HOUSE COMMITTEE ON GENERAL GOVERNMENT

 

April 05, 2005 Hearing Room B

8:30 A.M. Tapes  36 - 37

 

MEMBERS PRESENT:            Rep. Vickie Berger, Chair

Rep. Peter Buckley, Vice-Chair

Rep. Mac Sumner Vice-Chair

Rep. Kevin Cameron

Rep. Sal Esquivel

Rep. Larry Galizio

Rep. Brad Witt

 

STAFF PRESENT:                  Caralyn Fischer, Committee Administrator

Jania Zeeb, Committee Assistant

 

MEASURES/ISSUES HEARD:

                                                HB 3329 – Public Hearing

                                                HB 3067 – Work Session

                                                HB 2916 – Work Session

                                                HB 2094 –Work Session

 

 

These minutes are in compliance with Senate and House Rules.  Only text enclosed in quotation marks reports a speaker’s exact words.  For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE 36, A

002

Chair Berger

Calls the meeting to order at 8:35 A.M. and opens a public hearing on HB 3329.

HB 3329 – PUBLIC HEARING

007

Cara Fischer

Committee Administrator.  Summarizes HB 3329.

017

Martin Taylor

Oregon Nurses Association and Association of Perioperative Registered Nurses.  Testifies in support of HB 3329.

028

Deb Cassell

Certified Registered Nurse First Assistant (CRNFA) in the Mid-Willamette Valley.  Submits and reads prepared testimony in support of HB 3329 (EXHIBIT A)

067

Dr. Stephen Newman

Orthopedic Surgeon.  Submits prepared testimony in support of HB 3329 (EXHIBIT B).  Gives information on how the CRNFA and the surgeon work together in the operating room. 

121

Newman

Discusses how nurse first assistants have helped alleviate problems with the current system.

133

Newman

Comments on the problems with payments for the first assistants. Comments on the importance of HB 3329 and discusses the negative ramifications of not passing HB 3329. 

157

Rep. Sumner

Inquires what a Registered Nurse (RN) does to become a Registered Nurse First Assistant (RNFA) .

161

Cassell

Explains the process of becoming an RNFA.

165

Rep. Sumner

Asks if in the position of RNFA you are a life saving factor in the operating room.

167

Cassell

Responds that he is correct and give examples of how they can help in the operating room.

171

Rep. Sumner

Gives an example of how much an RNFA can charge for services and how much they typically receive.  Inquires if he is correct.

178

Cassell

Concurs with Rep. Sumner’s example.

179

Rep. Cameron

Asks if they are required by hospitals to have two people in the operating room.

181

Newman

Answers that in certain operations they are required to have two people.

183

Rep. Cameron

Inquires if when another surgeon helps with the operation they are able to bill for their time.

187

Newman

Responds that they use the same billing as the RNFA and states that they are typically reimbursed at a higher rate.

192

Rep. Galizio

Inquires what is happening with Medicare to get them to recognized the RNFA.

194

Cassell

Gives a history of what is being done to get Medicare to cover RNFAs. 

234

Marilyn Hudson

Oregon State Board of Nursing (OSBN).  Submits and reads prepared testimony in opposition to HB 3329 (EXHIBIT C)

283

Rep. Buckley

Asks if she knows of another precedent of health care workers in Oregon not being compensated for their services.

286

Hudson

Responds that she cannot speak to reimbursement issues because that is not part of the OSBN’s mission.

291

Rep. Buckley

Inquires what the additional cost would be to the OSBN as a result of HB 3329.

297

Hudson

Responds that they do not currently certify the RNFA because they are classified as an RN.  Comments on where the additional cost would come.

307

Rep. Buckley

Asks what the additional cost would be for certification.

310

Hudson

Responds that they have not done a cost analysis, but estimates that the cost would be in thousands of dollars

314

Rep. Buckley

Asks if it would be thousands of dollars per application.

316

Hudson

Answers that it would not.

318

Rep. Esquivel

Inquires if the nurse gets paid by the hospital.

320

Hudson

Responds that she does not know how nurses are paid.

328

Rep. Esquivel

Asks if the individual could be on a salary and then the charge for the  surgery would be additional to the salary.

334

Hudson

Reiterates that she is not able to speak on reimbursement. 

338

Martin Taylor

Gives information on how RNFAs are reimbursed.  Gives information about who relies on reimbursement and who is paid salary.

355

Rep. Cameron

Asks Ms. Hudson if she has a personal opininon on how the RNFA should be reimbursed for services provided.

360

Hudson

Responds that she does not have a personal opinion.

368

Rep. Cameron

Asks for clarification on the OSBN’s position.

371

Hudson

Gives information on the current certifications the OSBN gives and comments on the dilemma that would be create by HB 3329.

393

Rep. Cameron

Asks if there is two years of training in order to be qualified.

398

Taylor

Responds that is correct and explains how a person becomes an RNFA.  Explains why the RNFA needs to be recognized by statute.

420

Rep. Cameron

Inquires if there are any other states that have similar incentives for people to go to work in the health care fields. 

433

Taylor

Explains that he drew this legislation by looking at other states.

TAPE 37, A

014

Rep. Witt

Inquires if the certification is enhanced by limiting the number of individual credentials within the RN certification.

037

Hudson

Responds that it would be unnecessary to add other certifications and it would be more limiting to the nurses.

046

Rep. Witt

Inquires if the OSBN has a policy to restrict the number of credentials within a field.

048

Hudson

Responds that there is no restriction.

050

Rep. Galizio

Asks if it would be in the area of public safety to require reimbursement so in rural areas there are RNFAs who are reimbursed for their services.

060

Hudson

Responds that from the boards perspective it is a reimbursement issue not a public safety issue. 

070

Taylor

Responds that it is not a primary mission of HB 3329 to deal with public safety, but points out that any time there is a certification process it decreases the potential of someone falsely saying they are an RNFA, which is a public safety issue.

078

Chair Berger

Asks for the difference between an advanced practice nurse and an RN.

080

Hudson

Discusses the differences between the advanced practice nurses and an RN.

097

Chair Berger

Clarifies that we have two nursing scopes, advanced practice and RN, and the objection that the OSBN has is that one small area of one of the scopes would be given a special status.

100

Hudson

Concurs.

109

Chair Berger

Asks how other states deal with this problem of different certifications in the RN status.

114

Taylor

Responds that his research was how other states deal with just the RNFA, and he does not know how other states deal with the different certifications in the RN status. 

123

Chair Berger

States that she wants to create a work group on the issue and lists who will be involved in the group.

128

Rep. Esquivel

States he would like to have the information on how other states handle different certifications in the RN.

130

Taylor

Responds that the information can be given to the committee.

134

John Powell

Regence Blue Cross Blue Shield.  States that Regence has a policy to reimburse first assistants and they would like to encourage the further development of first assistants.  Comments that there are some changes that are needed in the language in HB 3329. 

151

Rep. Cameron

Asks why they want to encourage the development of first assistants. 

153

Powell

Responds that there must be an assistant in surgery, and for a surgeon to do this is not good use of time and increases cost.  States that this is a category of people who are trained, and this is a more efficient use of healthcare dollars. 

171

Chair Berger

Closes the public hearing on HB 3329 and opens a work session on HB 3067.

HB 3067 – WORK SESSION

178

Cara Fischer

Committee Administrator.  Summarizes HB 3067.

189

Rep. Buckley

MOTION:  Moves HB 3067 to the floor with a DO PASS recommendation.

193

 

VOTE:  7-0-0

 

Chair Berger

Hearing no objection, declares the motion CARRIED.

REP. BOONE will lead discussion on the floor.

198

Chair Berger

Closes the work session on HB 3067 and opens a work session on HB 2916.

HB 2916 –WORK SESSION

206

Rep. Cameron

MOTION:  Moves HB 2916 to the floor with a DO PASS recommendation.

210

 

VOTE:  7-0-0

 

Chair Berger

Hearing no objection, declares the motion CARRIED.

REP. CAMERON will lead discussion on the floor.

218

Chair Berger

Closes the work session on HB 2916 and opens a work session on HB 2094.

HB 2094 – WORK SESSION

224

Rep. Sumner

MOTION:  Moves to SUSPEND the rules for the purpose of reconsidering the vote on House Bill 2094.

230

 

VOTE:  7-0-0

 

Chair Berger

Hearing no objection, declares the motion CARRIED.

231

Patrick Allen

Office of Regulatory Streamlining.  Discusses the need for the -3 amendments (EXHIBIT D)

262

Rep. Sumner

MOTION:  Moves to RECONSIDER the vote that "Moves HB 2094 to the floor with a DO PASS AS AMENDED recommendation."

263

 

VOTE:  7-0-0

 

Chair Berger

Hearing no objection, declares the motion CARRIED.

269

Rep. Sumner

MOTION:  Moves to WITHDRAW the -2 amendments dated 3/21/05 and replace it with the -3 amendments dated 4/4/05.

269

 

VOTE:  7-0-0

 

Chair Berger

Hearing no objection, declares the motion CARRIED.

270

Rep. Sumner

MOTION:  Moves HB 2094 to the floor with a DO PASS AS AMENDED recommendation.

275

 

VOTE:  7-0-0

 

Chair Berger

Hearing no objection, declares the motion CARRIED.

REP. SUMNER will lead discussion on the floor.

292

Chair Berger

Closes the work session on HB 2094 and adjourns the meeting at 9:24 a.m.

 

 

EXHIBIT SUMMARY

 

  1. HB 3329, prepared testimony, Deb Cassell, 3 pp
  2. HB 3329, prepared testimony, Stephen Newman, 2 pp
  3. HB 3329, prepared testimony, Marilyn Hudson, 1 p
  4. HB 2094, -3 amendments, staff, 2 pp