Legislature(2021 - 2022)BUTROVICH 205
09/10/2021 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB67 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 67 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
September 10, 2021
3:39 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator Shelley Hughes, Vice Chair
Senator Mia Costello (via teleconference)
Senator Lora Reinbold
Senator Tom Begich
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 67
"An Act relating to the licensure of nursing professionals;
relating to a multistate nurse licensure compact; and providing
for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 67
SHORT TITLE: NURSING: LICENSURE; MULTISTATE COMPACT
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/03/21 (S) READ THE FIRST TIME - REFERRALS
02/03/21 (S) HSS, L&C
02/23/21 (S) HSS AT 1:30 PM BUTROVICH 205
02/23/21 (S) Heard & Held
02/23/21 (S) MINUTE(HSS)
02/25/21 (S) HSS AT 1:30 PM BUTROVICH 205
02/25/21 (S) -- Public Testimony --
04/15/21 (S) HSS AT 1:30 PM BUTROVICH 205
04/15/21 (S) Heard & Held
04/15/21 (S) MINUTE(HSS)
04/20/21 (S) HSS AT 1:30 PM BUTROVICH 205
04/20/21 (S) Failed to Move Out of Committee
04/20/21 (S) MINUTE(HSS)
09/02/21 (S) THIRD SPECIAL SESSION BILL
09/03/21 (H) THIRD SPECIAL SESSION BILL
09/10/21 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
SARA CHAMBERS, Director
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community, and Economic Development
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 67.
ACTION NARRATIVE
3:39:28 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:39 p.m. Present at the
call to order were Senators Costello (via teleconference),
Hughes, Reinbold, and Chair Wilson. Senator Begich joined the
committee thereafter.
SB 67-NURSING: LICENSURE; MULTI-STATE COMPACT
3:40:11 PM
CHAIR DAVID WILSON announced the consideration of SENATE BILL
NO. 67 "An Act relating to the licensure of nursing
professionals; relating to a multistate nurse licensure compact;
and providing for an effective date."
CHAIR WILSON explained that the bill failed to move from
committee on April 20, so it falls within the committee's
jurisdiction to take it up again.
3:41:08 PM
SENATOR REINBOLD requested an explanation of why the committee
was taking the bill up after it failed to move from committee
and what changes had been made since that time.
CHAIR WILSON responded that the bill was still within the
committee's purview, so there was no need to rescind the
previous action.
SENATOR REINBOLD asked why the committee was hearing the bill
now when members chose not to move the bill from committee [on
4/20/21.]
CHAIR WILSON stated that Ms. Chambers would answer the question.
3:42:04 PM
CHAIR WILSON moved to adopt the work draft committee substitute
(CS) for SB 67, work order 32-GS1603\B as the working document.
3:42:16 PM
SENATOR HUGHES objected for purposes of discussion.
CHAIR WILSON explained that the CS includes the amendments the
members passed previously, although the bill did not advance
from committee. The three amendments that were adopted were A.5
[2], A.6 [3], and A.7 [4], which are incorporated into the work
draft. The CS also contains an additional amendment for the
members to consider.
SENATOR HUGHES asked for a recapitulation of the three
amendments that were adopted.
3:43:22 PM
At ease
3:43:39 PM
CHAIR WILSON reconvened the meeting and reviewed the amendments
that were adopted on 4/15/21 and 4/20/21. Amendment 2 was
related to the employment of nurses holding a multistate
license.
SENATOR HUGHES asked if Amendment 2 addressed the maintenance of
an out-of-state nurse registry.
CHAIR WILSON replied yes.
CHAIR WILSON explained that Amendment 3 was clarifying and
conforming language regarding the privilege to practice.
Amendment 4 was regarding two hours of Alaska Native culture
training.
3:46:10 PM
At ease.
3:48:11 PM
CHAIR WILSON reconvened the meeting. He explained that Amendment
2 [added a new bill section that] required employers to notify
the nursing board of an out-of-state nurse's hire and
termination within 30 days. In addition, the board of nursing
would create regulations regarding items in the database and be
responsible for informing employers. [This is Section 21 in the
CS.] The CS also adds a new subsection (e) to Section 21 on page
11, line 28. It states that a fine of $1,500 may be imposed if
an employer fails to report the information to the Department of
Commerce, Community and Economic Development (DCCED). The
legislature may appropriate the money from these fines back to
DCCED to offset investigative costs. A registry provides an
accurate accounting of out-of-state nurses working in Alaska,
making the investigation of a complaint easier.
3:50:46 PM
SENATOR HUGHES asked if he would support a conceptual change to
make the registry public on the Board of Nursing website; this
would hold businesses accountable for hiring Alaska residents.
CHAIR WILSON deferred the question to Ms. Chambers; he did not
know if that information was public.
3:51:55 PM
SARA CHAMBERS, Director, Division of Corporations, Business and
Professional Licensing, Department of Commerce, Community, and
Economic Development, Juneau, Alaska, answered yes; an Alaskan's
licensing information is available on the department's website.
It would be possible to make a separate public registry for
multistate licensed nurses.
3:52:23 PM
SENATOR HUGHES asked if she would support specifying in SB 67
that DCCED would publicly post the registry for compact nurses.
MS. CHAMBERS replied that the addition to the bill would not be
a problem for DCCED.
3:53:00 PM
SENATOR BEGICH joined the committee.
3:53:08 PM
CHAIR WILSON asked Senator Hughes if she maintained her
objection to adopting the CS.
3:53:14 PM
SENATOR HUGHES removed her objection.
CHAIR WILSON found no further objection, and version B was
adopted.
3:53:24 PM
At ease.
3:55:37 PM
CHAIR WILSON reconvened the meeting. He asked Ms. Chambers why
the administration asked the committee to reconsider SB 67 and
what had changed since the committee last heard the bill.
3:56:42 PM
MS. CHAMBERS expressed appreciation for the invitation to
comment. She explained the urgent need for the Nurse Licensure
Compact (NLC) and the reason for adding it to the Special
Session call. She read the following prepared testimony:
Due to the surge of COVID 19 across Alaska and the
healthcare workforce shortage, it is imperative that
we find a solution to allow competent and capable
nurses to fill vacancies and provide services to
Alaskans. The most immediate and safest solution is
for Alaska to join the Nurse Licensure Compact.
We all have read the daily headlines about the current
status of Alaska's health care situation. "Crisis,"
"dire," and "disaster mode" are just some of the words
that have been used to describe what it is like within
hospitals and long-term care facilities. Healthcare
providers are pleading for relief.
In response, the Alaska State Hospital and Nursing
Home Association has requested assistance through DHSS
in expediting recruitment of 298 registered nurses and
105 certified nurse aides through a request to FEMA to
fill vacancies across the state. We anticipate these
nurses could be here as soon as the end of the month.
While this influx of much needed healthcare worker
assistance would be welcomed, this requires the Board
of Nursing staff to vet and process licenses for each
individual arriving. I cannot stress enough the
enormous burden this will place on our already maxed-
out staff, and the effect a delay in getting those
nurses into hospitals due to licensure will have on
already maxed-out health care facilities.
So, is the NLC really the best solution?
3:58:28 PM
MS. CHAMBERS continued reading:
Our division, which is responsible for licensing more
than 90,000 professionals to provide services to
Alaskans, has bent over backwards, with a lot of help,
to identify every tool that could possibly be placed
in our toolbox to safely and efficiently get qualified
nurses to workparticularly in the last 18 months that
we have responding to COVID demands.
Last fall, the Board of Nursing adopted regulations
creating an emergency courtesy licenseor ECLfor
registered nurses. Since November 2020, our staff has
issued hundreds of ECLs, which receive expedited
review, are valid for a limited time, and are only
issued for emergency purposes. Since then, the demand
for longer-term licensure has also increased. Our
nursing program issued 14 percent more licenses in
FY21 than the previous year.
3:59:29 PM
For high-volume programs like nursing, ECLs cannot be
expedited any more than they are right now. If just a
handful of applications are received, it only takes
our staff a few days to issue ECLs, once a complete
and correct application is submitted. However, if we
receive hundreds of nursing ECL applications at once-
as we have over the last eighteen months and we are
expecting through the FEMA request later this month
these will take weeks to process due to the high
volume and our current capacity. We don't expect this
trend to slow down any time soon.
We are hiring additional staff and are offering
overtime to current staff; however, the demand to
perform this work has dramatically outpaced our
ability to hire, train, and supervise the number of
people needed to properly vet applications for health
care licenses.
As of today, forty-four percent of nurses licensed by
the Alaska board hold an address of record that is
outside Alaska. Traveling nurses are always in high
demand since Alaska nursing programs do not have the
capacity to produce the thousands of nurses required
to meet Alaska's healthcare needs, especially during
COVID.
The only way to further expedite professional
licensure is to bypass it, and the only way to do that
without creating a potential risk to public health and
safety is by joining the Nurse Licensure Compact so
nurses can get to work immediately.
4:01:01 PM
MS. CHAMBERS continued reading:
Multi-state-licensed nurses have been vetted at a
higher standard than our own law requires, standards
that are written directly into SB 67. The compact
legislation before you spells out the legal
responsibilities of the Alaska board to enforce and
report unsafe nurses, just as they do now. Embedding
the compact into Alaska law ensures these standards
cannot be changed without an act of the Alaska State
Legislature, and it guarantees the Board of Nursing
retains full authority over the practice of nursing in
our state. The Alaska State Board of Nursing and
89percent of Alaska-resident nurses support the NLC
for these very reasons.
As with any state law, the legislature has the power
to repeal this legislation at any time if it's
determined the NLC is not the best fit for Alaska.
To summarize, Legislative adoption of the Nurse
Licensure Compactor NLCis the only immediate
solution to safely allow qualified nurses to provide
desperately needed healthcare services to Alaskans.
This is brought to your attention right now because
the governor does not have the power to write and
adopt or amend state law, even under a disaster
declaration. Because the effort needed to help our
hospitals and nursing homes requires substantive
changes to state law, the governor is asking the
legislature to put political motivations aside and
pass this critical, beneficial legislation to
immediately relieve Alaska's health care network.
Chair Wilson and members of the committee, I
appreciate your time and consideration of this
important and urgent piece of legislation today. On
behalf of the governor, I urge you to consider the
overwhelming support that has come from health care
stakeholders across the state and enact meaningful
change to address this crisis.
4:03:04 PM
CHAIR WILSON thanked Ms. Chambers. He recognized that Senator
Begich had joined the committee and that Senator Costello was
attending via teleconference.
SENATOR BEGICH said that while Ms. Chambers mentioned not
wanting to politicize the Nurse Licensure Compact, using the
pandemic to pass legislation could be considered politicizing.
He stated he is not convinced of Ms. Chamber's facts. He asked
if SB 67 is a temporary solution to the nursing shortage.
MS. CHAMBERS replied that the administration proposed this
needed legislation before the pandemic. The shortage has been
exacerbated by COVID. DCCED has worked with departments,
organizations, and the administration trying to find solutions.
It has added positions and overtime, which takes time and
training. If alternatives to the NLC could maintain the safety,
standards, accountability, and jurisdiction of the Alaska Board
of Nursing, the department would consider them. The NLC is the
fastest no sacrifice means to resolve the growing pre-pandemic
nursing shortage crisis.
SENATOR BEGICH responded that members did not feel the
legislation was necessary before the pandemic, had a different
opinion from DCCED, and did not advance it. Although there is
now pressure because of the pandemic, the facts do not merit
change. He concluded that joining the compact would not fix
Alaska's shortage problem since the shortage is nationwide.
4:07:44 PM
MS. CHAMBERS agreed that there is a greater need for nurses
nationwide. However, Oregon's implementation of the model, which
DHSS has leveraged through requests from the Alaska State
Hospital and Nursing Home Association (ASHNHA), shows that 500
nurses can be requested and obtained. The department's purpose
is not to impede facilities' hiring, yet licensing is taking six
weeks. There may not be enough nurses nationwide. However,
providers and facilities call DCCED asking for a faster way to
get through the licensing process so people they have hired can
begin working.
CHAIR WILSON announced online were Heidi Hedburg, Division
Director of Public Health; Gene Wiseman, Section Chief for Rural
Community Health Systems, Division of Public Health; and Clint
Farr, Deputy Director for the Division of Public Health.
SENATOR BEGICH said we have emergency regulations that allow for
expedited and courtesy licenses. He suggested hiring licensing
staff for vetting would be better than creating a permanent
statutory change that gives away legislative authority.
4:10:43 PM
SENATOR BEGICH asked why the emergency hire regulations are
inadequate and whether the CS would make Alaska ineligible for
the compact.
MS. CHAMBERS replied that the department has struggled with
staffing for eighteen months. COVID has led some state agency
workers and health care providers to be exhausted, and nursing
board staff have resigned due to burnout. The administration has
been generous in authorizing positions, but not enough qualified
people have applied and those hired need training. Overtime has
been offered to examiners. She said she is carrying two boards
to free up staff. The addition of staff to address licensing
needs becomes an expense to licensees.
SENATOR BEGICH interjected that over half a billion dollars in
COVID relief money and discretionary money within the Governor's
Office and DHSS could legitimately cover licensing expenses so
that fees are not passed to licensees.
MS. CHAMBERS responded DCCED has worked with health and social
services and public health to identify available money to use
for overtime pay. The COVID funding that he mentioned is being
used for licensing the 300 nurses requested by ASHNA, but COVID
has been taxing the department for eighteen months. Permanent
positions will need to be added. The department is working to
address the nursing shortage and is open to additional
suggestions that help.
SENATOR BEGICH asked whether the CS would make Alaska ineligible
for the compact.
MS. CHAMBERS replied that she has not read the memo provided to
the committee. However, if members support the CS with its
presented changes, the department will see if changes need to
happen in a future committee.
4:15:24 PM
At ease.
4:17:06 PM
CHAIR WILSON reconvened the meeting. He asked Ms. Chambers if
she recalled any compact concerns with Amendment 7 when it
passed on 4/20/21. He noted that compact representatives were
online. He also asked if she had any comments on the memo after
reading it.
MS. CHAMBERS responded that she recollected that there was not
an additional opportunity to speak to the amendments. SB 67
subsequently was not discussed further in the committee. There
was no opportunity to address Amendment 7's required cultural
education training for compact nurses. She stated that it would
prevent Alaska from entering the compact, and cultural education
is not required for nurses licensed in Alaska. No test even
approaches that level of education for any Alaska nurse or nurse
among the forty-four percent applying for and receiving
licensure in Alaska now.
4:18:30 PM
SENATOR REINBOLD asked if the compact had anything to do with
money from the Federal Emergency Management Agency (FEMA) or US
General Services Administration (GSA).
MS. CHAMBERS replied that the nursing compact has nothing to do
with any federal agreement or funding. It does not make the
state beholding to any federal contract, and it is separate from
DHSS efforts, which Ms. Hedburg could address.
SENATOR REINBOLD asked if there are any vaccine requirements
regarding this compact.
MS. CHAMBERS answered that vaccination requirements are not part
of the compact and are not part of DCCED's licensing scheme.
SENATOR REINBOLD asked what the vaccination status would be of
the 300 needed health care providers.
MS. CHAMBERS replied that the department does not know the
vaccination status of any nurse working or who comes to work in
Alaska.
4:20:05 PM
SENATOR HUGHES asked if the Board of Nursing would be open to
the suggestion of required cultural training for all Alaska
nurses unless they have lived in Alaska for a certain amount of
time.
MS. CHAMBERS responded that all the department's licensing
programs require continuing education, and cultural education
could become a requirement for all Alaska nurses.
4:22:09 PM
MS. CHAMBERS said that adding licensing requirements for compact
nurses to complete before they can begin work defeats the
purpose of the compact. Before compact attorneys can determine
whether the additional training requirement would affect compact
eligibility, the National Council of State Boards of Nursing
(NCSBN) would need to decide the training specifications.
SENATOR HUGHES doubted whether having all nurses take the
training would help compact eligibility. She asked if the
Emergency Courtesy License (ECL) requirements are as stringent
as Alaska-only or multistate license requirements. She asked if
a multistate license ensures a safer setup for patients than an
ECL.
MS. CHAMBERS answered that the legislature originally authorized
the ECLs in Senate Bill 241. It was called an expediated process
because it had very few requirements. The department looks at
whether an applicant has an encumbered license and whether they
are under investigation. When an issue is found, there is a
process for further investigation. A permanent Alaska license
has these same two and many other requirements.
The permanent Alaska license is less rigorous than the
multistate license. The standards for the multistate license
would not be delegated to the board of nursing, as is currently
done with the Alaska license. The multistate license standards
would be set through the legislature. By joining the compact,
the state would be raising the standards for licensing without
ceding authority and joining the compact would speed up the
hiring process.
4:25:07 PM
SENATOR HUGHES summarized that the most stringent license is
multistate, and the least stringent license is ECL. She stated
she believes this is an important realization because it is the
responsibility of legislators to think about patients and
safety. She reiterated that DCCED is short-staffed, has
positions open and money to hire but not enough qualified
applicants. She asked if ECL nurses are hired from outside the
state.
MS. CHAMBERS responded yes; ECL nurses are recruited from
outside the state and offered a position by an Alaskan facility.
At the facility's request, the department tries to fast-track
the applicant using the ECL standards. The ECL is a limited 180-
day license with an additional 180 days possible. It is a
shorter-term license, but once a person has been issued it
twice, they need to obtain a permanent license.
SENATOR HUGHES surmised that the licensing options for solving
the nursing shortage in Alaska are either bringing in out-of-
state nurses at a less stringent standard using the ECL or
bringing in out-of-state nurses at a more stringent standard
using the multistate license. Staff to promptly process ECLs is
lacking. She stated she wants every Alaskan nurse to have the
first chance at a job opening. The registry for nurses hired
outside the state will hold employers accountable for hiring in-
state nurses when possible. She stated her belief that safety is
essential, and nurses employed from outside the state should
meet high standards.
4:28:05 PM
SENATOR COSTELLO questioned whether the higher standards
required of the multistate license would put state-licensed
Alaskans at a disadvantage for employment.
MS. CHAMBERS replied that she is not implying the Alaska Board
of Nursing has low standards. Under state standards, there are
optional elements to licensing that the Board of Nursing has
control over. There are no optional elements to the multistate
license because the compact states universally adopt the
standards. The purpose of the multistate license is to expedite
hiring and ensure nurses meet or exceed state standards. State
nursing boards decide individually if a nursing misdemeanor
disqualifies a nurse from being state-licensed. Under the
compact, a nurse who has had a nursing misdemeanor will not be
eligible for a multistate license. The standard is universally
established by all states who are in the compact.
4:30:13 PM
Healthcare providers are desperate for anyone qualified and
safe. The department is seeing health care providers, such as
ASHNA and its members, supporting the NLC. Alaska has a lot of
great nurses, but there are not enough of them. Employers are
not looking at a tiered system. They are looking to hire
employees they desperately need.
SENATOR COSTELLO stated that a process to expedite emergencies
was contemplated and put into place because the state has
struggled with nursing shortages. She suggested the better long-
term solution would be reassigning, training, and using the
established emergency licensing process.
MS. CHAMBERS replied that those tools are being fully utilized
and are not adequate to meet the surge in demand caused by
COVID. She reiterated that she is open to new ideas.
4:32:45 PM
SENATOR BEGICH responded that it is misleading to say members
have two options for bringing nurses into the state; in fact,
there are no nurses available. Getting nurses licensed under the
less stringent ECL requirements is the easier path. He asked how
a more stringent multistate licensing pathway fixes the shortage
if there are not enough nurses using the easier pathway.
Alaska's continuing education standards exceed those of many
compact states. He voiced aversion to giving the Alaska nursing
board's local discretion to a compact managed by consensus and
unfamiliar with Alaska's needs. He sought confirmation of the
state's ability to change laws that conflict with the compact.
MS. CHAMBERS answered that there is no handing over or ceding of
power. The compact would be state law. The Alaska Legislature
would make decisions about standards. Alaska could be a member
of the compact and still have an Alaska-only state licensing
process. Nurses could choose to have an Alaska-only license. The
department does not want to get rid of the existing process and
laws. The compact is a different licensing path that the Alaska
Legislature could put into law. The legislature could align
state licensing standards with compact licensing if it chooses;
the Alaska license is a separate purview. The compact is a
business agreement that says all participating states agree to a
specified set of standards for a specified license that has
specified benefits. All compact states participate in the
national state legislature change process when any state desires
a change. Alaska would then decide whether to continue to
participate in the compact.
The ECL is an emergency response tool that the board adopted to
process nurses faster. The compact could be another tool of the
legislature that can do more than the department has the legal
authority to do.
4:37:19 PM
SENATOR BEGICH asked if the state would be able to collect a
licensing fee from compact nurses.
MS. CHAMBERS explained that DCCED would be able to offer the
compact multistate license to Alaskan nurses. There are almost
10,000 Alaska licensed nurses who have an address of record in
Alaska. These nurses could choose to keep their Alaska license
and apply for a multistate license; Alaska would receive the fee
if they did. Each state retains its own receipting. Alaska would
not accept funds for multistate licensed nurses coming into
Alaska. Alaska multistate licensed nurses likewise would not pay
a fee to work in another compact state.
SENATOR BEGICH sought clarification and stated his understanding
that Alaska will receive compact fees for nurses who are Alaskan
residents that choose to obtain multistate licenses. Alaska will
not collect a compact licensing fee from nurses coming from
outside the state.
MS. CHAMBERS replied, correct.
4:39:35 PM
SENATOR HUGHES asked if any part of a nurse's multistate license
causes the state or the Board of Nursing to sacrifice autonomy.
MS. CHAMBERS replied that there is no sacrifice of autonomy
coming to or while working in Alaska. The board of nursing
retains complete jurisdiction over nurses operating in the state
regardless of their license type. The board of nursing, through
DCCED, can take away a multistate licensed nurse's right to
practice in Alaska when complaints are reported.
When complaints are reported against a multistate licensed
nurse, DCCED files a report to a national database and the
nurse's home state. Revoking the nurses practice in Alaska
consequently revokes their practice in other compact states
until the home state completes an investigation. Licensing fees
paid to the home state help pay for the investigation done by
the home state. The home state issues the multistate license and
determines if the license should be revoked or disciplined. The
Alaska Board of Nursing solely determines whether a nurse can
practice in Alaska.
SENATOR HUGHES recalled hearing that DCCED is backlogged with
ECL applications. She asked if the state joined the compact,
were some nurses in the backlog holding multistate licenses, and
if so, could they be put to work immediately.
4:42:23 PM
MS. CHAMBERS answered that the department receives multiple
applications a day for ECL nurses that are desperately needed in
hospitals and long-term care facilities. Regardless of where
they are from, ECL applicants must submit documentation and
await review.
She presumed that since there are thirty-eight compact states
and the department accepts ECL applications from all states,
many of the nurses in the backlog would be from compact states.
DCCED does not ask ECL applicants if they have multistate
licenses because Alaska is not a compact state, and the
department does not have a way to bypass the paperwork. If
Alaska were to become a compact state, any nurse holding a
multistate license would be able to start work. An employer
would only need to register them within 30 days. Until Alaska
enters the compact, every applicant will be processed through
the backlog that existed prior to and made worse by COVID.
SENATOR HUGHES asked if it is correct that eighty-nine percent
of nurses in Alaska want to be part of the compact.
4:44:05 PM
MS. CHAMBERS replied yes; the department did a comprehensive
statistically sound study in 2019 and provided the methodology
to the legislature. In the study, ninety-two percent of nurses
want the Nurse Licensing Compact (NLC), and eighty-nine percent
of those respondents are Alaska-based nurses.
SENATOR COSTELLO asked if there is information available on
nursing shortages in compact states. Idaho is a compact state
that is experiencing a nursing shortage. She said she is unsure
if joining the compact will provide the needed result.
MS. CHAMBERS replied that she would give information to the
members.
SENATOR BEGICH said he would like to address Article V of the
compact. It says only the home state has the power to take
adverse action against a nurse's multistate license. He asked
whether it is correct that the nursing board can ask the nurse
to leave [not practice] but cannot take adverse action against
them.
MS. CHAMBERS replied that adverse action on a license is a legal
action that restricts the license itself. Included in the CS,
the privilege to practice does not legally alter a nurse's
license, and it is not an adverse action or discipline.
Privilege to practice enables the nursing board to tell a nurse
they may not practice in Alaska. For example, a 17-year-old may
not lose his license, but the mother has the privilege to say he
may not drive her car.
SENATOR BEGICH questioned how an adverse action is conveyed to
the home state if Alaska cannot take adverse action.
4:48:08 PM
MS. CHAMBERS said the department would send a report to the home
state and the national nurse discipline database. The notice
informs the home state that there is a problem. Under the
awareness of all states, the home state would work with
investigators and act on the license. If it were an adverse
action like a felony, the license would be revoked. The home
state would report the action taken to the national database.
CHAIR WILSON said the CS adds to SB 67 relating to a $1500 fine
per infraction by any employer who does not comply with the
registry reporting requirements. Fees collected will be used by
licensing to offset costs associated with maintaining the
database and carrying out investigations. It changes the
effective date from January 1, 2022, to immediately.
4:50:17 PM
CHAIR WILSON recessed the meeting to five minutes after the
floor session ends.
5:27:55 PM
CHAIR WILSON reconvened the meeting. He asked Ms. Chambers for
her closing comments.
MS. CHAMBERS thanked the committee for considering a way to
address Alaska's immediate health care need. She restated that
ninety-two percent of Alaska licensed nurses are supportive of
the NLC. Eighty-nine percent of those are Alaskan residents, and
eighty-seven percent are union members. Nurses are asking for
relief.
MS. CHAMBERS said she received a text during recess from the
Board of Nursing Chair [Danette Scholeder], who stated every
nurse wanting to work in Alaska would have a job because there
are not enough Alaska nurses to fill the need. The NLC is a new
concept for Alaska that members should continue learning about.
The NLC is a logical, reasonable, small government approach to
getting health care providers to Alaska with no risk.
5:30:30 PM
SENATOR REINBOLD stated concern with SB 67. She has a letter
from the Alaska Nurses Association stating that 1,500 nurses in
Alaska are opposed to SB 67. She opined that the 2019 survey Ms.
Chambers mentioned is outdated and taken out of context. Many
individuals and the AFL-CIO oppose the legislation. She asked
that members read the letters of opposition. She stated she
believes in holistic care, supports Alaskan workers first, and
hopes SB 67 is tabled.
SENATOR BEGICH stated that Alaska does not produce enough
nurses. The state has a high-quality nursing program, but there
is a waitlist to get in. He suggested the state should do more
to build Alaska's workforce of nurses. He recommended the
legislature determine the amount of funding it would take to
move Alaska's first-class nursing school to a place where it is
producing so many nurses that a shortage is no longer an issue.
He stated he hopes legislators join him in making this broader
solution happen. It is a better long-term solution for Alaska.
5:35:06 PM
CHAIR WILSON stated he would hold SB 67 in committee for future
consideration.
5:35:54 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 5:35 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 67, DCCED, Alaska's COVID Response & the NLC - 9.7.21.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67, DCCED, Addressing Claims Against the NLC - 9.7.21.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67 Amendment A.5 Wilson (Adopted).pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67 Amendment A.6 Begich (Adopted).pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67 Amendment A.7 Begich (Adopted).pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67, Letter of Support, Redacted 9.8.21.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| Sb 67, Letter of Support Fresenius 9.9.21.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67, Letter of Opposition 9.9.21.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67, Letter of Support 9.10.21.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67, CS version B, legal memo.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |
| SB 67, CS 32GS -1603.B.pdf |
SHSS 9/10/2021 3:30:00 PM |
SB 67 |