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Enrolled SB 21: Relating to occupational licensing of members of the military and their spouses; relating to mobile intensive care paramedics; relating to duties of the State Medical Board and the Department of Health and Social Services; and providing for an effective date.

00Enrolled SB 21 01 Relating to occupational licensing of members of the military and their spouses; relating to 02 mobile intensive care paramedics; relating to duties of the State Medical Board and the 03 Department of Health and Social Services; and providing for an effective date. 04 _______________ 05 * Section 1. AS 08.01.063(a) is amended to read: 06 (a) Except as provided in (d) of this section, and notwithstanding another 07 provision of law, the department or appropriate board shall [MAY] issue a temporary 08 courtesy license to an active duty member of the armed forces of the United States 09 or the spouse of an active duty member of the armed forces of the United States if the 10 active duty member or spouse meets the requirements of this section and applies 11 to the department or appropriate board in the manner prescribed by the department or 12 appropriate board. An application must include evidence satisfactory to the department 13 or appropriate board that the applicant

01 (1) is an active duty member of the armed forces of the United 02 States or is married to and living with a member of the armed forces of the United 03 States who is on active duty and assigned to a duty station in this state under official 04 active duty military orders; 05 (2) holds a current license or certificate in another state, district, or 06 territory of the United States, or that is recognized by the United States, including a 07 branch of the armed forces of the United States, with requirements that the 08 department or appropriate board determines are substantially equivalent to those 09 established under this title for that occupation; 10 (3) if required by the department or appropriate board for obtaining a 11 license in the applicant's profession, has been fingerprinted and has provided the fees 12 required by the Department of Public Safety under AS 12.62.160 for criminal justice 13 information and a national criminal history record check; the fingerprints and fees 14 shall be forwarded to the Department of Public Safety to obtain a report of criminal 15 justice information under AS 12.62 and a national criminal history record check under 16 AS 12.62.400; 17 (4) has not committed an act in any jurisdiction that would have 18 constituted grounds for the refusal, suspension, or revocation of a license or certificate 19 to practice that occupation under this title at the time the act was committed; 20 (5) has not been disciplined by a licensing or credentialing entity in 21 another jurisdiction and is not the subject of an unresolved complaint, review 22 procedure, or disciplinary proceeding conducted by a licensing or credentialing entity 23 in another jurisdiction; and 24 (6) pays any fees required under this title. 25 * Sec. 2. AS 08.01.063(b) is amended to read: 26 (b) The department or appropriate board shall issue a temporary license 27 under this section to a person who meets the requirements [EXPEDITE THE 28 PROCEDURE FOR ISSUANCE OF A LICENSE] under (a) of this section within 30 29 days after the department or appropriate board receives the person's completed 30 application for the temporary license. 31 * Sec. 3. AS 08.64.107 is amended to read:

01 Sec. 08.64.107. Regulation of physician assistants [AND INTENSIVE 02 CARE PARAMEDICS]. The board shall adopt regulations regarding the licensure of 03 physician assistants [AND REGISTRATION OF MOBILE INTENSIVE CARE 04 PARAMEDICS,] and the medical services that they may perform, including the 05 (1) educational and other qualifications, including education in pain 06 management and opioid use and addiction; 07 (2) application and licensing [REGISTRATION] procedures; 08 (3) scope of activities authorized; and 09 (4) responsibilities of the supervising or training physician. 10 * Sec. 4. AS 08.64.170(a) is amended to read: 11 (a) A person may not practice medicine, podiatry, or osteopathy in the state 12 unless the person is licensed under this chapter, except that 13 (1) a physician assistant may examine, diagnose, or treat persons under 14 the supervision, control, and responsibility of either a physician licensed under this 15 chapter or a physician exempted from licensing under AS 08.64.370; 16 (2) [A MOBILE INTENSIVE CARE PARAMEDIC MAY RENDER 17 EMERGENCY LIFESAVING SERVICE; 18 (3)] a person who is licensed or authorized under another law of the 19 state [CHAPTER OF THIS TITLE] may engage in a practice that is authorized under 20 that law [CHAPTER]; and 21 (3) [(4)] a person may perform routine medical duties delegated under 22 AS 08.64.106. 23 * Sec. 5. AS 08.64.360 is amended to read: 24 Sec. 08.64.360. Penalty for practicing without a license or in violation of 25 chapter. Except for a physician assistant [, A MOBILE INTENSIVE CARE 26 PARAMEDIC,] or a person licensed or authorized under another law of the state 27 [CHAPTER OF THIS TITLE] who engages in practices for which that person is 28 licensed or authorized under that law [CHAPTER], a person practicing medicine or 29 osteopathy in the state without a valid license or permit is guilty of a class A 30 misdemeanor. Each day of illegal practice is a separate offense. 31 * Sec. 6. AS 08.64.369(d) is amended to read:

01 (d) In this section, "health care professional" includes an emergency medical 02 technician certified under AS 18.08, health aide, physician, nurse, mobile intensive 03 care paramedic licensed under AS 18.08, and physician assistant, but does not include 04 a practitioner of religious healing. 05 * Sec. 7. AS 12.55.185(11) is amended to read: 06 (11) "paramedic" means a mobile intensive care paramedic licensed 07 under AS 18.08 [AS 08.64]; 08 * Sec. 8. AS 18.08.075 is amended to read: 09 Sec. 18.08.075. Authority of emergency medical technician and mobile 10 intensive care paramedic. (a) An emergency medical technician or mobile intensive 11 care paramedic who responds to an emergency with an ambulance service or first 12 responder service, who has in the technician's or mobile intensive care paramedic's 13 possession a current emergency medical technician or mobile intensive care 14 paramedic identification card, and who provides emergency medical care or other 15 emergency medical service, has the authority to 16 (1) control and direct activities at the accident site or emergency until 17 the arrival of law enforcement personnel; 18 (2) order a person other than the owner to leave a building or place in 19 the vicinity of the accident or other emergency for the purpose of protecting the person 20 from injury; 21 (3) temporarily block a public highway, street, or private right-of-way 22 while at the scene of an accident, illness, or emergency; 23 (4) trespass upon property at or near the scene of an accident, illness, 24 or emergency at any time of day or night; 25 (5) enter a building, including a private dwelling, or premises where a 26 report of an injury or illness has taken place or where there is a reasonable cause to 27 believe an individual has been injured or is ill to render emergency medical care; and 28 (6) direct the removal or destruction of a motor vehicle or other thing 29 that the emergency medical technician or mobile intensive care paramedic 30 determines is necessary to prevent further harm to injured or ill individuals. 31 (b) A person who knowingly refuses to comply with an order of an emergency

01 medical technician or mobile intensive care paramedic authorized under (a) of this 02 section is, upon conviction, guilty of a class B misdemeanor. In this subsection, 03 "knowingly" has the meaning given in AS 11.81.900(a). 04 * Sec. 9. AS 18.08.080 is amended to read: 05 Sec. 18.08.080. Regulations. (a) The department shall adopt, with the 06 concurrence of the Department of Public Safety, regulations establishing standards and 07 procedures for the issuance, renewal, reissuance, revocation, and suspension of 08 certificates or licenses required under AS 18.08.084, as well as other regulations 09 necessary to carry out the purposes of this chapter. 10 (b) The department may charge fees set by regulation for the certification or 11 licensure of individuals and organizations under this chapter. 12 * Sec. 10. AS 18.08.082(a) is amended to read: 13 (a) The department shall prescribe by regulation a course of training or other 14 requirements prerequisite to the issuance of certificates or licenses that provide for the 15 following: 16 (1) certification of a person who meets the training and other 17 requirements as an emergency medical technician, emergency medical technician 18 instructor, or emergency medical dispatcher; 19 (2) authorization for an emergency medical technician certified under 20 this chapter to provide under the written or oral direction of a physician the advanced 21 life support services enumerated on the certificate or enumerated on a written 22 document filed with the department by the technician's medical director and approved 23 by the department under its regulations; 24 (3) certification that a person, organization, or government agency that 25 provides an emergency medical service, conducts a training course for a mobile 26 intensive care paramedic, or represents itself as a trauma center meets the minimum 27 standards prescribed by the department for that service, course, or designation; [AND] 28 (4) authorization for an emergency medical service certified under this 29 chapter to provide under the written or oral direction of a physician the advanced life 30 support services enumerated on the certificate or enumerated on a written document 31 filed with the department by the medical director for the emergency medical service

01 and approved by the department under its regulations; and 02 (5) licensure of a mobile intensive care paramedic and the medical 03 services that a mobile intensive care paramedic may perform, including the 04 (A) educational and other qualifications, which may include 05 education in pain management and opioid use and addiction; 06 (B) application and licensing procedures; 07 (C) scope of activities authorized; and 08 (D) responsibilities of a supervising or training physician. 09 * Sec. 11. AS 18.08.082(b) is amended to read: 10 (b) The department is the central certifying and licensing agency for a 11 person, organization, or governmental agency that is [PERSONNEL] certified or 12 licensed under (a) [(a)(1) AND (2)] of this section and under regulations adopted 13 under AS 18.08.080. 14 * Sec. 12. AS 18.08.084(a) is amended to read: 15 (a) One may not represent oneself, nor may an agency or business represent an 16 agent or employee of that agency or business, as an emergency medical dispatcher, 17 emergency medical technician, mobile intensive care paramedic, or emergency 18 medical technician instructor certified or licensed by the state unless the person 19 represented is certified or licensed for that occupation under AS 18.08.082. 20 * Sec. 13. AS 18.08.086(a) is amended to read: 21 (a) A person certified or licensed under AS 18.08.082 who administers 22 emergency medical services to an injured or sick person, a person or public agency 23 that employs, sponsors, directs, or controls the activities of persons certified or 24 licensed under AS 18.08.082 who administer emergency medical services to an 25 injured or sick person, or a health care professional or emergency medical dispatcher 26 acting within the scope of the person's certification or licensure who directs or 27 advises a person to administer emergency medical services to an injured or sick person 28 is not liable for civil damages as a result of an act or omission in administering those 29 services or giving that advice or those directions if the administering, advising, and 30 directing are done in good faith and the injured or sick person reasonably seems to be 31 in immediate danger of serious harm or death. This subsection does not preclude

01 liability for civil damages that are the proximate result of gross negligence or 02 intentional misconduct, nor preclude imposition of liability on a person or public 03 agency that employs, sponsors, directs, or controls the activities of persons certified or 04 licensed under AS 18.08.082 if the act or omission is a proximate result of a breach of 05 duty to act created under this chapter. In [FOR THE PURPOSES OF] this subsection, 06 "gross negligence" means reckless, wilful, or wanton misconduct. 07 * Sec. 14. AS 18.08.089(a) is amended to read: 08 (a) A mobile intensive care paramedic licensed under this chapter, a [OR] 09 physician assistant registered or licensed under AS 08.64.107, or an emergency 10 medical technician certified under this chapter may make a determination and 11 pronouncement of death of a person under the following circumstances: 12 (1) the mobile intensive care paramedic or emergency medical 13 technician is an active member of an emergency medical service certified under this 14 chapter; 15 (2) neither a physician licensed under AS 08.64 nor a physician 16 exempt from licensure under AS 08.64 is immediately available for consultation by 17 radio or telephone communications; 18 (3) the mobile intensive care paramedic, physician assistant, or 19 emergency medical technician has determined, based on acceptable medical standards, 20 that the person has sustained irreversible cessation of circulatory and respiratory 21 functions. 22 * Sec. 15. AS 18.08.200 is amended by adding a new paragraph to read: 23 (14) "mobile intensive care paramedic" means an individual licensed 24 by the department who has completed a paramedic training program approved by the 25 department and is authorized by law to provide advanced life support under the direct 26 or indirect supervision of a physician. 27 * Sec. 16. AS 29.45.050(r) is amended to read: 28 (r) A municipality may by ordinance exempt from taxation an amount not to 29 exceed $10,000 of the assessed value of real property owned and occupied as a 30 permanent place of abode by a resident who provides in the municipality volunteer (1) 31 fire fighting services and is certified as a firefighter by the Department of Public

01 Safety, or (2) emergency medical services or mobile intensive care paramedic 02 services and is certified or licensed under AS 18.08.082. If two or more individuals 03 are eligible for an exemption for the same property, not more than two exemptions 04 may be granted. 05 * Sec. 17. AS 37.05.146(c)(77) is amended to read: 06 (77) the following fees, receipts, income, and monetary recoveries 07 collected by the Department of Health and Social Services: 08 (A) receipts of the Department of Health and Social Services, 09 Bureau of Vital Statistics; 10 (B) monetary recoveries of Medicaid expenditures from 11 recipients, third parties, and providers under AS 47; 12 (C) the state's share of overpayments collected under 13 AS 47.05.080; 14 (D) income received from a state or federal agency for children 15 in foster care under AS 47.14.100; 16 (E) fees received or collected under AS 44.29.022 for nursing 17 and planning services provided at health centers, genetic screening clinics and 18 specialty clinics, the certification of x-ray machines, the alcohol safety action 19 program, and other public health programs and services; 20 (F) fees received under AS 18.08.080 for the certification or 21 licensure of emergency medical technicians, emergency medical dispatchers, 22 mobile intensive care paramedics, and emergency medical technician 23 instructors; 24 (G) fees received under AS 47.32; 25 (H) the state's share of child support collections for 26 reimbursement of the cost of the Alaska temporary assistance program as 27 provided under AS 25.27.120, 25.27.130, and AS 47.27.040; and 28 (I) monetary recoveries under AS 09.58 (Alaska Medical 29 Assistance False Claim and Reporting Act); 30 * Sec. 18. AS 08.64.366, 08.64.380(3), and 08.64.380(4) are repealed. 31 * Sec. 19. The uncodified law of the State of Alaska is amended by adding a new section to

01 read: 02 TRANSITION: EXISTING REGISTRATIONS; REGULATIONS. (a) 03 Notwithstanding the amendment to AS 08.64.107 made by sec. 3 of this Act, a registration of 04 a mobile intensive care paramedic issued before the effective date of sec. 3 of this Act is valid 05 until the registration 06 (1) expires under AS 08.64.107, as that section read on the day before the 07 effective date of sec. 3 of this Act; 08 (2) is suspended or revoked; or 09 (3) is converted to a license under AS 18.08.082(a) and (b), as amended by 10 secs. 10 and 11 of this Act. 11 (b) On January 1, 2022, the Department of Commerce, Community, and Economic 12 Development and the State Medical Board shall transfer the files of all pending records and 13 proceedings, including applications and disciplinary actions, relating to mobile intensive care 14 paramedics to the Department of Health and Social Services. 15 (c) The Department of Health and Social Services shall adopt regulations necessary to 16 implement this Act. The regulations must allow for the conversion of an unexpired 17 registration of a mobile intensive care paramedic issued under regulations authorized by 18 AS 08.64.107, as that section read on the day before the effective date of sec. 3 of this Act, to 19 a license under AS 18.08.082(a) and (b), as amended by secs. 10 and 11 of this Act. 20 * Sec. 20. Section 19(c) of this Act takes effect immediately under AS 01.10.070(c). 21 * Sec. 21. Except as provided in sec. 20 of this Act, this Act takes effect January 1, 2022.