SB 28-LIMIT OVERTIME FOR REGISTERED NURSES  1:34:18 PM CHAIR ELLIS announced SB 28 to be up for consideration and that the committee had been working from the CSSB 28(HES) version [25-LS0212\L]. The committee now had a Labor and Commerce CS before it, which he asked his staff to explain. DANA OWEN, Staff to Senator Ellis, explained the changes in CSSB 28(L&C) [25-LS0212\V]. The first change was on page 2, line 24, that added to the exceptions a new paragraph (1) to include nurses at an occasional school event. It was suggested by nurses who pointed out that they often accompany field trips that last longer than the normal work day. 1:35:32 PM The second change was on page 4, line 25, where a new section AS 18.20.440 spells out an enforcement mechanism for the prohibition against retaliation set out in AS 18.24.30. Under this section the commissioner has 90 days to determine whether a facility has violated this statute. If the determination is yes, the commissioner must request that the Office of the Attorney General represent the department in the complaint and seek all appropriate relief. The Department of Labor and Workforce Development (DOLWD) suggested this amendment. The idea is to provide clear authority to the department to investigate and act on allegations of violations. This provision is similar to that for violations of occupational safety and health. 1:36:22 PM The third change, he said, was on page 5, line 4, where new language specifies that the report required by Section 18.20.445 is to be submitted to the division responsible for enforcement. Earlier drafts sent the report to the research and analysis section of the department, which also requested this amendment. The effective dates had all been moved a year forward to recognize the current year. 1:36:56 PM CHAIR ELLIS asked if it was fair to say the changes in the CS improve the legislation. MR. Owen replied yes. CHAIR ELLIS stated he would hold consideration of the CS to have the benefit of public testimony. NANCY DAVIS, Vice President, Alaska Nurses Association, said she has been a registered nurse for the past 39 years and supported the proposed CS to SB 28. This bill is a great step forward for a number of reasons, she said, to protect the health and safety of patients and nurses alike. The CS recognizes the impacts of fatigue on nurses who are the mainstay of round-the-clock patient care. She said, "It's well known that excessive work hours for some occupations become a critical issue for safety. Excessive work hours for nurses is a very risky response to the staffing crisis." Errors may be made due to fatigue, which is bad in terms of patient care, but it is also a liability for workers' compensation issues. Nurses are more prone to be injured and this is exacerbated by the fact that this professional group is already facing a shortage, which could get worse. Many other opportunities exist in the workforce for nurses and it is getting more difficult to encourage people into the profession. MS. DAVIS said that a number of states have passed legislation similar to CSSB 28(L&C). 1:43:14 PM SENATOR BUNDE said he didn't want people to work overtime if it harms patients. However there is a nursing shortage and he asked if this would create more of a nursing shortage. MS. DAVIS replied that there are different management approaches to the nursing shortage. It will continue, but it won't get better if people keep leaving the profession. 1:44:55 PM SENATOR STEVENS followed up by asking for statistics on why people are leaving the profession. MS. DAVIS replied that this is the hard part; nurses say they can't do 12-hour shifts or double shifts; so they pick other employment like home care and out-of-institution places. "Clearly the 24/7 patient situations are the most critical ones for which this makes a difference." She said this is considered a problem nationally, especially as the nursing workforce ages. 1:46:23 PM MR. TOM RENKES, Executive Director, Alaska Nurses Association, added that the record on mandatory overtime is mostly anecdotal at this point. They know the shortage of nurses will encompass millions of nurses in the future. Fourteen states have already passed the mandatory overtime legislation and it has been shown that the hospitals that work toward garnering better workforce working conditions have a virtually 0 to 3 percent rate on the RN positions. The hospitals that continue to use the practice of mandatory overtime and mandatory call can have open positions up to the 10 - 20 percent around the country. 1:48:03 PM ROD BETIT, Alaska State Hospital and Nursing Home Association (ASHNHA), said he still could not support CSSB 28(L&C). He has been monitoring mandatory overtime use in the Alaska. Hard data from member facilities indicate that mandatory overtime is not one of the tools they use to close the nursing shortage gap, but they rather use temporary nursing staff. In addition, facilities have been working hard to try to produce an adequate number of nurses for health care in Alaska by working with the University of Alaska Anchorage to increase the nursing student graduation rate from about 100 students a year (four years ago) to 200 a year. Data shows that 93 percent of those nurses are staying in Alaska to practice. 1:50:11 PM He also said that going down this road will not really improve health care or help support facilities attempting to strike reasonable working conditions for nurses, which is locally managed now mostly through collective bargaining. He didn't see any evidence presented to the committee that would suggest this is an area that requires legislative attention at this time. CHAIR ELLIS asked if he wanted to comment on the CS specifically. MR. BETIT replied no; most of those changes impact the department that is responsible for managing the reporting. That reporting requirement would be onerous to facilities to comply with without having any concrete evidence that a problem exists. 1:52:34 PM SENATOR BUNDE asked if this bill would leave wards or beds uncovered. MR. BETIT replied he thought so. His members say the shortage is improving and not worsening. 1:54:06 PM SENATOR BUNDE said one nursing organization suggested doubling nursing wages, but he wondered if that would just elevate the cost of health care. MR. BETIT replied that was an astute observation. 1:55:26 PM SENATOR STEVENS asked if complaint investigations were still an issue for him and what did it mean. MR. BETIT replied that the whole complaint investigation area is of concern if it's to be done any time someone wants to file a complaint. This particular bill requires the kind of reporting that goes down to the individual nurse using overtime rather than the aggregate kind of facility reporting that is applicable in other states that have adopted this kind of approach. 1:56:30 PM SENATOR DAVIS moved to adopt CSSB 28(L&C) version V. There were no objections and it was so ordered. CHAIR ELLIS said he is personally persuaded that this is reasonable public policy, because he has been concerned about the nursing shortage. He thought this bill would help with it. Other states have moved in this direction and have reported a positive effect. 1:57:27 PM SENATOR BUNDE commented if mandatory overtime isn't being used in Alaska, this won't help much. He didn't think the problems in the nursing field were over. CHAIR ELLIS responded that it may be an incremental change. 1:59:08 PM SENATOR DAVIS moved to pass CSSB 28(L&C) from committee with individual recommendations and accompanying fiscal notes. There were no objections and it was so ordered.