(Alaska Statutes 18.20.400 18.20.499) HB 50 passed Alaska State Legislature in April 2010 after six years of effort and became law in October 2010. Representative Peggy Wilson and Senator Bettye Davis were prime sponsors. Another 28 legislators signed on as co-sponsors or cross-sponsors. Operative sections of law take effect on January 1, 2011.
The following describes several key definitions contained in the new law. Nurse means an individual licensed to practice registered nursing or practical nursing under AS 08.68 who provides nursing services through direct patient care or clinical services and includes a nurse manager when delivering in-hospital patient care. (AS 18.20.499(3)) 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; intermediate care facility; ambulatory surgical facility; Alaska Pioneers Home or Alaska Veterans Home; correctional facility own or administered by the state; a private, municipal or state facility employing one or more public health nurses; long-term care facility; psychiatric hospital; residential psychiatric treatment center; secure residential psychiatric treatment center; and juvenile detention facility, detention home, and work camp or treatment facility. (AS 18.20.499(2)) On-call means a status in which a nurse must be ready to report to the health care facility and may be called to work by the health care facility. (AS 18.20.499(4))
Subject to certain exceptions, a nurse in a health care facility may not be required or coerced, directly or indirectly, (1) to work beyond a predetermined and regularly scheduled shift that is agreed to by the nurse and the health care facility; or (2) to accept an assignment of overtime if, in the judgment of the nurse, the overtime would jeopardize patient or employee safety. (AS 18.20.400(a)) Subject to certain exceptions, a nurse shall be allowed not less than 10 consecutive hours of off-duty time immediately following a predetermined and regularly scheduled shift that is agreed to by the nurse and health care facility. (AS. 18.20.400(b))
AS 18.20.400(c) list several exceptions. The following describes key provisions. Specific interpretations of each provision will be governed by regulations, decisions by the Alaska Department of Labor, or subsequent court actions. A nurse can volunteer to work overtime so long as the work is consistent with professional standards and safe patient care and does not exceed 14 consecutive hours. The first two hours on overtime status when the health care facility is obtaining another nurse to come in, so long as the nurse in overtime status is not on duty for more than 14 consecutive hours. A nurse fulfilling on-call time that is agreed on by the nurse and 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.
The following describes other exceptions contained in the law. A school nurse on duty for more than 14 consecutive hours during an occasional special event, or a nurse voluntarily working overtime on an aircraft in use for medical transport. A nurse on duty in overtime status participating in a medical procedure or surgery that has begun but has not been completed, because of a unforeseen emergency situation that could jeopardize patient safety, because of a scheduling problem caused by unforeseen weather conditions, or works at a health care facility in a rural community that declares a nurse staffing emergency. A nurse employed in a health care facility that is operated by the federal government or a tribal organization as defined in 25 U.S.C. 450(b). (AS 18.20.460)
The new law contains several provisions to ensure compliance and enforcement. Each health care facility must provide for an anonymous process by which a nurse or patient may make a complaint about staffing levels and patient safety that relates to overtime work by nurses. (AS. 18.20.420) AS 18.20.430 provides a mechanism for the filing of a formal complaint against a health care facility with the Alaska Department of Labor alleging a violation. Complaints must be filed within 30 days after the date of the alleged violation. The law provides for a graduated scale of penalties against a health care facility if there is a determination that the facility knowingly violated a provision of the new law. AS 18.20.440 explicitly prohibits a health care facility from any form of retaliation against a nurse for exercising rights under the new law or for the good faith reporting of an alleged violation. This includes an attempt to discharge, discipline, threaten, discriminate against, or file a report with the Board of Nursing for these actions.