Legislature(2021 - 2022)GRUENBERG 120
05/06/2021 03:00 PM House STATE AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| SB47 | |
| HJR7 | |
| HB73 | |
| HB187 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 47 | TELECONFERENCED | |
| += | HJR 7 | TELECONFERENCED | |
| += | HB 73 | TELECONFERENCED | |
| += | HB 187 | TELECONFERENCED | |
| += | HB 66 | TELECONFERENCED | |
| *+ | HB 161 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
SB 47-VEHICLE REGISTRATION/PERSONS W/DISABILITY
3:04:51 PM
CHAIR KREISS-TOMKINS announced that the first order of business
would be SENATE BILL NO. 47, "An Act relating to special
registration plates for vehicles owned by persons with
disabilities."
3:05:13 PM
SENATOR ELVI GRAY-JACKSON, Alaska State Legislature, as prime
sponsor, presented SB 47. She spoke from the sponsor statement
[included in the committee packet], which read as follows
[original punctuation provided]:
SB47 amends AS 28.10.18(d) to allow speech-language
pathologists, physical therapists, and occupational
therapists to provide proof of disability to their
clients. Currently, only chiropractors, physicians,
physicians' assistants, or advanced practice
registered nurses can provide proof of disability to
their clients.
By expanding the ability for medical professionals in
different fields to provide proof of disability to
individuals, the opportunity to obtain special
registration plates for vehicles is expanded for
people with different kinds of disabilities.
Oftentimes, individuals with disabilities are in more
constant contact with their physical or occupational
therapists than with physicians because their issues
require more specialized care. It can be cumbersome
for these people, who are already suffering with
disabilities, to make an additional visit to the
physician purely for the purpose of acquiring their
plaques. To provide ease and accessibility for these
disabled people, it would be more efficient and
effective to allow these additional types of
professionals to provide proof of disability.
3:06:53 PM
BESSE ODOM, Staff, Senator Elvi Gray-Jackson, Alaska State
Legislature, presented a sectional analysis of SB 47 [included
in the committee packet] on behalf of Senator Gray-Jackson,
prime sponsor. She stated that Section 1 would amend AS
28.10.181(d) to include a person licensed as a speech-language
pathologist or as a physical therapist or occupational therapist
under AS 08.84
3:07:33 PM
REPRESENTATIVE EASTMAN drew attention to language on page 1,
lines [7-8], of SB 47, which refers to a person with a
disability that limits or impairs the ability to walk. He
offered his understanding that speech-language pathologists
would be added to those who can provide proof of a person being
limited in their ability to walk. He inquired about why
dentists and other providers would not also be added.
SENATOR GRAY-JACKSON replied that that question hadn't been
given any thought.
3:08:31 PM
REPRESENTATIVE TARR said she supports SB 47 because she believes
in having providers take full advantage of their training,
especially given the current shortage of providers and the
difficulty in getting appointments with them. She explained
that in relation to speech-language pathologists, the structures
of the inner ear are related to balance and equilibrium and
people who have that kind of disorder might have issues related
to mobility and go to other health care providers.
REPRESENTATIVE STORY offered her appreciation for the detailed
letters of support for SB 47 provided in the committee packet,
which painted the picture of why this bill is needed. She said
the bill is very timely.
3:10:31 PM
REPRESENTATIVE KAUFMAN asked whether, if the bill became law,
the speech-language therapist would use some sort of grading
system to determine the extent of disability.
SENATOR GRAY-JACKSON responded that she assumes the process will
work exactly as it does today when a person goes to a doctor or
chiropractor.
REPRESENTATIVE KAUFMAN stated he is asking because he assumes a
doctor would have a profound ability to diagnose a structural
disability and assess range of mobility. He surmised that if a
speech-language pathologist was assessing someone for a physical
disability that wasn't related to balance, the pathologist may
need the tools to be able to do so accurately, and he is
interested in any background information.
MS. ODOM answered that a person experiencing a mobility issue or
a disability impacting their mobility is usually referred to a
speech-language pathologist and others as part of their care
plan.
3:12:23 PM
REPRESENTATIVE EASTMAN observed that the current structure of
this statute limits disabilities to those who are impaired in
walking. He inquired about opening this type of license plate
to those who are disabled in other ways.
SENATOR GRAY-JACKSON replied that she believes changing this
statute to include occupational therapists and speech therapists
would take care of handling folks who have disabilities in other
ways.
REPRESENTATIVE EASTMAN asked whether the sponsor would be
supportive of an amendment that adjusts language on page 1, line
7, because the way he reads the language is that currently the
only person who can request this type of license plate is one
who has a limit with the ability to walk. He posited that
someone with other kinds of disabilities would not be able to
make that initial request and apply for the plate.
SENATOR GRAY-JACKSON deferred to [Ms. Alfonsi, an invited
witness] to provide an answer.
3:14:27 PM
ANNETTE ALFONSI provided invited testimony in support of SB 47.
She noted she is speaking on behalf of herself and that she is
the Alaska volunteer partner for the Unmasking Brain Injury
Project. She related that she has a college degree and used to
work full-time until 2012 when she was a passenger in a rollover
car accident that resulted in internal injuries and persistent
concussion symptoms. She spent her savings on medical care by
people who did not understand her injuries nor the right
treatment for them. She now works part-time in food service
while doing volunteer advocacy. Since 2015 she has planned and
implemented annual brain injury education with continuing
education credits for chiropractic, physical therapy,
occupational therapy, and physician continuing medical education
(CME). Getting credits approved requires an understanding of
each field's scope of practice. She has been a patient in
offices of every field listed in SB 47 and has worked in medical
and dental offices.
MS. ALFONSI provided examples of why the bill is valid for the
scopes of practice. She referred to numbered qualifications
listed on the application for a special disability parking
permit to obtain a disability placard. She noted that numbers 1
and 2 on the form reference walking distance and walking with
assistance. She stated that physical therapists usually assess
walking more extensively than do physicians who look for
neurological ability to walk but don't physically assess the
distance, stamina, or assistive technology. It is in the scope
of practice for an occupational therapist to do a driving test,
and these results are officially accepted by workers'
compensation, but occupational therapists don't have the ability
to provide [a signature on an application for a special
disability parking permit]. The sixth qualification is if the
applicant is "severely limited in their ability to walk due to
an arthritic, neurological, or orthopedic condition." Speech
therapists can provide cognitive assessments and cognitive re-
training regarding that neurological factor. Cognitive fatigue,
full response time, or problems juggling multiple variables can
make driving unsafe and can increase the chances for an
accident. Currently, when a physical therapist, occupational
therapist, or [speech-language pathologist] does an assessment,
the patient must then make another appointment to get that
[disability] parking placard. This takes additional time,
expense, and medical appointments in a state with a health care
shortage, as well as puts more obstacles on rural residents.
Cumulatively, the bill will save money, re-injuries, and time,
and increase independence, healing, and economic vitality. Ms.
Alfonsi urged the committee to pass SB 47.
3:18:16 PM
MS. ALFONSI addressed the previous questions from committee
members. She said speech-language pathologists and all these
fields routinely do various kinds of assessments that are
accepted nationally; these are accreditations, certifications,
and licensures that are accepted nationally. Of the assessments
done by a speech-language pathologist, some are the very same
assessments done by a neuropsychologist, so those are approved
nationally. Plus, rather than just a test result spit out by a
neuropsychologist's computer, a speech-language pathologist can
catch whether someone is giving themselves an assistive factor,
such as someone with vision impairment using auditory assistance
while taking the test that they otherwise would have failed.
Regarding Representative Eastman's question about an amendment
[for those who are disabled in ways other than walking], she
suggested that after the phrase "to walk" the words "or drive"
be added; so, if somebody can't walk or drive without this
placard, it would be an easy way to adjust for various kinds of
disability. She reiterated her support for SB 47.
3:21:22 PM
REPRESENTATIVE EASTMAN asked whether it would be in the state's
interest to assess someone's vulnerability to cognitive fatigue
as part of the application for driving and receiving a license.
MS. ALFONSI related her understanding that some states have this
requirement and others don't. She said she thinks the states
that have this requirement have much better incorporated
infrastructure for brain injury assessment and treatment. In
Alaska, for example, the Monday following her car accident she
saw her primary care provider who wrote in her chart that she
had brain fog and trouble with expressing herself. This was
with receiving one day off work with obviously active concussion
symptoms, and even with the information available at that time,
it was not appropriate. The idea of SB 47 is to increase the
capability of these different therapists, who typically have a
greater amount of patient interaction, to be able to provide
each patient with what they need in a timely manner. Cognitive
difficulties can change quickly, and people can heal quickly if
they get what they need in a timely manner. Ms. Alfonsi said
would feel better about a system that allows people to try to
heal as soon as possible instead of a system with a medical
shortage that punishes people for not being able to heal.
3:24:01 PM
REPRESENTATIVE VANCE inquired whether a stroke is considered a
disability.
SENATOR GRAY-JACKSON responded that it is a disability in her
opinion.
MS. ALFONSI replied that a stroke is considered a type of brain
injury.
3:24:38 PM
REPRESENTATIVE VANCE shared the experience of a constituent who
had had a stroke and was trying to get his driver license
reinstated, but due to liability concerns his physician would
not sign off for him to continue driving. The constituent
reported that the physician did not provide any measures to work
toward for showing improvement [and ability to drive]. However,
the constituent heard that if he went out of state and paid a
few thousand dollars, a physician would sign off, something the
constituent felt was unfair and illegal. She asked whether the
sponsor had researched instances concerning physician liability
and the providers that would be added through SB 47.
CHAIR KREISS-TOMKINS suggested the question might be outside of
the bill's scope as written, although he understands that there
is an adjacent issue.
SENATOR GRAY-JACKSON agreed the question is out of the bill's
scope. She added that she has been working on this bill since
2019 and did her homework before introducing the bill, which was
vetted through meetings where doctors, chiropractors, physical
therapists, and speech therapist were present.
3:26:51 PM
REPRESENTATIVE EASTMAN, if the bill became law, asked whether a
speech-language pathologist could be held liable for harm in
court if he or she signs off for this disability, a [disability
parking placard] is received, and then the person has an
accident.
3:27:42 PM
JEFFREY SCHMITZ, Director, Division of Motor Vehicles (DMV),
Department of Administration, replied he would not have any
comment in terms of liability. He said the DMV would maintain
the exact procedures and processes that it does now when issuing
placards. This bill would simply expand the number of people
who could sign such a certificate. There would be no change
from DMV's perspective.
CHAIR KREISS-TOMKINS, independent from there being no change in
liability from the DMV's perspective, asked whether there is
currently a liability relationship between the agency and an
accident scenario as described by Representative Eastman.
MR. SCHMITZ responded that he is not aware of any liability that
the DMV or the state would have with respect to this.
3:28:52 PM
REPRESENTATIVE KAUFMAN stated it would be good to know what the
typical liability insurance profile is for this new group of
people who would be able to assess this versus the typical
liability insurance levels that a physician carries. There may
be a difference and a distinction, he added, that could prevent
heartbreak in the future.
SENATOR GRAY-JACKSON answered that she thinks the liability
would be the same as it currently is for chiropractors, doctors,
and nurses, but she would investigate it.
3:29:46 PM
CHAIR KREISS-TOMKINS announced that SB 47 was held over.