Legislature(2013 - 2014)BELTZ 105 (TSBldg)
03/04/2014 01:30 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB166 | |
| SB167 | |
| SB189 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 166 | TELECONFERENCED | |
| *+ | SB 167 | TELECONFERENCED | |
| += | SB 189 | TELECONFERENCED | |
| += | SB 193 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 166-BOARD OF NURSING; NURSES
1:37:02 PM
CHAIR DUNLEAVY announced the consideration of SB 166. "An Act
relating to nursing and to the Board of Nursing." He noted this
was the first hearing and there was a draft committee substitute
(CS) that incorporates changes requested by the sponsor.
1:37:24 PM
SENATOR CATHY GIESSEL, Alaska State Legislature, sponsor of SB
166, stated that the bill is analogous to a revisor's bill,
because it eliminates and updates obsolete statutes from the
Board of Nursing. These changes have been on the docket for the
Board of Nursing for at least 10 years and the board finally has
asked that they be brought forward for correction. She deferred
to her staff to discuss the proposed CS.
CHAIR DUNLEAVY asked for a motion to adopt the CS.
1:38:49 PM
SENATOR MICCICHE moved to adopt the CS for SB 166, labeled 28-
LS1010\Y, as the working document.
CHAIR DUNLEAVY objected for discussion purposes.
1:39:10 PM
JANE CONWAY, Staff, Senator Cathy Giessel, stated that Version Y
incorporates two changes. First, it rewrites the whistleblower
protection to include both the nurse that delegates a task to
another who is not educated to perform the task and the nurse
asked to perform the task that they are not educated to perform.
This is found on page 7, beginning on line 28. The second change
corrects a reference to the department of labor in the original
bill and writes out the full name of the Department of Labor and
Workforce Development. This is found on page 8, line 19.
SENATOR OLSON asked for an example of the obsolete statutes that
were deleted or rewritten.
SENATOR GIESSEL said the term vocational practical nurse is
obsolete and has been changed to licensed practical nurse. The
statute referring to a written examination is obsolete because
the examination is now computer-based. Recognition of the
Canadian licensing examination is obsolete because that exam is
no longer accepted by the board. Most of the changes to the
statutes are updates other than the whistleblower protection in
Section 15 and the qualifications for board membership in
Section 5. The latter was updated to add the practical nurse
identification and to identify the length of practice to serve
on the board. It also creates a designated seat for the advanced
nurse practitioner.
SENATOR OLSON asked if a person who has a Canadian nursing
license is able to continue to work under that license.
MS. CONWAY said the bill repeals the endorsement for nurses
completing the Canadian Nursing Association test.
SENATOR OLSON asked if this applies only to new licensees or
also to those who are already working under a Canadian nursing
license.
SENATOR GIESSEL deferred to the executive director of the Board
of Nursing.
1:43:48 PM
CHAIR DUNLEAVY asked if the bill does anything that would
prevent that from happening.
SENATOR GIESSEL said yes. The bill removes a provision in
statute that allows licensed practical nurses who are foreign
graduates to get a temporary six-month license prior to taking
the National Council Licensure Examination (NCLEX). The reason
is that about 42 percent of the foreign licensed nurses who take
the NCLEX don't pass it.
SENATOR MICCICHE asked if she had any comment on the requirement
for two separate criminal record checks to qualify as a
certified nursing assistant (CNA). It's necessary to get the
results from the first test before the second can be submitted,
which is very time-consuming. A constituent brought it to his
attention that medical facilities are finding it difficult to
fill CNA positions because of this requirement.
SENATOR GIESSEL explained that both the federal government and
the Board of Nursing require FBI background checks. The federal
government requires the check for anyone working in a Medicaid
facility and the board requires the check for licensure. The
results can't be shared. The federal law also established
barrier crimes that limit employment opportunities for certain
felonies, but the Board of Nursing doesn't have any barrier
crimes to practice at any level of nursing. The board looks at
each case individually. She deferred further explanation to the
executive administrator of the Board of Nursing.
1:47:57 PM
CHAIR DUNLEAVY removed his objection. Finding no further
objection, Version Y was adopted.
1:48:37 PM
NANCY SANDERS, PhD, Executive Administrator, Alaska State Board
of Nursing, Division of Corporations, Business, and Professional
Licensing, Department of Commerce, Community and Economic
Development (DCCED), Anchorage, Alaska, introduced herself.
SENATOR MICCICHE asked what could be done to streamline the
second background check.
DR. SANDERS replied there isn't a positive answer, because the
Board of Nursing can only share the results of their background
check with other facilities that are using it as a licensing
requirement.
SENATOR MICCICHE asked if she could conceive of separating the
CNA requirements from the general nursing requirements since
CNAs have a lower level of responsibility and training
requirements. He offered his understanding that those positions
were the most difficult to retain.
DR. SANDERS replied that has not been the experience of the
Board of Nursing. CNAs are intimately involved with the people
they care for, including those who are in their homes. In
keeping with the mission of the Board of Nursing to protect the
public, this is an important licensing category that should have
oversight. She also clarified that someone who has passed the
CNA certification examination may practice under a six-month
temporary permit while they wait for the results of the second
background check.
LAURA SARCONE, Certified Nurse Midwife representing the Alaska
Advanced Practiced Registered Nurse Alliance, Anchorage, Alaska,
stated support for SB 166. She voiced particular support for
paragraph (3) in Section 1 that designates one seat on the Board
of Nursing to an advanced nurse practitioner (ANP). That
designation contributes positively to the ongoing communication
and cooperation between the Board of Nursing and the regulated
community of advanced practice nurses, she said.
SENATOR OLSON asked where she practices midwifery.
MS. SARCONE replied she is a fulltime nurse midwife at
Southcentral Foundation in Anchorage.
SENATOR OLSON asked if she had ever practiced in rural Alaska.
MS. SARCONE said no.
1:54:54 PM
JANA SHOCKMAN, President, Alaska Nurses Association (ANA),
Anchorage, Alaska, stated support for SB 166, particularly the
formal designation of a seat for an advanced practice nurse on
the board. The nurses association recognizes that the Board of
Nursing has needed these updates for awhile, she said.
1:55:36 PM
BETH FARNSTROM, Chair, Alaska State Board of Nursing, Division
of Corporations, Business, and Professional Licensing,
Department of Commerce, Community and Economic Development
(DCCED), Anchorage, Alaska, testified in support of SB 166. She
said the board has discussed these changes for a number of years
and at its January 2014 meeting voted unanimously to work with
the legislature on this issue.
1:56:42 PM
DON HABEGER, Director, Division of Corporations, Business &
Professional Licensing, Department of Commerce, Community and
Economic Development (DCCED), raised concern with the provision
in Section 3, page 3, lines 14-15, that requires the executive
administrator of the board to hold a master's degree in nursing.
The most highly qualified RN applicant would be hired, just as
when Dr. Nancy Sanders was selected, but it would provide the
division more flexibility if the requirement wasn't in statute.
SENATOR OLSON asked how many people in Alaska hold master's
degrees in nursing.
MR. HABEGER said he didn't know, but 15,000 nurses are licensed.
SENATOR OLSON asked how many doctor of nursing degrees are held
in Alaska.
MR. HABEGER replied he only knew of Dr. Nancy Sanders.
SENATOR MICCICHE commented that the bill has clearly increased
the competency of the board and he believes that's a good idea.
He said he'd like to hear why the sponsor believes that level of
competence is important for the administrative position.
2:01:08 PM
GREY MITCHELL, Assistant Commissioner, Department of Labor and
Workforce Development (DOLWD), discussed the department's
perspective of SB 166. He said Sections [15 and 16] on pages 7
and 8 would affect the department. The new subsection (d) in
Section 16 assigns DOLWD the authority to impose a civil penalty
of up to $10,000 on a person who knowingly violates AS
08.68.279(a). DOLWD has a program to pursue similar protections
for workers who bring forward occupational, safety, and health
complaints, but the concern is that they wouldn't be able to use
their existing investigator because the position is partially
funded through the U.S. Department of Labor Occupational Safety
and Health Administration (OSHA). However, if these complaints
are minimal, as indicated through preliminary discussions with
the sponsor, DOLWD may be able to accommodate the costs with
existing staff and additional training, he said.
SENATOR OLSON questioned the advantage of having DOLWD
investigate these complaints as opposed to the current
investigative process.
MR. MITCHELL said he didn't know the current investigation
process.
SENATOR OLSON asked if DOLWD views this amendment as an
advantage.
MR. MITCHELL opined that it was an issue for the sponsor to
address.
SENATOR OLSON asked why he was opposing the amendment.
MR. MITCHELL clarified that he was merely voicing a concern.
CHAIR DUNLEAVY asked if this was an issue that would prevent the
bill from moving forward.
MR. MITCHELL said no.
2:05:23 PM
CHAIR DUNLEAVY asked the sponsor to address the two issues that
were raised.
SENATOR GIESSEL addressed the question from Section 3 about the
minimum requirement for the executive administrator of the Board
of Nursing to hold a master's degree in nursing. She explained
that the Board of Nursing regulates about 17,000 licensees or 25
percent of the professional licenses in the state. Because of
that large volume, the board delegates to the executive
administrator the authority to review license applications and
initial complaints to determine whether they rise to the level
of an investigation. The executive director has to be fully
versed in the practice of nursing at all levels because the
Board of Nursing regulates from a high school diploma to a
doctoral level.
Addressing the question about the potential pool of applicants,
she explained that an advanced nurse practitioner has to have,
at minimum, a master's degree in nursing. In this state there
are about 500 nurses who hold master's degrees and a rising
number are doctorially prepared, so there is an adequate pool of
applicants, she said.
SENATOR MICCICHE asked if an RN program was typically four or
five years.
SENATOR GIESSEL replied there is encouragement to go to a four-
year baccalaureate degree, but currently it can be either a two
or four year degree.
SENATOR MICCICHE asked if it's a one-year program to transition
from an RN four-year degree to a master's degree in nursing.
SENATOR GIESSEL confirmed there are bridge programs like that;
the University of Alaska, Anchorage program is a four-year
baccalaureate and a two-year master's degree.
CHAIR DUNLEAVY summarized that the bill increases the
qualifications for the executive administrator position and the
sponsor doesn't believe it will be difficult to find qualified
candidates.
SENATOR GIESSEL said that having been in an interview process
twice, she didn't believe there would be a problem.
SENATOR MICCICHE stated support for the requirement for the
executive administrator to have a master's degree at a minimum.
CHAIR DUNLEAVY asked the sponsor to comment on the second issue
that was raised.
SENATOR GIESSEL deferred to the executive administrator. She
worked with the Department of Law to write the section and they
encouraged assigning the authority to the Department of Labor
and Workforce Development (DOLWD). She suggested the committee
also hear from Ms. Shockman because the Alaska Nurse's
Association strongly endorsed this provision.
CHAIR DUNLEAVY asked Ms. Shockman to comment on the provision on
page 8, lines 19-21, related to DOLWD.
MS. SHOCKMAN said the ANA strongly supports the whistleblower
protection language in the bill. She provided an example to
illustrate why this is important. She explained that she is a
very experienced intensive care nurse with specialty
certifications in critical care and cardiac surgery. If her
employer were to decide, because of short-staffing, that she
should work a shift in obstetrics, it might be dangerous to a
patient. Her only training in obstetrics was generalized in
nursing school 17 years ago. The language in this section would
protect her from punitive or retaliatory actions by the employer
if she declined the assignment due to safety concerns. The ANA
believes there should be a penalty in a civil action if the
employer knowingly violates this and attempts to force a nurse
to take an assignment for which they are not trained.
SENATOR OLSON questioned how this will affect nurses' attitudes
in smaller hospitals. There may be only one trained RN on duty
with licensed practical nurses (LPNs).
MS. SHOCKMAN directed attention to page 8, line 13. It says the
nurse must report to the board the improper attempt to assign or
delegate the task, and the board will determine whether or not
the assignment was improper. It's not a matter of a nurse not
wanting to perform; it's a matter of public safety, she said.
SENATOR OLSON questioned what happens if there's nobody to
respond.
MS. SHOCKMAN said nursing occurs in a variety of environments,
and in smaller hospitals nurses tend to be less specialized.
SENATOR OLSON said his concern relates to 10-12 bed facilities
in rural Alaska that have nursing shortages. It's a disservice
to the nursing administration if a nurse declines an assignment
because he/she didn't feel like doing it, he said.
2:16:09 PM
SENATOR GIESSEL acknowledged that he made a strong point then
directed attention to paragraph (1)(A), (B), (C), and (D) in
Section 15. These four sidebars make it clear that a nurse isn't
declining an assignment because they didn't feel like doing it.
SENATOR OLSON said his issue is that the director of nursing in
a rural facility may be hesitant to assign a task if they're
worried about a whistleblower complaint and potentially a
$10,000 civil penalty.
SENATOR GIESSEL said it's a valid concern, but nurses in small
hospitals are more generalists and the board will look at the
complaint before it goes forward to a penalty.
SENATOR OLSON voiced concern that the board might not know much
about practicing in rural Alaska.
SENATOR GIESSEL reviewed the membership of the Board of Nursing
in Section 1 to allay his concerns. She stressed that the board
is very diverse and would look at a whistleblower complaint from
a rural community with an understanding of what it's like to
practice there.
2:25:09 PM
SENATOR MICCICHE pointed out that the whistleblower section was
repealed and reenacted to give it more teeth.
SENATOR GIESSEL agreed.
SENATOR OLSON asked the sponsor to list the various categories
of licenses.
SENATOR GIESSEL explained that there are certified nursing aides
(CNA), licensed practical nurses (LPN), registered nurses (RN),
and advanced nurse practitioners (ANP).
CHAIR DUNLEAVY held SB 166 in committee for further
consideration. Public testimony was open.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 166 vsO.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB 166_version Y_CS.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB166 Sponsor Statement.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB 166 Sectional Analysis.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB 166_Sectional Analysis_VersionY.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB167 ver A.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB 167 Sponsor Statement.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB193_FullText_VersionN.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB 193 Sponsor Statement.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB 193 Fiscal Note DCCED.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB 193 Support - Brice.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB 193 Support - Craig Taylor Equipment.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB 193 Support - Rain Proof.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB 193 Support - Roger Hickel Contracting.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB 193 SupportLetter_Marsh McLennan.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 193 |
| SB189_FullText_VersionC.PDF |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB189_Sponsor_Statement.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB189-DCCED-CBPL-02-21-14.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB189_OppositionLetter_IABA.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB189_SupportLetter_BuildersInc.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB189_SupportLetter_FirstNational.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB189_SupportLetter_KitchenBathDesign.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB189_SupportLetter_RichardCarr.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB166_FiscalNote_DCCED.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB166_SupportLetter_ Evans.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB166_FiscalNote_DOLWD.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB166_SupportLetter_ Gillette.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB166_SupportLetter_ Sanders.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB166_SupportLetter_Farnstrom.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 166 |
| SB167_FiscalNote_DCCED.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB167_SupportLetter_NAMIC.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB167_SupportLetter_Horace Mann.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB167_SupportLetter_StateFarm.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB189_SupportLetter_ChuckHoman.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB167_SupportLetter_PCI.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB189_OppositionLetter_Dalton.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |
| SB167_InfoGraphUpdated.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 167 |
| SB189_OppositionLetter_ Nenana and Goode.pdf |
SL&C 3/4/2014 1:30:00 PM |
SB 189 |