SB 12-LIMIT OVERTIME FOR REGISTERED NURSES    2:22:56 PM CHAIR DAVIS announced consideration of SB 12. She said this bill had come before them previously and a couple of changes had been made since then. The committee also had a couple of amendments to ponder. CHAIR DAVIS said she would like someone from the Nurses Associate to tell her if they want them. One has to do with a program that is like the Baylor Plan and that language was in last year's bill. 2:25:22 PM MARK HICKEY, Alaska Nurses Association, said the exemption that was in the bill last year has been referred to as the Baylor Plan although it really isn't. It allows weekend back-to-back eight-hour shifts followed by an eight-hour break and an additional 16-hour shift at residential psychiatric treatment centers. They are still looking for a solution to the present language which they don't support. The reason it was added last year is that the nature of the care at this facility was different than an acute care 24-hour facility. Their concern was about nurses being overly tired and possibly making mistakes. He suggested to the sponsor that the bill start out without this language while the issue was researched. A compromise provision already allows hospitals to get up to 14 hours of consecutive work to come up with adequate staff and balance that with not having nurses' excessive numbers of hours without adequate rest. However, he repeated the Nurse's Association does not support the amended language today. CHAIR DAVIS asked if he was saying is that the bill is fine in its present form. MR. HICKEY replied yes. 2:28:48 PM CHAIR DAVIS asked Senator Dyson if he would have a problem moving this bill, and he indicated no. 2:29:13 PM RYAN SMITH, CEO, Central Peninsula Hospital, Soldotna, AK, supplemented the ASHNHA data saying that nurses at their hospital worked approximately 14,000 shifts last year and 44 of them were greater than 14 hours; 21 of the 44 were 14.25 hours; so about 23 out of 14,000 shifts were over 14 hours. He said he was unaware of any Alaska studies that show mandatory overtime is causing any patient safety problems. His hospital does not use on-call and mandatory overtime to supplement a nursing shortage. In fact, the Peninsula doesn't actually have a nursing shortage, because they make a significant contribution to the UAA Kenai Peninsula College Nursing Program to help subsidize an instructor position that has hired approximately 50 nurses from the prior two graduating classes. This bill also creates another mandatory reporting requirement which will raise operating costs for both them and the state. As a participant of the Health Care Commission, they have taken an interest in lowering the cost of health care. And, finally, he said they are currently in contract negotiations with their RNs and have always been able to negotiate shift issues with their nurses. 2:32:45 PM TAMMY McCUTCHEON, Human Resources Director, Alaska Regional Hospital, said they have a "weekend flex program" that allows nurses in certain areas of the hospital to work two shifts per week and receive payment as well as benefits as a full-time employee. The current language would limit those nurses' ability to be with their families during the week. They also they hire a lot of snowbirds who enjoy being able to work and make a living when they come to Alaska. 2:34:08 PM SENATOR DYSON asked how many hours the nurses work on the weekend to be considered full time. MS. MCCUTCHEON replied that they work two 12-hour shifts with 12 hours between them. 2:35:01 PM BRANDY PROCTOR, Registered Nurse (RN), North Star Behavioral Health, supported continuing the Baylor plan at their hospitals throughout the state. They allow two consecutive 16-hour shifts on Saturday and Sunday only. North Star doesn't have mandatory overtime and she chooses to work the 16 hour shifts voluntarily. If she were to feel impaired for any reason, she could ask to be relieved. It works for her because she can stay home during the week and be with her family - which decreases her child care costs as a side benefit. TRACY CURLEE, Registered Nurse (RN), North Star Hospital, said she works the same modified Baylor plan with two 16-hour shifts on the weekend and an 8-hour break in-between. Without this shift opportunity she couldn't finish her education. Also, she said North Star has a very unstable and sometimes very acute population and during the week they have school and other activities that bring them off the unit. But on the weekends most of their time is spent "on unit" it helps them to have one RN available during their waking hours - which is for their safety. 2:37:51 PM DIEDRA JOSEPH, Registered Nurse (RN), North Star Hospital, said she also works the 16-hour "Baylor Plan" on Friday/Saturday. She was a nursing student when she started working this shift and this schedule helped her finish school. Now it helps her because she can pick up another job during the week which helps her to pay for debt incurred due to moving her family after Hurricane Katrina. It provides opportunities and options for nurses, she said, and she didn't feel that the patients were at risk as a result of this plan. 2:39:52 PM LEVI WASHINGTON, RN Manager, North Star Hospital, said they have not incurred any issues related to the nurses on the Baylor Plan, and he felt it actually enhanced the quality of care. It provides continuity to the kids in the plan. They are always tracking patient safety. It also allows him the time to be a great dad to his kids. MR. WASHINGTON said he thinks there is a genetic factor that makes it possible for some people to recover quickly enough to work these shifts. It doesn't work for everyone, but some people can do it and do it well. He doesn't see how the language in this bill addresses patient safety or the needs of the nurses. He asked the committee to put the exemption language back in and continue research to determine whether it is a problem.{ 2:44:00 PM ROBIN RICHARDSON, Director, Critical Care Services, Alaska Regional Hospital, said their nurses don't have mandatory overtime, but they have the weekend flex program (Baylor Plan) with two 12-hour shifts on Fri/Sat or Sat/Sun. At least 50 percent of her critical care staff, whether on the Baylor plan or not, also work at another facility. So she didn't feel nurses would be any more tired because they worked Baylor versus other shifts in other facilities. She has had no increase in reports of errors during the year they have had the Baylor plan and it has hugely benefited the nurses. It has also helped to bring nurses up from the Lower 48 to Alaska. 2:46:36 PM CHAIR DAVIS recognized that Senator Thomas arrived earlier. SENATOR THOMAS asked how the 16-hour shifts work on weekends and what the average hourly wage of a nurse is. MS. CURLEE responded that those who work the 16-hour weekend shifts do not work during the week at North Star. They work 32 hours on the weekend and are paid for 40 hours with full benefits. MS. RICHARDSON added that the Alaska Regional nurses work two 12-hour shifts and get paid for 36 hours with full benefits. The average wage is based on years of experience. SENATOR THOMAS asked what that the range of average wages is. MS. RICHARDSON replied that at least two years of experience is required to get into the ICU, so those nurses average $28 per hour. CHAIR DAVIS closed public testimony on SB 12. 2:50:34 PM SENATOR PASKVAN moved to report SB 12 from committee with individual recommendations and attached fiscal note(s). There being no objection, the motion carried.