Legislature(2009 - 2010)BUTROVICH 205

03/25/2009 01:30 PM HEALTH & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 101 STUDENT QUESTIONNAIRES AND SURVEYS TELECONFERENCED
Heard & Held
*+ SB 139 INCENTIVES FOR CERTAIN MEDICAL PROVIDERS TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled
+= SB 12 LIMIT OVERTIME FOR REGISTERED NURSES TELECONFERENCED
Moved SB 12 Out of Committee
          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.                                                                                         
                                                                                                                                

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