                                              
with their care if their condition  is stable and long term. Those                                                              
delegating  and  being delegated  to  depend  on the  guidance  of                                                              
statutes and regulations  to set standards for  safe practice. She                                                              
urged members  to pass CSHB 276(L&C)  so the Board of  Nursing has                                                              
the authority to protect both the  public and practitioners in the                                                              
delegation process.                                                                                                             
                                                                                                                                
MS. NANCY  DAVIS, Chief  of Public Health  Nursing for  the Alaska                                                              
Division of  Public Health, stated  support for CSHB  276(L&C) and                                                              
appreciates  the language  changes  that clarify  the  endorsement                                                              
licensure  process.   The  division  especially   appreciates  the                                                              
attention  given to  the  delegation of  authority  issue and  the                                                              
definition  of UAPs. Public  health nurses  work throughout  rural                                                              
Alaska in villages and, in order  to accomplish health care across                                                              
Alaska, it is essential to be able to delegate.                                                                                 
                                                                                                                                
SENATOR  WARD moved  CSHB  276(L&C)  and its  accompanying  fiscal                                                              
notes from committee with individual recommendations.                                                                           
                                                                                                                                
CHAIRWOMAN  GREEN announced  that  with no  objection, the  motion                                                              
carried. The committee then took up HB 209.                                                                                     

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