REPRESENTATIVE PEGGY WILSON, sponsor of HB 276, informed members that the measure is a clean-up bill that aligns the nursing statutes with current practice in three ways: · It gives licensed nurses the authority to delegate nursing duties to other personnel; · It increases the length of time available for a temporary nursing certificate from four to six months to accommodate the length of time it takes to get a criminal background check done; · It changes the wording regarding licensure by endorsement and aligns the statute with what is already being done. · The Labor and Commerce Committee added a definition of "unlicensed assistive personnel" so there would be no question of who is covered. CHAIRWOMAN GREEN asked for clarification. REPRESENTATIVE WILSON said it specifies who a nurse can delegate duties to in Section 6. She also pointed out the bill has a zero fiscal note. CHAIRWOMAN GREEN noted the term "unlicensed assistive personnel" first appears in the bill on page 2, line 10. REPRESENTATIVE WILSON said she has letters of support for HB 276 from the Alaska State Hospital and Nursing Home Association, the Alaska Nurses Association, the Alaska School Nurses Association, and the Alaska Board of Nursing, and the Division of Public Health also support the measure. She indicated that she does not know of anyone who opposes the bill. SENATOR WILKEN stated support for HB 276 but noted that concerns were expressed on behalf of the physicians. He asked if those concerns have been addressed and whether any outstanding issues remain. REPRESENTATIVE WILSON said that adding the definition of unlicensed assistive personnel raised the physicians' comfort level. She said that as far as she knows, they are not opposed to the measure. CHAIRWOMAN GREEN asked what physicians Senator Wilken was referring to. SENATOR WILKEN said the Alaska Medical Association and private physicians. The committee took public testimony. MS. LYNN HARTZ, a member of the Board of Nursing, said she will only address amendments made to HB 276 in the Senate Labor and Commerce Committee since she testified before the committee on SB 283, the companion bill to HB 276. The amendment, which is the only change from the bill passed from committee, SB 283, puts the term "unlicensed assistive personnel" into statute and defines that term. It is a broad definition but a broad one is required since UAPs work under many different job titles and new job titles are created regularly. She emphasized the importance of passing this bill because current nursing practice is to delegate to unlicensed assistants daily and has been an accepted part of the health care system for years. However, that practice is not legally authorized in Alaska according to the assistant attorney general. The board realizes this is going on and does not intend to discipline nurses who currently delegate to unlicensed personnel since enforcement would literally risk bringing health facilities to a halt. Until this bill has passed, the board will be unable to write or enforce any safety regulations regarding delegation to UAPs. The board is advising nurses to abide by the delegation guidelines, described in its 1993 position statement on delegation, but that is not satisfactory since guidelines in the position statement do not have the weight of regulation. The board of nursing appreciates passage of SB 283 and CSHB 276(L&C) with equal speed. The committee took a brief at-ease. MS. PATRICIA SENNER, Alaska Nurses Association, stated support for CSHB 276(L&C). The Alaska Nurses Association is in agreement with the definition of UAPs. She asked the committee to support the bill and pass it out quickly. MS. MARY WEYMILLER, Board of Nursing, told members the Board is charged with the protection of the public for safe medical practice. CSHB 276(L&C) will provide the legal authority needed to write regulations to provide for safe delegation of nursing tasks. One way that delegation is used in this changing health care environment is for people who choose to stay in their homes for as long as their conditions permit. Often these people do not need skilled nursing care on a continuous basis but assistance with their care if their condition is stable and long term. Those delegating and being delegated to depend on the guidance of statutes and regulations to set standards for safe practice. She urged members to pass CSHB 276(L&C) so the Board of Nursing has the authority to protect both the public and practitioners in the delegation process. MS. NANCY DAVIS, Chief of Public Health Nursing for the Alaska Division of Public Health, stated support for CSHB 276(L&C) and appreciates the language changes that clarify the endorsement licensure process. The division especially appreciates the attention given to the delegation of authority issue and the definition of UAPs. Public health nurses work throughout rural Alaska in villages and, in order to accomplish health care across Alaska, it is essential to be able to delegate. SENATOR WARD moved CSHB 276(L&C) and its accompanying fiscal notes from committee with individual recommendations. CHAIRWOMAN GREEN announced that with no objection, the motion carried. The committee then took up HB 209.