SB 103-CNA TRAINING  2:02:31 PM VICE-CHAIR MERRICK announced the consideration of SENATE BILL NO. 103 "An Act relating to certified nurse aide training; and providing for an effective date." 2:02:58 PM SENATOR GRAY-JACKSON speaking as the sponsor presented SB 103 as follows: [Original punctuation provided.] Currently in Alaska, Certified Nurse Aides, also referred to as CNA's, go through training programs that meet federal and state standards, but we've heard a growing recognition that these standards need to evolve to reflect the increasing complexities of patient care in Alaska. Our population is aging, and our CNAs are relied on to be well trained, not only in physical care, but also in emotional and cognitive support. One area for improved training would be in dementia and Alzheimer care, client communication, and recognizing the psychosocial and emotional needs of patients experiencing these conditions. These symptoms are being overlooked because we are not properly training our nurse aides to identify the symptoms sooner. This bill before us today would strengthen training requirements to ensure that all certified nurse aides in our state are equipped with the necessary skills to provide high quality, compassionate care. Enhancing training standards is the least we can do for our aging population in Alaska. Most, if not all of us, have experienced the terrors of Alzheimer's and dementia firsthand, and by modernizing training requirements, Senate Bill 103 will help build a more skilled workforce, which will in return improve patient outcomes, and ensure that Alaskans receive the highest level of care. Many states across the country are implementing laws requiring dementia and Alzheimer's training for Certified Nurse Assistants, and SB103 would align Alaska with those high-quality standards of patient care. 2:04:51 PM DEIRDRE GOINS, Staff, Senator Elvie Gray-Jackson, Alaska State Legislator, Juneau, Alaska, presented the sectional analysis for SB 103: [Original punctuation provided.] Sectional Analysis Version A  Section 1- Adds a new subsection to AS 08.68.331.  Certification of Nurse Aides  (c) Regulations adopted under (a)(1) of this section establishing standards for a Certified Nurse Aide (CNA) training program must require that the program (1) be conducted in a manner ensuring clients receive safe and competent care; and (2) train a certified nurse aide to (A) form a relationship, communicate, and interact competently with a client; (B) demonstrate sensitivity to the emotional, social, and mental health needs of a client through skillful and direct interactions; (C) assist a client in reaching and maintaining independence; (D) support and promote the rights of a client; (E) demonstrate the skills of observing and monitoring a client during caregiving, as well as reporting those observations to enable the assessment of the health, physical condition, and well-being of a client; (F) demonstrate knowledge of the abilities and care needs of a client; (G) use a problem-solving approach when providing care; (H) use techniques that ensure and preserve the respect, values, choices, and dignity of a client; (I) demonstrate knowledge of client assessment and care planning best practices; (J) use effective communication skills, including while communication with a client with psychosocial needs or Alzheimer's disease, dementia, a mental illness, an intellectual disability, or another cognitive disability or impairment; (K) provide care to a client who is cognitively impaired or has a decline in cognitive function related to dementia; and (L) demonstrate basic knowledge of Alzheimer's disease, dementia, dementia- related behaviors, and the activities of daily living; in this subparagraph, "activities of daily living" means eating, dressing, grooming, bathing, and toileting. Section 2 This Act takes effect January 1, 2026. 2:06:30 PM VICE-CHAIR MERRICK announced invited testimony on SB 103. 2:06:43 PM At ease. 2:07:05 PM VICE-CHAIR MERRICK reconvened the meeting. 2:07:19 PM MAUREEN TOWNSEND, Board Member, Alaska Chapter, Alzheimer's Association, Soldotna, Alaska, testified by invitation on SB 103. She stated that even with her CNA training she felt unprepared for the challenges she experienced working in the dementia wing. She said better training could have helped her work with dementia patients. She stated that her experience in the dementia wing led her to switch careers because she felt like training would not prepare her to work as a CNA. 2:08:47 PM SENATOR DUNBAR asked Ms. Townsend where she received her CNA training. 2:08:58 PM MS. TOWNSEND responded that she went to Kenai Peninsula College (KPC) located in Soldotna. 2:09:06 PM SENATOR YUNDT asked what are the CNA training requirements and how are they affected by SB 103. 2:09:27 PM MS. TOWNSEND replied she completed six months of CNA training. 2:09:45 PM SENATOR YUNDT asked what changes she would make to CNA training. 2:09:56 PM MS. TOWNSEND responded she would like to see more training on managing behavioral challenges because she felt unprepared to handle or de-escalate patients in distress. 2:10:58 PM MICHELLE CASSANO, Member, Alzheimer's Association, Akron, Ohio, testified by invitation on SB 103. She read the following: [Original punctuation provided.] I'm a retired nurse, and I support Senate Bill 103. I care deeply about quality dementia education and person-centered care training for CNAs because my husband, Larry, deserved better care. He had Alzheimer's, and our family made the difficult decision to place him in a facility here in Anchorage. While it is a respected facility, and of higher quality than some others in Alaska, their staff were still very uneducated about dementia and person- centered care. Subsequently, Larry was frequently unnecessarily transported to Emergency Services, which averaged $14,000 at least once a month, mostly very late or in the middle of the night. Larry did not need emergency care. He was exhibiting normal, non- emergency dementia behaviors and needed to simply be put back to bed. The lack of quality education of Alaska's CNAs is a burden to emergency rooms, a poor use of resources, and terribly upsetting to patients and families. CNAs trained in dementia care can effectively manage challenging behaviors and ensure the safety and security of our loved ones. The educational content outlined in Senate Bill 103 would give families peace of mind, knowing that their family member is in capable hands, even in difficult situations. CNAs trained in dementia care can recognize early signs and symptoms of cognitive decline. This enables timely interventions and support services, potentially slowing the progression of dementia. I was later able to get my husband into a facility with better trained and experienced staff, who understood common dementia behaviors, like lying on the floor when tired, they helped him avoid falls and gave him the personal care he needed. He spent two years at that new facility with educated staff without one hospital visit. CNAs are an important part of the healthcare team, and all of Alaska's CNA programs should cover person centered care, signs and symptoms of dementia, and content on responding to challenging dementia-related behaviors. Further CNA's want to have the skills needed to care for their patients, resources are available...I even took a series of classes called Savy Care Giving and used online resources during our long journey. 2:15:48 PM KAY PAPAKRISTO, Outreach Director, Alzheimer's Resource of Alaska (ARA), Anchorage, Alaska, testified by invitation on SB 103. She read the following: [Original punctuation provided.] I'm here today to speak in strong support of Senate Bill 103, which will help ensure that Certified Nurse Aides across Alaska receive essential dementia training. The importance of dementia training is something many of us come to learn about through personal experience. Prior to working with our agency, one of our ARA team members had her parents in different dementia care homes. Her parents required about the same level of care and, in both settings, CNAs were reported to be kind, caring, and deeply committed to their work but the difference in the quality of care was profound. In one home, the father was treated with dignity, largely because his dementia care needs and challenges were anticipated. In the other home, lack of dementia understanding and training led to missed signs, misinterpreted behavior, and unnecessary stress not just for the mother, but for other residents and staff too. Speaking of staff, I was invited to observe a VA hospital where young CNAs and nurses on [the] dementia wing were feeling overwhelmed and unsafe. Many of the veterans were living with dementia alongside other complex conditions, like PTSD, which just make things even more complex. With proper dementia training, CNAs can anticipate needs, respond with confidence, and create a calmer, more supportive environment. Good training doesn't just help CNAs feel more prepared it ensures they are safer, more capable in their roles, and recognized as essential members of the care These stories are not isolated they reflect a statewide need. SB 103 is a simple, cost-effective, and meaningful step in the right direction. It supports our CNA workforce by giving them what they need to succeed. It strengthens our healthcare system, supports those who provide direct care, and honors the people for whom they care. 2:19:14 PM VICE-CHAIR MERRICK held SB 103 in committee.