Bill Summary – FastDemocracy

31-LS0240\M
                                              HOUSE BILL NO. 17
                         IN THE LEGISLATURE OF THE STATE OF ALASKA
                          THIRTY-FIRST LEGISLATURE - SECOND SESSION
     BY REPRESENTATIVES RAUSCHER, Vance
     Introduced: 2/20/19
     Referred: Health and Social Services, Finance
                                                     A BILL
                                          FOR AN ACT ENTITLED
 "An Act repealing the certificate of need program for health care facilities; making
 conforming amendments; and providing for an effective date."
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
   * Section 1. AS 18.20.400(c) is amended to read:
                  (c) Subsection (a) of this section does not apply to
                          (1)    a nurse who is employed by a health care facility providing
         services for a school, school district, or other educational institution, when the nurse is
         on duty for more than 14 consecutive hours during an occasional special event, such as
         a field trip, that is sponsored by the employer;
                          (2) a nurse voluntarily working overtime on an aircraft in use for
         medical transport, so long as the shift worked is allowable under regulations adopted
         by the Board of Nursing based on accreditation standards adopted by the Commission
         on Accreditation of Medical Transport Systems;
                          (3) a nurse on duty in overtime status
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                                (A)    who is participating in the performance of a medical
                procedure or surgery that has begun but has not been completed;
                                (B) because of an unforeseen emergency situation that could
                jeopardize patient safety; in this subparagraph, "unforeseen emergency
                situation" means an unusual, unpredictable, or unforeseen situation caused by
                an act of terrorism, disease outbreak, natural disaster, major disaster as defined
                in 42 U.S.C. 5122, or disaster emergency under AS 26.23.020 or 26.23.140,
                but does not include a situation in which a health care facility has reasonable
                knowledge of increased patient volume or inadequate staffing because of some
                other cause, if that cause is foreseeable;
                                (C) because the health care facility has a scheduling problem
                caused by unforeseen weather conditions that prevent a second nurse from
                arriving at the facility to relieve the nurse on duty; in this subparagraph,
                "unforeseen weather conditions" means unusual, unpredictable, or unforeseen
                weather so extreme as to impair travel to the health care facility, but does not
                include a situation in which the health care facility has knowledge of the
                weather conditions far enough in advance to act so that a scheduling problem
                under this subparagraph can reasonably be avoided; or
                                (D) at a health care facility located in a rural community that
                declares a temporary nurse staffing emergency under AS 18.20.410;
                        (4) a nurse fulfilling on-call time that is agreed on by the nurse and a
         health care facility before it is scheduled unless fulfilling the on-call time would, in the
         nurse's judgment, create an unacceptable risk to the physical safety of the nurse, a
         patient, or an employee of the facility;
                        (5)   a nurse voluntarily working overtime so long as the work is
         consistent with professional standards and safe patient care and does not exceed 14
         consecutive hours;
                        (6) a nurse voluntarily working beyond 80 hours in a 14-day period so
         long as the nurse does not work more than 14 consecutive hours without a 10-hour
         break and the work is consistent with professional standards and safe patient care;
                        (7) a nurse who
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                                (A) is employed
                                       (i) at a psychiatric treatment hospital that treats only
                      children or at a residential psychiatric treatment center, as defined in
                      (d) of this section [UNDER AS 18.07.111], that treats only children; in
                      this sub-subparagraph, "children" means persons under 19 years of age
                      who are receiving psychiatric treatment from a hospital or center or
                      who are residing in a center and who were under 18 years of age on the
                      date that the treatment or period of residence commenced;
                                       (ii)   at a residential psychiatric treatment center as
                      defined under AS 47.32.900; or
                                       (iii) at a secure residential psychiatric treatment center
                      as defined under AS 47.12.990;
                                (B) voluntarily agrees to work a 16-hour shift for the period
              between 5:00 p.m. on a Friday and 8:00 a.m. on the Monday that immediately
              follows and receives pay and benefits for that work that are equal to or greater
              than the pay and benefits the nurse would receive for working 20 regular hours
              in the same position; and
                                (C) during the period described in (B) of this paragraph does
              not work a 16-hour shift consecutive with another shift of eight hours or more
              without an intervening break of at least eight hours;
                      (8) the first two hours on overtime status when the health care facility
       is obtaining another nurse to work in place of the nurse in overtime status, so long as
       the nurse in overtime status is not on duty for more than 14 consecutive hours.
  * Sec. 2. AS 18.20.400 is amended by adding a new subsection to read:
              (d) In (c)(7)(A)(i) of this section, "residential psychiatric treatment center"
       means a secure or semi-secure psychiatric facility or inpatient program in a psychiatric
       facility that is licensed by the Department of Health and Social Services and that
       provides therapeutically appropriate and medically necessary diagnostic, evaluation,
       and treatment services
                      (1) 24 hours a day for children with severe emotional or behavioral
       disorders;
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                         (2) under the direction of a physician; and
                         (3) under a professionally developed and supervised individual plan of
         care designed to achieve the recipient's discharge from inpatient status at the earliest
         possible time that is intensively and collaboratively delivered by an interdisciplinary
         team involving medical, mental health, educational, and social service components.
  * Sec. 3. AS 18.20.499(2) is amended to read:
                         (2) "health care facility" means a private, municipal, or state hospital;
         independent diagnostic testing facility; primary care outpatient facility; skilled nursing
         facility; kidney disease treatment center, including freestanding hemodialysis units;
         intermediate care facility; ambulatory surgical facility; Alaska Pioneers' Home or
         Alaska Veterans' Home administered by the Department of Health and Social Services
         under AS 47.55; correctional facility owned or administered by the state; private,
         municipal, or state facility employing one or more public health nurses; long-term care
         facility; psychiatric hospital; residential psychiatric treatment center, as defined in
         AS 18.20.400(d) [AS 18.07.111] or AS 47.32.900; secure residential psychiatric
         treatment center as defined in [UNDER] AS 47.12.990; juvenile detention facility;
         juvenile detention home, juvenile work camp, or treatment facility as defined in
         AS 47.12.990;
  * Sec. 4. AS 18.26.220 is amended to read:
                Sec. 18.26.220. Facility compliance with health and safety laws and
         licensing requirements. A medical facility constructed, acquired, improved, financed,
         or otherwise under the provisions of this chapter and all actions of the authority are
         subject to [AS 18.07,] AS 47.32 [,] and any other present or future state licensing
         requirements for the facilities or services provided under this chapter. [A MEDICAL
         FACILITY ISSUED A CERTIFICATE OF NEED UNDER SEC. 4, CH. 275, SLA
         1976, BY VIRTUE OF BEING IN EXISTENCE OR UNDER CONSTRUCTION
         BEFORE JULY 1, 1976, MUST FULLY MEET THE REQUIREMENTS OF
         AS 18.07 IN ORDER TO BE ELIGIBLE FOR FUNDING UNDER THIS
         CHAPTER.]
  * Sec. 5. AS 18.07.021, 18.07.031, 18.07.035, 18.07.041, 18.07.043, 18.07.045, 18.07.051,
 18.07.061, 18.07.071, 18.07.081, 18.07.091, 18.07.101, 18.07.111; AS 21.86.030(c)(1);
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 AS 44.64.030(a)(18); and AS 47.80.140(b) are repealed.
   * Sec. 6. Section 4, ch. 275, SLA 1976, is repealed.
   * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to
 read:
         CERTIFICATES OF NEED; APPLICABILITY.                    The Department of Health and
 Social Services may not take action on or after the effective date of this Act to revoke,
 enforce, or modify a certificate of need issued to a health care facility before the effective date
 of this Act.
   * Sec. 8. This Act takes effect July 1, 2020.
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Statutes affected: 
HB0017A, AM HB 17, introduced 02/20/2019: 18.20.400, 26.23.020, 26.23.140, 18.20.410, 18.07.111, 47.32.900, 47.12.990, 18.20.499, 18.26.220, 18.07.021, 18.07.031, 18.07.035, 18.07.041, 18.07.043, 18.07.045, 18.07.051, 18.07.061, 18.07.071, 18.07.081, 18.07.091, 18.07.101, 21.86.030, 44.64.030, 47.80.140