SB 53-ADVANCED PRACTICE REGISTERED NURSES  1:43:24 PM CHAIR STEDMAN announced the consideration of SB 53. 1:43:51 PM SENATOR CATHY GIESSEL, sponsor of SB 53, explained that the bill updates Alaska's 34-year-old statutory title from "Advanced Nurse Practitioner" (ANP) and "Nurse Anesthetist" (NA) to now be called "Advanced Practice Registered Nurse" (APRN). She drew attention to a chart that identifies the various current titles for practicing nurses and the new titles proposed in the bill. She said the statutes have not kept up on the titles. Nationally, the titles are becoming more unified. The use of the APRN title will increase clarity of practice roles, insurance billing, Medicare, and Veterans Administration procedures, and interaction with agencies. She concluded that nothing in the bill changes scope of practice, certification or licensing requirements, nor changes fee structures to the board. 1:48:06 PM JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State Legislature, presented the sectional analysis of SB 53. She read from the following: Section 1 amends AS 08.02.010 and adds APRNs to the list of professions that are required to use their professional titles on stationery, signs, or other advertising. Sections 2-4 are conforming amendments that change the statutory reference from "advanced nurse practitioner" to "advance practice registered nurse." Section 5 amends AS 08.68.100(a) by requiring that the Board of Nursing regulations pertaining to APRNs include the practices of APRNs who practice as certified registered nurse anesthetists, certified clinical nurse specialists, certified nurse practitioners, or certified nurse midwives and makes conforming amendments. Section 6 amends AS 08.68.160 by adding advanced practice registered nursing to the licenses issued under AS 08.68 and changes the term "professional nursing" to "registered nursing." Section 7 adds a new subsection to AS 08.68.170 that sets out the qualifications for an advanced practice registered nursing license. Section 8 repeals and reenacts AS 08.68.190 concerning license examinations and adds an advanced practice registered nursing examination to the licensing examinations conducted under AS 08.68. Section 9 is a conforming amendment that changes a statutory reference from "advanced nurse practitioner" to advance practice registered nurse." Section 10 amends AS 08.68 by adding a paragraph requiring the Department of Commerce, community and Economic Development to set fees related to advanced practice registered nursing and deletes "vocational" nursing. Section 11 amends AS 08.68.230(a) by removing "licensed professional nurse" from the titles authorized for persons licensed under AS 08.68. Section 12 amends AS 08.68.230 by adding new subsections authorizing the use of the titles "advanced practice registered nurse", "certified registered nurse anesthetist", "certified clinical nurse specialist", "certified nurse practitioner", or "certified nurse midwife" and associated initials. Section 13 amends AS 08.65.265 to add advanced practice registered nurses to the persons authorized to supervise a practical nurse. Section 14 adds impersonation of an advanced practice registered nurse as a grounds for denial, suspension, or revocation of a nursing license. Section 15 requires institutions that are applying for accreditation of advanced practice registered nurse training to provide certain information to the Board of Nursing. Section 16 adds impersonation of an advanced practice registered nurse as a grounds for denial, suspension, or revocation of a certificate to practice as a nurse aide. Sections 17-19 add advanced practice registered nursing to the licenses issued by the board, and change the term "professional nursing" to "registered nursing" in AS 08.68.360 - 08.68.390, which declare the unlicensed practice of nursing a public nuisance and provide for injunctive relief. Section 20 adds advanced practice registered nurses to the licensees who may delegate certain nursing duties. Section 21 is a conforming amendment that changes a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse" and makes a related technical change. Section 22 defines the practice of advanced practice registered nursing. Section 23-25 are conforming amendments that change a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse" and make other related technical amendments. Section 26 adds advanced practice registered nurses to persons who are considered justified in conduct that would otherwise be considered the use of force when delivering emergency medical care. Sections 27-28 are conforming amendments that change a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse." Section 29 adds advanced practice registered nurses to those licensees immune from civil liability for an act or omission in delivering patient care services while escorting an injured or sick person whose life is in danger in a conveyance that is not an ambulance. Section 30 is a conforming amendment that changes a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse." Section 31 adds advanced practice registered nurses to those practitioners authorized to draw blood for tests of persons charged with sex offenses. Sections 32-33 are conforming amendments that change a statutory reference from "advanced nurse practitioner" to "advance practice registered nurses." Section 34 clarifies that nurse-midwives and direct entry midwives are certified. Sections 35-38 are conforming amendments that change a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse" and make other related technical amendments. Section 39 changes the term "registered professional nursing" to "registered nursing." Section 40 clarifies that nurse-midwives must be certified to be a provider under AS 21.87. Section 41 is a conforming amendment that changes a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse." Sections 42-43 clarifies that nurse-midwives are certified and makes other technical amendments. Sections 44-46 are conforming amendments that change a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse." Section 47 adds advanced practice registered nurses to the definition of health care provider in statutory provisions concerning prisons. Section 48 is a conforming amendment that changes a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse." Section 49 adds advanced practice registered nurses to licensees with particular training who may assess a child with respect to the waiver under a statutory provision concerning home and community based medical assistance. Section 50 is a conforming amendment that changes a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse" and makes a related technical change. Section 51 adds advanced practice registered nurses to practitioners who are not liable for providing information to the Department of Health and Social Services for the purpose of providing services to certain children and makes a related technical change. Sections 52-54 add advanced practice registered nurses to practitioners who may under statutory provisions concerning mental health commitment, determine if a person may be administered psychotropic medication without the person's consent, and add advanced practice registered nurses with particular training to the definition of mental health professionals for those statutory provisions. Section 55 adds advanced practice registered nurses to practitioners who may review a health care plan for an assisted living home resident. Sections 56-59 are conforming amendments that change a statutory reference from "advanced nurse practitioner" to "advance practice registered nurse." Section 60 repeals specific statutes. Section 61 sets July 1, 2015 as the effective date for the bill. 1:54:08 PM CHAIR STEDMAN opened public testimony. DR. CARRIE DOYLE, Clinical Nurse Specialist, Alaska Clinical Nurse Specialist Association (ACNSA), testified in support of SB 53. She said she is also a member of the Alaska Advanced Practice Registered Nurses (APRN) Alliance, which is comprised of all four APRN specialties, University of Alaska - Anchorage, and the Board of Nursing. She related that nationwide, there are four types of APRN. This bill will bring Alaska into alignment with a national move called the APRN Consensus Model. She listed the types of nurse practitioners contained in the bill. She related that the Consensus Model was developed by the National Council of State Boards of Nursing in conjunction with an APRN work group. The Consensus Model seeks uniformity in APRN licensure, accreditation, certification, and education. 1:56:25 PM LAURA SARCONE, Co-Chair, Advanced Practice Registered Nurses (APRN) Alliance, testified in support of SB 53. She repeated much of the previous testimony. She said that eleven states are already in full compliance with the Consensus Model and another eleven states are three-quarters of the way to compliance. Alaska is half-way there and SB 53 "brings us over the finish line" by updating old titles. She thanked the sponsor and urged the passage of the bill. CHAIR STEDMAN closed public testimony. SENATOR GIESSEL stated that the fiscal note contains receipt services; three professional groups will pay for the expenses of enacting the bill. CHAIR STEDMAN held SB 53 in committee.