Legislature(2015 - 2016)BUTROVICH 205

04/08/2015 01:30 PM Senate HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 53 ADVANCED PRACTICE REGISTERED NURSES TELECONFERENCED
Heard & Held
*+ SB 90 MEDICAID: USED DURABLE MEDICAL EQUIPMENT TELECONFERENCED
Heard & Held
+ HB 4 AUTOMATED EXTERNAL DEFIBRILLATOR TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled:
+= SB 74 MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES TELECONFERENCED
Heard & Held
           SB 53-ADVANCED PRACTICE REGISTERED NURSES                                                                        
                                                                                                                                
1:43:24 PM                                                                                                                    
CHAIR STEDMAN announced the consideration of SB 53.                                                                             
                                                                                                                                
1:43:51 PM                                                                                                                    
SENATOR CATHY GIESSEL,  sponsor of SB 53, explained  that the bill                                                              
updates  Alaska's  34-year-old   statutory  title  from  "Advanced                                                              
Nurse Practitioner"  (ANP) and "Nurse Anesthetist" (NA)  to now be                                                              
called  "Advanced  Practice  Registered Nurse"  (APRN).  She  drew                                                              
attention to  a chart that  identifies the various  current titles                                                              
for practicing  nurses and  the new titles  proposed in  the bill.                                                              
She  said   the  statutes  have   not  kept  up  on   the  titles.                                                              
Nationally, the titles  are becoming more unified. The  use of the                                                              
APRN  title will  increase clarity  of  practice roles,  insurance                                                              
billing,  Medicare, and  Veterans  Administration procedures,  and                                                              
interaction with agencies.                                                                                                      
                                                                                                                                
She  concluded  that   nothing  in  the  bill   changes  scope  of                                                              
practice,  certification or  licensing  requirements, nor  changes                                                              
fee structures to the board.                                                                                                    
                                                                                                                                
1:48:06 PM                                                                                                                    
JANE   CONWAY,  Staff,   Senator  Cathy   Giessel,  Alaska   State                                                              
Legislature, presented  the sectional analysis of SB  53. She read                                                              
from the following:                                                                                                             
                                                                                                                                
     Section  1 amends  AS 08.02.010  and adds  APRNs to  the                                                                   
     list  of professions  that  are  required to  use  their                                                                   
     professional  titles  on  stationery,  signs,  or  other                                                                   
     advertising.                                                                                                               
                                                                                                                                
     Sections 2-4  are conforming amendments that  change the                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurse."                                                                                    
                                                                                                                                
     Section 5 amends  AS 08.68.100(a) by requiring  that the                                                                   
     Board  of   Nursing  regulations  pertaining   to  APRNs                                                                   
     include   the  practices  of   APRNs  who  practice   as                                                                   
     certified   registered  nurse  anesthetists,   certified                                                                   
     clinical    nurse    specialists,     certified    nurse                                                                   
     practitioners,  or certified  nurse  midwives and  makes                                                                   
     conforming amendments.                                                                                                     
                                                                                                                                
     Section  6  amends  AS  08.68.160   by  adding  advanced                                                                   
     practice  registered  nursing  to  the  licenses  issued                                                                   
     under  AS  08.68  and  changes  the  term  "professional                                                                   
     nursing" to "registered nursing."                                                                                          
                                                                                                                                
     Section  7 adds a  new subsection  to AS 08.68.170  that                                                                   
     sets  out the  qualifications for  an advanced  practice                                                                   
     registered nursing license.                                                                                                
                                                                                                                                
     Section 8  repeals and reenacts AS 08.68.190  concerning                                                                   
     license  examinations  and  adds  an  advanced  practice                                                                   
     registered   nursing   examination  to   the   licensing                                                                   
     examinations conducted under AS 08.68.                                                                                     
                                                                                                                                
     Section  9 is  a  conforming  amendment that  changes  a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to advance practice registered nurse."                                                                                     
                                                                                                                                
     Section  10  amends  AS  08.68  by  adding  a  paragraph                                                                   
     requiring  the  Department  of Commerce,  community  and                                                                   
     Economic  Development to  set fees  related to  advanced                                                                   
     practice  registered  nursing and  deletes  "vocational"                                                                   
     nursing.                                                                                                                   
                                                                                                                                
     Section   11   amends  AS   08.68.230(a)   by   removing                                                                   
     "licensed   professional    nurse"   from   the   titles                                                                   
     authorized for persons licensed under AS 08.68.                                                                            
                                                                                                                                
     Section   12  amends   AS   08.68.230   by  adding   new                                                                   
     subsections   authorizing   the   use  of   the   titles                                                                   
     "advanced   practice   registered   nurse",   "certified                                                                   
     registered   nurse  anesthetist",  "certified   clinical                                                                   
     nurse  specialist", "certified  nurse practitioner",  or                                                                   
     "certified nurse midwife" and associated initials.                                                                         
                                                                                                                                
     Section   13  amends  AS   08.65.265  to  add   advanced                                                                   
     practice  registered nurses  to  the persons  authorized                                                                   
     to supervise a practical nurse.                                                                                            
                                                                                                                                
     Section 14  adds impersonation  of an advanced  practice                                                                   
     registered  nurse as a  grounds for denial,  suspension,                                                                   
     or revocation of a nursing license.                                                                                        
                                                                                                                                
     Section 15  requires institutions that are  applying for                                                                   
     accreditation  of  advanced  practice  registered  nurse                                                                   
     training  to provide  certain information  to the  Board                                                                   
     of Nursing.                                                                                                                
                                                                                                                                
     Section 16  adds impersonation  of an advanced  practice                                                                   
     registered  nurse as a  grounds for denial,  suspension,                                                                   
     or revocation  of a certificate  to practice as  a nurse                                                                   
     aide.                                                                                                                      
                                                                                                                                
     Sections   17-19   add  advanced   practice   registered                                                                   
     nursing  to  the  licenses  issued  by  the  board,  and                                                                   
     change  the term "professional  nursing" to  "registered                                                                   
     nursing"  in AS  08.68.360  - 08.68.390,  which  declare                                                                   
     the  unlicensed practice  of nursing  a public  nuisance                                                                   
     and provide for injunctive relief.                                                                                         
                                                                                                                                
     Section 20  adds advanced practice registered  nurses to                                                                   
     the licensees who may delegate certain nursing duties.                                                                     
                                                                                                                                
     Section  21 is  a conforming  amendment  that changes  a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to  "advance  practice  registered nurse"  and  makes  a                                                                   
     related technical change.                                                                                                  
                                                                                                                                
     Section  22 defines  the practice  of advanced  practice                                                                   
     registered nursing.                                                                                                        
                                                                                                                                
     Section 23-25  are conforming  amendments that  change a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance  practice registered  nurse" and make  other                                                                   
     related technical amendments.                                                                                              
                                                                                                                                
     Section 26  adds advanced practice registered  nurses to                                                                   
     persons  who are  considered justified  in conduct  that                                                                   
     would  otherwise be  considered  the use  of force  when                                                                   
     delivering emergency medical care.                                                                                         
                                                                                                                                
     Sections 27-28  are conforming amendments that  change a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurse."                                                                                    
                                                                                                                                
     Section 29  adds advanced practice registered  nurses to                                                                   
     those licensees  immune from civil liability  for an act                                                                   
     or omission  in delivering  patient care services  while                                                                   
     escorting  an injured or  sick person  whose life  is in                                                                   
     danger in a conveyance that is not an ambulance.                                                                           
                                                                                                                                
     Section  30 is  a conforming  amendment  that changes  a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurse."                                                                                    
                                                                                                                                
     Section 31  adds advanced practice registered  nurses to                                                                   
     those practitioners  authorized to draw blood  for tests                                                                   
     of persons charged with sex offenses.                                                                                      
                                                                                                                                
     Sections 32-33  are conforming amendments that  change a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurses."                                                                                   
                                                                                                                                
     Section  34  clarifies that  nurse-midwives  and  direct                                                                   
     entry midwives are certified.                                                                                              
                                                                                                                                
     Sections 35-38  are conforming amendments that  change a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance  practice registered  nurse" and make  other                                                                   
     related technical amendments.                                                                                              
                                                                                                                                
     Section  39 changes  the term  "registered  professional                                                                   
     nursing" to "registered nursing."                                                                                          
                                                                                                                                
     Section  40   clarifies  that  nurse-midwives   must  be                                                                   
     certified to be a provider under AS 21.87.                                                                                 
                                                                                                                                
     Section  41 is  a conforming  amendment  that changes  a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurse."                                                                                    
                                                                                                                                
     Sections   42-43  clarifies   that  nurse-midwives   are                                                                   
     certified and makes other technical amendments.                                                                            
                                                                                                                                
     Sections 44-46  are conforming amendments that  change a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurse."                                                                                    
                                                                                                                                
     Section 47  adds advanced practice registered  nurses to                                                                   
     the  definition of  health  care provider  in  statutory                                                                   
     provisions concerning prisons.                                                                                             
                                                                                                                                
     Section  48 is  a conforming  amendment  that changes  a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurse."                                                                                    
                                                                                                                                
     Section 49  adds advanced practice registered  nurses to                                                                   
     licensees  with particular  training  who  may assess  a                                                                   
     child  with  respect to  the  waiver under  a  statutory                                                                   
     provision  concerning home  and community based  medical                                                                   
     assistance.                                                                                                                
                                                                                                                                
     Section  50 is  a conforming  amendment  that changes  a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to  "advance  practice  registered nurse"  and  makes  a                                                                   
     related technical change.                                                                                                  
                                                                                                                                
     Section 51  adds advanced practice registered  nurses to                                                                   
     practitioners   who  are   not   liable  for   providing                                                                   
     information  to  the  Department of  Health  and  Social                                                                   
     Services  for  the  purpose  of  providing  services  to                                                                   
     certain children and makes a related technical change.                                                                     
                                                                                                                                
     Sections 52-54  add advanced practice  registered nurses                                                                   
     to  practitioners  who may  under  statutory  provisions                                                                   
     concerning  mental  health  commitment, determine  if  a                                                                   
     person  may  be  administered   psychotropic  medication                                                                   
     without   the  person's   consent,   and  add   advanced                                                                   
     practice registered  nurses with particular  training to                                                                   
     the  definition  of  mental   health  professionals  for                                                                   
     those statutory provisions.                                                                                                
                                                                                                                                
     Section 55  adds advanced practice registered  nurses to                                                                   
     practitioners who  may review a health care  plan for an                                                                   
     assisted living home resident.                                                                                             
                                                                                                                                
     Sections 56-59  are conforming amendments that  change a                                                                   
     statutory reference  from "advanced nurse  practitioner"                                                                   
     to "advance practice registered nurse."                                                                                    
                                                                                                                                
     Section 60 repeals specific statutes.                                                                                      
                                                                                                                                
     Section 61 sets  July 1, 2015 as the effective  date for                                                                   
     the bill.                                                                                                                  
                                                                                                                                
1:54:08 PM                                                                                                                    
CHAIR STEDMAN opened public testimony.                                                                                          
                                                                                                                                
DR.  CARRIE  DOYLE, Clinical  Nurse  Specialist,  Alaska  Clinical                                                              
Nurse Specialist  Association (ACNSA), testified in  support of SB
53.  She  said  she  is also  a  member  of  the  Alaska  Advanced                                                              
Practice  Registered Nurses  (APRN) Alliance,  which is  comprised                                                              
of all  four APRN specialties,  University of Alaska  - Anchorage,                                                              
and the Board  of Nursing. She related that nationwide,  there are                                                              
four types  of APRN.  This bill will  bring Alaska into  alignment                                                              
with a national  move called the APRN Consensus  Model. She listed                                                              
the types of nurse practitioners contained in the bill.                                                                         
                                                                                                                                
She  related  that  the  Consensus  Model  was  developed  by  the                                                              
National Council  of State Boards  of Nursing in  conjunction with                                                              
an APRN work  group. The Consensus Model seeks  uniformity in APRN                                                              
licensure, accreditation, certification, and education.                                                                         
                                                                                                                                
1:56:25 PM                                                                                                                    
LAURA  SARCONE,  Co-Chair,  Advanced  Practice  Registered  Nurses                                                              
(APRN)  Alliance, testified  in  support of  SB  53. She  repeated                                                              
much of  the previous testimony.  She said that eleven  states are                                                              
already in  full compliance with  the Consensus Model  and another                                                              
eleven  states  are  three-quarters  of  the  way  to  compliance.                                                              
Alaska is  half-way there  and SB  53 "brings  us over  the finish                                                              
line" by  updating old titles. She  thanked the sponsor  and urged                                                              
the passage of the bill.                                                                                                        
                                                                                                                                
CHAIR STEDMAN closed public testimony.                                                                                          
                                                                                                                                
SENATOR  GIESSEL  stated that  the  fiscal note  contains  receipt                                                              
services; three professional  groups will pay for  the expenses of                                                              
enacting the bill.                                                                                                              
                                                                                                                                
CHAIR STEDMAN held SB 53 in committee.                                                                                          
                                                                                                                                

Document Name Date/Time Subjects
APRN bill_diagram_for core message.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
APRN bill_core message 09_07_2014.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
AaNA Letter of Support for SB53 to Senator Stedman.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
APRN Info page.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
Letter re SB 53_Stedman_APRN-A_Juneau.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Fiscal Note APRN vsn N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Hearing Request SEN HSS.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Sectional Analysis vsn N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Sponsor Statement vsn N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AaNA 3-9-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AARP 3-3-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AK Affiliate ACNM 2-23-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AK Pharmacists 3-6-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AKANA 2-22-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support ANPA 2-24-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support APRN Alliance 2-22-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support ASHNHA 3-5-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Bd of Nursing 3-9-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Dooley 3-6-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support FASDx Services 2-26-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Hartz 2-26-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Hiles 3-16-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Myers 2-24-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Rader 2-22-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Version N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
HB 4 Information Services Request.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB 04 Hearing Request Senate HSS.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB 4 Fiscal Note.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB 4 Testimony.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 AED Bill Power Point Presentation.pptx SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support for AED's AFCA.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support for AEDs Michael Levy MD.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 1 - Heart Rhythm Society Sudden Cardiac Arrest Fact Sheet.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 2 - What Is an Automated External Defibrillator.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 3 - Research report_ Effects of AED device features on performance by untrained laypersons.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 4 - Research report_ Automated external defibrillator use by untrained bystanders can the public use model work.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support - AHA.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support - Dr BradleyAlaskaLtr2-4-15.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Sectional Analysis.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Sponsor Statement.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Ver. A.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
SB90 Support Material.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB90 Sponsor Statement.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB90 Hearing Request.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB90 ver A.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB53 Backup States Adopting APRN Consensus Model.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Backup Benefits of APRN model.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Fiscal Note DCCED 4-7-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB 90 Letter from AK PT Association.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
CS SB 74 Version I.pdf SHSS 4/8/2015 1:30:00 PM
SB 74