HB 50-LIMIT OVERTIME FOR REGISTERED NURSES 4:42:53 PM CO-CHAIR HERRON announced that the final order of business would be HOUSE BILL NO. 50, "An Act relating to limitations on mandatory overtime for registered nurses and licensed practical nurses in health care facilities; and providing for an effective date." 4:43:31 PM REPRESENTATIVE PEGGY WILSON, Alaska State Legislature, declared that HB 50 was a patient and nurse safety bill. She referred to the earlier hearing on the bill, and announced that the changes to the bill addressed the four major concerns. 4:44:48 PM CO-CHAIR HERRON said that he would continue to work with the sponsor on HB 50. 4:45:16 PM NANCY DAVIS, President, Alaska Nurses Association (ANA), said that the ANA was aware of the proposed changes to the bill, and that the ANA supported the bill. She stated that nurses, employers, and health care facilities should all assure the safety of patients. She declared that a statewide standard would protect patients and nurses, and that patient safety should not be a negotiable issue. She expressed support for flexible staffing, and said that employers and nurses could agree on the shift length. She pointed out that an important part of HB 50 was the protection against retaliation for a nurse who spoke up for safety. She noted the challenges for rural staffing. She directed attention to the limitations placed by other professions to the number of hours worked. She said that ANA had worked for five years to limit excessive work hours and overtime, and that ANA offered its support for HB 50. 4:51:16 PM LANETTA LUNDBERG, Director, Human Resources, Ketchikan General Hospital, said that HB 50 placed unwarranted regulation and management, and that it was a response to isolated situations. She opined that HB 50 was structured for a few people, but would place an undue hardship on the majority. 4:53:23 PM MICHAEL SMITH, Tanana Chiefs Conference (TCC), explained that Tanana Chiefs Conference (TCC) was a tribal consortium that provided health care services to the Interior Native community. He acknowledged the shortage of nurses, but stated that HB 50 exacerbated the problem for Native non-profit health services. He directed attention to the unique challenges of Alaska. He listed some of the TCC major concerns for regulation, which included the application to federal facilities and the Indian Health Services. He noted the ambiguity for travel time in the proposed bill. He offered to listen to the proposed amendments and then to work with the sponsor for changes that would not adversely affect rural healthcare providers. 4:58:22 PM STACY ALLEN, Health Care Representative, said that HB 50 was about patient safety. She stated that unlimited overtime was not a safe nursing practice. She offered support for HB 50. 5:00:08 PM REPRESENTATIVE LYNN noted that he had a conflict of interest, as his daughter was a registered nurse. 5:00:31 PM JUANITA DIAMOND stated that the bill was for the promotion of better patient care and nurse safety. She pointed out that 15 states had already adopted similar legislation. She said that she supported HB 50. 5:01:55 PM CHRISTINA VANCLEVE, RN, said that the passage of HB 50 was crucial to protect the health and safety of Alaskans, and to protect the occupational safety of nurses. 5:02:54 PM PATRICIA SENNER, RN, said that HB 50 had a lot of workforce implications. She noted that the average age of nurses was 48, and that extending the number of hours worked could impact the decisions for nurses to stay in the work force. She noted that younger nurses had families and could not work long hours and overtime. She shared an example of mandated overtime at Alaska Psychiatric Institute which resulted in the departure of the young nurses. She stated that the other states in the Pacific Northwest had eliminated mandatory overtime. 5:04:35 PM DEBBIE THOMPSON, Executive Director, Alaska Nurses Association (ANA), said that ANA supported HB 50, and she offered assistance with the draft work for any changes to the bill. 5:05:30 PM KATHLEEN GETTYES, President, Providence Registered Nurses Bargaining Unit, Providence Hospital, shared a personal story about nursing care. She spoke in support of HB 50, and she said that Alaskans should expect that nurses are alert and properly rested. She stated that HB 50 would protect the patients, the nurses, and the health care facility. 5:08:02 PM LEE ANN COX, Human Resources Manager, Wildflower Court, said that Wildflower Court opposed HB 50. She explained that Wildflower Court did not have any mandatory overtime, or mandatory on-call, and did not have any complaints. She stated that HB 50 "would eliminate our ability as a healthcare provider to responsibly staff in a time of need if it was to arise." She detailed its staffing schedule options. She pointed out that the bill would set a needless precedent for government intervention for Wildflower Court, and many other facilities. She questioned the need to report on a non-existent issue at Wildflower Court, especially with the myriad of already required reports and forms. 5:12:28 PM ANGEL DOTOMAIN, President & CEO, Alaska Native Health Board (ANHB), agreed with the concerns raised by other tribal health care services. She acknowledged the concerns by the ANA, and its goal to improve the workplace and patient safety. She listed the concerns of ANHB, to include: similar legislation had not been implemented in any rural states; there was not a documented need for HB 50, as the shortage of nurses allowed the freedom to move; ANHB organizations did not agree that mandatory overtime was an issue, as there were existing processes for addressing nurse concerns; the exemption for some facilities raised legal questions, especially for any impact on the Alaska Native Medical Center (ANMC) Level II trauma center; the legislation did not address the regional recruitment concerns. She commented on the onerous and costly reporting requirements. She explained that the Fair Labor Standards Act was recently revised to recognize the need for flexibility with some nurse scheduling. She pointed out that Tribal Health facilities would be adversely impacted by HB 50. She offered to work with all the stakeholders to meet the needs for patient safety. 5:19:26 PM CO-CHAIR HERRON asked to see some data that supported the assumption that patient safety was at risk. He referred to the current bargaining discussions between Providence Hospital and its nurses, and questioned whether mandatory overtime was an issue. 5:21:39 PM REPRESENTATIVE WILSON referred to a power point and a nurses' survey [included in the members' packets.] and pointed out that these were a good source for many answers. 5:22:25 PM REPRESENTATIVE CISSNA expressed her concern for the rural communities. REPRESENTATIVE WILSON acknowledged that there was a problem for the rural areas, and she posed the possibility that an exemption might be allowed. REPRESENTATIVE CISSNA said that she would like to work with Representative Wilson on that possibility. 5:23:48 PM CO-CHAIR HERRON reflected that it was important to not create two types of nurses, based on federal and private facilities. 5:24:01 PM REPRESENTATIVE SEATON expressed concern with the allowable working hours and the reporting requirements of HB 50. [HB 50 was held over.] 5:25:00 PM