HOUSE BILL 217 "An Act relating to certified nurse aides; and providing for an effective date." MARK ROSEN, STAFF, REPRESENTATIVE JOE RYAN, introduced HB 217 which would give the Board of Nursing the authority to oversee the training, supervision, utilization and registration of Certified Nurse Aides. CATHERINE REARDON, DIRECTOR, DIVISION OF OCCUPATIONAL LICENSING, DEPARTMENT OF COMMERCE AND ECONOMIC DEVELOPMENT, explained there are 2,800 Certified Nurses Aides (CNA's) working in Alaska's long-term care facilities and home health agencies. These aides provide care to those most unable to care for themselves, the aged and the infirm. The Certified Nurse Aides work under the supervision of a nurse licensed by the Board of Nursing, performing only those duties specifically delegated by that nurse. The 8 Omnibus Budget Reconciliation Act of 1987 (federal) required that states establish Nurse Aide Certification programs for aides working in long-term care and home health agencies receiving Medicare and Medicaid funding. Since 1989, the responsibility for the Certified Nurse Aide program has been divided between the Department of Health and Social Services (DHSS), Division of Medical Assistance, Health Facilities and Licensing and Department of Commerce and Economic Development (DCED), Occupational Licensing, Board of Nursing. The legislation would delineate responsibility for oversight of Certified Nurse Aides clearly to the Board of Nursing. The Board of Nursing has been responsible for establishing minimum training standards, approval of training programs and maintenance of the Certified Nurses Aide registry. HB 217 protects Alaska's most vulnerable population by insuring that the people who care for them are properly trained and that oversight of that care be provided. She proceeded to explain the differences between the Finance and Labor & Commerce Committees version of the bill. Representative Martin recommended that the Board of Nursing screen themselves at their own expense. Ms. Reardon replied that the program was required by State statute to be financially self- sufficient. The fees charged to the nurse aides must cover those costs. The Board of Nursing is aware that the fees will increase as a result of the legislation. She pointed out that this would be a general fund/program receipts. Ms. Reardon spoke to the fiscal note which indicates new State expenditures. The way to calculate fees for each occupation is through audits. Part of the costs of running the board are shared by spreading the costs on a per capita basis. Any direct costs caused by nurse aides would be included as would the administrative indirect costs. Representative G. Davis asked if there was an established indirect cost rate. Ms. Reardon replied that the cost would be $35 dollars. All costs are related to license processing and billings. (Tape Change HFC 97-118, Side 1). RON COWAN, (TESTIFIED VIA TELECONFERENCE), DEPARTMENT OF HEALTH AND SOCIAL SERVICES, ANCHORAGE, offered to answer any questions of the Committee, noting that the Department fully supports the proposed legislation. Representative Martin MOVED that 0-LS0737\L, Lauterbach, 4/30/97, be the version before the Committee. There being 9 NO OBJECTION, it was adopted. Representative J. Davies MOVED to report CS HB 217 (FIN) out of Committee with individuals recommendations and with the accompanying fiscal notes. Co-Chair Therriault noted that he would like to change the DCED fiscal note to reflect that the funds are program receipts. Following discussion between Co-Chair Therriault and Representative J. Davies on the effect of that intent, there was NO OBJECTION, and the bill was moved from Committee. CS HB 217 (FIN) was reported out of Committee with a "do pass" recommendation and with fiscal notes by the Department of Health and Social Services dated 4/17/97 and the Department of Commerce and Economic Development.