Legislature(2019 - 2020)BARNES 124

04/24/2019 03:15 PM LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 24 LIMITED TEACHER CERTIFICATES; LANGUAGES TELECONFERENCED
Heard & Held
+ HB 97 TELEHEALTH: PHYSICIAN ASSISTANTS; DRUGS TELECONFERENCED
Scheduled but Not Heard
+ HB 29 INSURANCE COVERAGE FOR TELEHEALTH TELECONFERENCED
Heard & Held
+= HB 78 INSURER & GROUP INSURANCE DISCLOSURE TELECONFERENCED
<Bill Hearing Canceled>
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= SB 29 EXTEND BOARD OF MARINE PILOTS TELECONFERENCED
Moved SB 29 Out of Committee
-- Public Testimony --
+= SB 36 EXTEND BOARD OF NURSING TELECONFERENCED
Moved SB 36 Out of Committee
-- Public Testimony --
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                         
                         April 24, 2019                                                                                         
                           3:20 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Gabrielle LeDoux, Co-Chair                                                                                       
Representative Adam Wool, Co-Chair                                                                                              
Representative Zack Fields                                                                                                      
Representative Sara Hannan                                                                                                      
Representative Louise Stutes                                                                                                    
Representative Dave Talerico                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Josh Revak                                                                                                       
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 29                                                                                                              
"An Act extending the termination date of the Board of Marine                                                                   
Pilots; and providing for an effective date."                                                                                   
                                                                                                                                
     - MOVED SB 29 OUT OF COMMITTEE                                                                                             
                                                                                                                                
SENATE BILL NO. 36                                                                                                              
"An Act extending the termination date of the Board of Nursing;                                                                 
and providing for an effective date."                                                                                           
                                                                                                                                
     - MOVED SB 36 OUT OF COMMITTEE                                                                                             
                                                                                                                                
HOUSE BILL NO. 24                                                                                                               
"An Act relating to instruction in a language other than                                                                        
English; and relating to limited teacher certificates."                                                                         
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 29                                                                                                               
"An Act relating to insurance coverage for benefits provided                                                                    
through telehealth; and providing for an effective date."                                                                       
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB  29                                                                                                                  
SHORT TITLE: EXTEND BOARD OF MARINE PILOTS                                                                                      
SPONSOR(s): SENATOR(s) STEDMAN                                                                                                  
                                                                                                                                
01/23/19       (S)       READ THE FIRST TIME - REFERRALS                                                                        

01/23/19 (S) L&C, FIN 02/07/19 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) 02/07/19 (S) Moved SB 29 Out of Committee 02/07/19 (S) MINUTE(L&C) 02/08/19 (S) L&C RPT 5DP 02/08/19 (S) DP: REINBOLD, BIRCH, BISHOP, COSTELLO, GRAY-JACKSON 03/01/19 (S) FIN AT 9:00 AM SENATE FINANCE 532 03/01/19 (S) Heard & Held 03/01/19 (S) MINUTE(FIN) 03/08/19 (S) FIN RPT 8DP 1NR 03/08/19 (S) DP: STEDMAN, VON IMHOF, MICCICHE, HOFFMAN, WIELECHOWSKI, OLSON, WILSON, BISHOP 03/08/19 (S) NR: SHOWER 03/08/19 (S) FIN AT 9:00 AM SENATE FINANCE 532 03/08/19 (S) Moved SB 29 Out of Committee 03/08/19 (S) MINUTE(FIN) 04/05/19 (S) TRANSMITTED TO (H) 04/05/19 (S) VERSION: SB 29 04/08/19 (H) READ THE FIRST TIME - REFERRALS 04/08/19 (H) L&C, FIN 04/17/19 (H) L&C AT 3:15 PM BARNES 124 04/17/19 (H) -- MEETING CANCELED -- 04/22/19 (H) L&C AT 3:15 PM BARNES 124 04/22/19 (H) Heard & Held 04/22/19 (H) MINUTE(L&C) 04/24/19 (H) L&C AT 3:15 PM BARNES 124 BILL: SB 36 SHORT TITLE: EXTEND BOARD OF NURSING SPONSOR(s): SENATOR(s) GIESSEL

01/25/19 (S) READ THE FIRST TIME - REFERRALS

01/25/19 (S) L&C, FIN 02/07/19 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) 02/07/19 (S) Moved SB 36 Out of Committee 02/07/19 (S) MINUTE(L&C) 02/08/19 (S) L&C RPT 5DP 02/08/19 (S) DP: REINBOLD, COSTELLO, BISHOP, BIRCH, GRAY-JACKSON 03/01/19 (S) FIN AT 9:00 AM SENATE FINANCE 532 03/01/19 (S) Heard & Held 03/01/19 (S) MINUTE(FIN) 03/13/19 (S) FIN RPT 6DP 2NR 03/13/19 (S) DP: STEDMAN, VON IMHOF, MICCICHE, OLSON, WILSON, BISHOP 03/13/19 (S) NR: SHOWER, WIELECHOWSKI 03/13/19 (S) FIN AT 9:00 AM SENATE FINANCE 532 03/13/19 (S) Moved SB 36 Out of Committee 03/13/19 (S) MINUTE(FIN) 04/01/19 (S) TRANSMITTED TO (H) 04/01/19 (S) VERSION: SB 36 04/03/19 (H) READ THE FIRST TIME - REFERRALS 04/03/19 (H) L&C, FIN 04/17/19 (H) L&C AT 3:15 PM BARNES 124 04/17/19 (H) -- MEETING CANCELED -- 04/22/19 (H) L&C AT 3:15 PM BARNES 124 04/22/19 (H) Heard & Held 04/22/19 (H) MINUTE(L&C) 04/24/19 (H) L&C AT 3:15 PM BARNES 124 BILL: HB 24 SHORT TITLE: LIMITED TEACHER CERTIFICATES; LANGUAGES SPONSOR(s): REPRESENTATIVE(s) KREISS-TOMKINS 02/20/19 (H) PREFILE RELEASED 1/7/19 02/20/19 (H) READ THE FIRST TIME - REFERRALS 02/20/19 (H) EDC, L&C 03/29/19 (H) EDC AT 8:00 AM CAPITOL 106 03/29/19 (H) Heard & Held 03/29/19 (H) MINUTE(EDC) 04/01/19 (H) EDC AT 8:00 AM CAPITOL 106 04/01/19 (H) Heard & Held 04/01/19 (H) MINUTE(EDC) 04/03/19 (H) EDC AT 8:00 AM CAPITOL 106 04/03/19 (H) Heard & Held 04/03/19 (H) MINUTE(EDC) 04/05/19 (H) EDC RPT 5DP 2NR 04/05/19 (H) DP: TUCK, ZULKOSKY, JOHNSON, STORY, DRUMMOND 04/05/19 (H) NR: REVAK, HOPKINS 04/05/19 (H) EDC AT 8:00 AM CAPITOL 106 04/05/19 (H) Moved HB 24 Out of Committee 04/05/19 (H) MINUTE(EDC) 04/24/19 (H) L&C AT 3:15 PM BARNES 124 BILL: HB 29 SHORT TITLE: INSURANCE COVERAGE FOR TELEHEALTH SPONSOR(s): REPRESENTATIVE(s) SPOHNHOLZ 02/20/19 (H) PREFILE RELEASED 1/11/19 02/20/19 (H) READ THE FIRST TIME - REFERRALS 02/20/19 (H) HSS, L&C 03/26/19 (H) HSS AT 3:00 PM CAPITOL 106 03/26/19 (H) Heard & Held 03/26/19 (H) MINUTE(HSS) 03/28/19 (H) HSS AT 3:00 PM CAPITOL 106 03/28/19 (H) Moved HB 29 Out of Committee 03/28/19 (H) MINUTE(HSS) 03/29/19 (H) HSS RPT 3DP 1NR 03/29/19 (H) DP: CLAMAN, DRUMMOND, SPOHNHOLZ 03/29/19 (H) NR: PRUITT 04/12/19 (H) L&C AT 3:15 PM BARNES 124 04/12/19 (H) -- MEETING CANCELED -- 04/15/19 (H) L&C AT 3:15 PM BARNES 124 04/15/19 (H) Scheduled but Not Heard 04/24/19 (H) L&C AT 3:15 PM BARNES 124 WITNESS REGISTER KAREN MORTON Alaska Nurses Association Soldotna, Alaska POSITION STATEMENT: Testified in support of SB 36. REPRESENTATIVE JONATHAN KRIESS-TOMKINS Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Introduced HB 24, as prime sponsor, and answered questions from the committee. JON SCANLAN, Staff Representative Jonathan Kreiss-Tomkins Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented HB 24 and answered questions from the committee, on behalf of Representative Kreiss-Tompkins, prime sponsor. SONDRA MERIDITH, Teacher Certification Administration Student Learning Division Department of Education and Early Development Juneau, Alaska POSITION STATEMENT: Answered questions during the hearing on HB 24. REPRESENTATIVE IVY SPOHNHOLZ Alaska State Legislature Juneau, Alaska POSITION STATEMENT: As prime sponsor, introduced HB 29 and answered questions from the committee. BERNICE NISBETT, Staff Representative Ivy Spohnholz Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented the sectional analysis of HB 29, on behalf of Representative Spohnholz, prime sponsor. LORI WING-HEIER, Director Division of Insurance Department of Commerce, Community & Economic Development Anchorage, Alaska POSITION STATEMENT: Answered questions during the hearing on HB 29. WADE ERICKSON, MD Capstone Family Medicine Wasilla, Alaska POSITION STATEMENT: Answered questions during the hearing on HB 29. ACTION NARRATIVE 3:20:13 PM CO-CHAIR ADAM WOOL called the House Labor and Commerce Standing Committee meeting to order at 3:20 p.m. Representatives Stutes, Talerico, Fields, Hannan, LeDoux, and Wool were present at the call to order. SB 29-EXTEND BOARD OF MARINE PILOTS 3:21:40 PM CO-CHAIR WOOL announced that the first order of business would be SENATE BILL NO. 29, "An Act extending the termination date of the Board of Marine Pilots; and providing for an effective date." 3:21:58 PM CO-CHAIR WOOL opened public testimony on SB 29. After Ascertaining that no one wished to testify, he closed public testimony. 3:22:31 PM CO-CHAIR LEDOUX moved to report SB 29 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, SB 29 was reported out of the House Labor and Commerce Standing Committee. SB 36-EXTEND BOARD OF NURSING 3:22:49 PM CO-CHAIR WOOL announced that the next order of business would be SENATE BILL NO. 36, "An Act extending the termination date of the Board of Nursing; and providing for an effective date." CO-CHAIR WOOL opened public testimony. 3:23:18 PM KAREN MORTON, Alaska Nurses Association, voiced support for extending the Board of Nursing and the passage of SB 36. 3:24:00 PM CO-CHAIR WOOL closed public testimony. 3:24:07 PM CO-CHAIR LEDOUX moved to report SB 36 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, SB 36 was reported out of the House Labor and Commerce Standing Committee. 3:24:31 PM The committee took an at-ease from 3:24 to 3:26 p.m. HB 24-LIMITED TEACHER CERTIFICATES; LANGUAGES 3:26:07 PM CO-CHAIR WOOL announced that the next order of business would be HOUSE BILL NO. 24, "An Act relating to instruction in a language other than English; and relating to limited teacher certificates." 3:26:20 PM REPRESENTATIVE JONATHAN KRIESS-TOMKINS, Alaska State Legislature, as prime sponsor of HB 24, introduced the bill and related its history. He said this is the second legislature in which this legislation has been introduced. Last legislature, the House passed the legislation and then it "died" in its last committee of referral in the Senate. He stated that this legislation has been broadly requested by school districts that have immersion language programs. Under HB 24, the state Board of Education and Early Development would expand the scope of the existing "Type M" limited certificates to include immersion language education. 3:27:43 PM JON SCANLAN, Staff, Representative Jonathan Kreiss-Tomkins, Alaska State Legislature, on behalf of representative Kreiss- Tompkins, prime sponsor, paraphrased parts of the sponsor statement [included in the committee packet], which read in its entirety as follows [original punctuation provided]: Language immersion education is an increasingly popular educational model that also produces impressive academic outcomes. In an immersion program, some of the academic subject matter is delivered in a language other than English. HB 24 provides needed flexibility to school districts operating language immersion programs. HB 24 gives the state board of education the tools necessary to tackle one of the biggest challenges facing Alaska's immersion programs: finding fully certified teachers also fluent in an Alaska Native or foreign language. Under HB 24, the state board could provide school districts case-by-case flexibility to hire language immersion teachers they know are qualified to lead a classroom but who for reasons such as limited English proficiency, advanced age, or familial responsibilities are unable at the time to get a full teacher certification. To do so, the state board would have to create a new certificate along the lines of the existing "Type M" or "Type I" limited certificates. Alaska already has a variety of successful and popular immersion programs, including Wasilla's Fronteras, Anchorage's Rilke Schule, and Anchorage School District's highly regarded world languages program. Immersion is also central to Alaska Native language revitalization efforts. In Israel, New Zealand, and Hawaii, immersion education was at the core of indigenous language revival. At Ayaprun Elitnaurvik in Bethel, instruction is done in Yup'ik, and interest in Alaska Native language immersion education is growing elsewhere in the state. HB 24 will help Alaska's language immersion programs continue to provide high-quality dual-language education. MR. SCANLAN added that limited certificates are issued on a "case-by-case" basis, only by request of the school district, for teachers with a specific subject area expertise for which there are few fully certified teachers. HB 24 would authorize the Board of Education to create a new type of limited certificate specifically geared towards language immersion programs. Furthermore, the bill would permit the board to write regulations to ensure "the certificate holder demonstrates instructional skills in subject matter expertise sufficient to assure the public that the person is competent as a teacher." Additionally, the certificate would only be valid for the language of instruction to be taught in specific subject areas, and only to the school district that requested it. Lastly, the certificate is initially issued for one year as a probationary period. 3:33:05 PM REPRESENTATIVE FIELDS questioned whether HB 24 would allow the "TEACH program" and the "Type I" certification to continue unimpeded for the certified associate teachers who are not in an immersion school. MR. SCANLAN confirmed that. He noted that the bill would not affect the "Type I" certificate aside from changing the initial certification period to one year. REPRESENTATIVE FIELDS expressed hope for future conversations with the Department of Education and Early Development (EED) about making technical assistance available to school districts so that the Lower Kuskokwim School District (LKSD) model could be implemented elsewhere if desired. He noted that the LKSD model has been successful at attaining local teachers, which improves tenure, reduces turnover, and thereby improves quality of instruction by having culturally fluent teachers in the classroom. 3:34:39 PM CO-CHAIR LEDOUX asked why there needs to be a separate "credential" for language immersion education. MR. SCANLAN acknowledged that under current statute, an educator could receive an Alaska Native language certificate to teach Yup'ik; however, HB 24 would allow them to teach different subjects in Yup'ik. Currently, it is difficult to find fully certified teachers also fluent in an Alaska Native language for reasons such as limited English proficiency, advanced age, or familial responsibilities. This bill would address this problem by providing a certificate that allows these educators to get into classrooms and teach in programs and subject areas beyond a strictly culture or language course. CO-CHAIR LEDOUX surmised that there are enough certified teachers who are fluent in the "European languages" or "major Asian languages" and fewer that are fluent in languages like Farsi or Afghan. MR. SCANLAN said that is what language immersion operators in Alaska have confirmed. He offered his understanding that it's also challenging to find fully certificated Spanish teachers who have the requisite level of fluency to be effective in language immersion programs. CO-CHAIR LEDOUX expressed her enthusiasm for the bill and asked if there is any pushback. 3:38:44 PM REPRESENTATIVE KREISS-TOMKINS clarified that this bill sets up a process - it doesn't guarantee that people get [teaching] certificates. He acknowledged that there have been some concerns. MR. SCANLAN directed attention to section D of the current bill. He said one change would be that the Board of Education wouldn't be able to require English competency exams in their regulations, as that has been relayed as a major limiting factor in the ability for fluent speakers to teach and help these programs thrive. 3:43:46 PM REPRESENTATIVE FIELDS noted that Anchorage's immersion programs have helped set its school district apart in a positive way. He opined that these programs would help attract and retain high- earning, professional families, and ultimately play a role in the economic competitiveness of Alaska's respective communities. 3:44:39 PM REPRESENTATIVE STUTES sought clarification on how the [new] certificates would be issued. 3:44:59 PM REPRESENTATIVE KREISS-TOMKINS explained that the certificates are issued by the EED. Under the process established by HB 24, local districts would identify qualified educators who wouldn't otherwise qualify for a traditional certificate and they would apply for their limited teachers' certificate. The board would then vote to forward the applications on to the state Board of Education who would then review them based on a set of criteria and approve or deny them. REPRESENTATIVE STUTES asked if the approved certificate would be limited to one language as well as to a specific school. MR. SCANLAN acknowledged that the certificate would be limited to the language that it was applied for, as well as the specific subjects that the candidate demonstrated subject area expertise in. He added that it would also be limited to a district. REPRESENTATIVE STUTES asked if it applies for any school within the district. MR. SCANLAN affirmed that. 3:47:17 PM REPRESENTATIVE HANNAN pointed out that the state already grants "Type M" certificates to speak and teach indigenous Alaskan languages and certain vocational skills, like military science. She expressed concern that HB 24 conjoins world language skillsets into that same "Type M" certification, which is designed around subjects you couldn't traditionally learn in academic training. She noted that there are 11 types of teacher certificates in Alaska. One of which, the subject-matter expert [limited] teacher certificate, allows individuals who are knowledgeable in a specific subject area to temporarily teach in a classroom while completing their teacher certificate education requirements. She shared her belief that the current bill would place teachers in schools "with no caveat of how long before you need to reach competency that other people had to meet to come through the door." Indigenous language teachers in Alaska, she said, have already been successfully credentialled in teaching across the state for over 20 years. MR. SCANLAN noted that the aforementioned subject-matter expert certificate [AS 14.20.022] statutorily requires a baccalaureate degree, which would be a limiting factor for many of the fluent Alaska Native language speakers. He continued by saying that HB 24 would operate under AS 14.20.25, the limited teacher certificates, which does not require a bachelor's degree. Nonetheless, the "Type I" limited certificate does require enrollment in a bachelor's degree program, a mentored teacher, and a number of other competency checks. 3:56:55 PM REPRESENTATIVE KREISS-TOMKINS added that under current law, the "Type M" limited certificate doesn't allow for adequate language immersion education because the Alaska Native language provision only refers to instruction of the language itself, rather than teaching different subjects in that specific language. He opined that the "Type M" Alaska Native language provision is narrow and restrictive in a manner that preempts the possibility of an immersion language program. 3:58:40 PM REPRESENTATIVE FIELDS addressed the "Type I" certificate and the LKSD, which to his understanding is the only district with that kind of certification. He stated that their "Type I" certification exists within the TEACH program, which is designed to get local teachers in the classroom. He explained that most "Type I" associate teachers are working towards completing their 4-year degree while working in the school district and gaining experience. He said it's a marriage of both the university degree program and a registered apprenticeship program that regulates under the U.S. Department of Labor. He expressed his support of retaining the flexibility to have teachers who don't have their bachelor's degree who are nonetheless working towards becoming fully certified teachers, adding that it's a great way to have local teachers who are culturally fluent and committed to their communities. CO-CHAIR WOOL requested a chart of the 11 different teacher certificates with their respective requirements. CO-CHAIR LEDOUX asked if under the current bill, the teachers would be eligible for tenure. 4:02:09 PM MR. SCANLAN noted that the certificate would be initially eligible for one year with specific requirements of renewal written by the department. 4:02:36 PM REPRESENTATIVE KREISS-TOMKINS added that the application process would be a "rigmarole." He stated that the intent is to create a stepping-stone for teachers on their way to full and traditional certification. He further noted that tenure, under Alaska law, is attained after four years, adding that it would be difficult to get tenured under a "Type M" certificate. 4:05:06 PM REPRESENTATIVE STUTES questioned the broad scope of the current bill, expressing concern that it covers "any language that is not English." REPRESENTATIVE KREISS-TOMKINS noted that when talking about subjects taught in language immersion programs, they are almost exclusively subjects taught at the earliest age levels. He further stated that the only way to create a generation of fluent speakers in a world language is through immersion language education. 4:09:13 PM REPRESENTATIVE TALERICO expressed his support for the bill and thanked the sponsor for the effort he put into this legislation and for bringing it forward. 4:10:34 PM REPRESENTATIVE HANNAN stated that she is not opposed to the goal of the bill; however, across the state there are currently people with Type M certificates in the classroom who don't have traditional academic degrees available to them. She opined that "Type M" certificates already allow teachers to teach language immersion in an indigenous language. She offered her understanding that the existing obstacle is with the Native language speakers at immersion schools being able to pass the competency exam. She expressed concern about the true intent of the bill and whether it concerned world languages or Native languages. She opined that there should be caveats that address the downstream effects of the current bill. 4:13:42 PM REPRESENTATIVE KREISS-TOMKINS clarified that HB 24 is for both world languages and Native languages. Regarding downstream effects, he said, it's important to emphasize that the bill sets up a process and not a guarantee of certification. He added that the state board and the department will promulgate regulations that include protections and vetting to avoid aforementioned concerns. 4:14:46 PM CO-CHAIR WOOL questioned whether this bill would create a new type of certification or fall under the "Type I" certificate. MR. SCANLAN clarified that if the bill passes, the department would create a new type of certificate. CO-CHAIR WOOL asked if the renewal process would be less rigorous than the initial application. MR. SCANLAN explained that under HB 24, the certificate would be valid for one year and the department would have to certify that the candidate has demonstrated skills in classroom instruction and student assessment. CO-CHAIR WOOL asked how many immersion schools exist in Alaska. MR. SCANLAN answered 8 immersion schools in Anchorage and various others across the state - some that are tribally operated, and others operated by charter schools or public schools. REPRESENTATIVE KREISS-TOMKINS, in response to Co-Chair Wool, replied that there are at least 10 immersion schools in Alaska. CO-CHAIR WOOL asked how many of those 10 teach Native languages. REPRESENTATIVE KREISS-TOMKINS answered four. 4:18:10 PM CO-CHAIR WOOL questioned weather this certificate would also allow individuals to teach certain subjects in English in addition the foreign language. MR. SCANLAN stated that the certificate would only be valid for the non-English language it was issued in. He noted that immersion schools aim to teach 50-100 percent of their program in that non-English language. CO-CHAIR WOOL sought clarification on whether the certificate would be subject-specific. MR. SCANLAN reiterated that the certificate would specify a specific subject area and language. 4:20:45 PM CO-CHAIR LEDOUX asked for clarification on what grades the certificate would cover. She noted that in the higher grades, like high school, the issue of the candidate's competency in certain subjects would be relevant. 4:21:30 PM REPRESENTATIVE KREISS-TOMKINS answered, "Almost exclusively lower grades." He noted that most immersion programs discharge their students into "normal" middle school and high school tracks by 5th or 6th grade. MR. SCANLAN, in response to Co-Chair LeDoux, added that under this bill, the department would be permitted to create separate certificates to target both the upper and lower grades if necessary. 4:23:07 PM REPRESENTATIVE FIELDS asked future invited testifiers to address how multi-lingual learning helps kids reach their full cognitive capacity in the same way that different languages teach people to see the world in different ways by structure of the language itself. CO-CHAIR WOOL asked how to resolve the shortage of foreign language teachers in traditional school districts. MR. SCANLAN said he was unsure of the answer. CO-CHAIR WOOL reflected on his own experience helping his daughter with advanced math in elementary school. He observed that word problems are more prevalent now, indicating that a math teacher would need to be skilled in both linguistics and mathematics. 4:26:50 PM CO-CHAIR WOOL questioned whether English is also taught in non- English immersion programs. 4:28:20 PM SONDRA MERIDITH, Teacher Certification Administration, Student Learning Division, Department of Education and Early Development, replied that she was familiar with a 50/50 proposition, where half the day is taught in English and the other half in the non-English language. 4:30:07 PM REPRESENTATIVE HANNAN asked how many "Type M" certificated language teachers currently work in Alaska. MS. MERIDITH answered less than 50. REPRESENTATIVE HANNAN questioned whether that number has decreased over the last 10 years as more academic programs that lead to traditional certification have become available. MS. MERIDITH said she would follow up with that answer. REPRESENTATIVE HANNAN asked if there are any restrictions on what [subject areas] "Type M" language teachers in a k-1 classroom can instruct. MS. MERIDITH stated that the statute limits that type of certification to teach language and cultural aspects; therefore, there would need to be a [fully] certified teacher to oversee math lessons, for example. REPRESENTATIVE HANNAN asked if "Type I" and "Type M" teachers could work together to complete a curriculum load. MS. MERIDITH replied that the "Type I" teacher could provide some instruction, but they would also be working in conjunction with a [fully] certified teacher and would not be provided the autonomy to teach without his or her oversight and supervision. REPRESENTATIVE HANNAN asked how many fully certified world language teachers are licensed in Alaska and under which type of certification. MS. MERIDITH stated that there are approximately 12 teachers certified under the "Type W" limited certificate for individuals with language expertise. Across the state, she said, there are at least 100 people that are certified in a foreign language. CO-CHAIR WOOL sought clarification on how "Type M" certified teachers become tenured. 4:35:09 PM MS. MERIDITH explained that it varies from district to district and how they choose to renew the certification. CO-CHAIR WOOL restated his question, asking if a "Type M" teacher automatically gets tenured after teaching for three or four years, and whether they must continue to renew their certification. MS. MERIDITH said she did not know how districts are extending tenure to "Type M" certificates. 4:37:28 PM CO-CHAIR WOOL announced that HB 24 was held over. 4:37:45 PM The committee took an at-ease from 3:37 to 3:42 p.m. [Co-Chair Wool passed the gavel to Co-Chair LeDoux.] HB 29-INSURANCE COVERAGE FOR TELEHEALTH 4:42:12 PM CO-CHAIR LEDOUX announced that the final order of business would be HOUSE BILL NO. 29, "An Act relating to insurance coverage for benefits provided through telehealth; and providing for an effective date." 4:43:47 PM REPRESENTATIVE IVY SPOHNHOLZ, Alaska State Legislature, introduced HB 29, as prime sponsor, and paraphrased parts of the sponsor statement [included in the committee packet], which read in its entirety as follows [original punctuation provided]: HB 29 will enhance access to healthcare services, primarily mental health and primary care, for Alaskans who have insurance plans regulated by the state of Alaska. HB 29 does this by allowing providers who contract with insurers regulated by the state of Alaska to reimburse for services delivered through telehealth. Healthcare services are currently being delivered through telehealth all over the country, and Alaska is at the forefront of providing telehealth services for urban, rural, aging, and the underserved communities across the state, primarily through Medicaid and tribal health care. Some of the advantages of telehealth include: ? Better access and privacy in rural, remote, and urban areas of Alaska. ? Early intervention which can lead to savings. ? Greater access for referrals to providers who specialize in treating specific health issues. ? Better, and potentially quicker, access means a potential reduction in suicides, domestic violence and other serious events. ? Zero impact on state budget. ? Reduces the need for expensive medical travel. Under HB 29, telehealth benefits for covered healthcare services, including mental health benefits, will be reimbursable for health care providers licensed in the state without an initial in-person appointment. Depending on the patient's needs, a telehealth appointment can provide education, reviewing of prescriptions and checking symptoms, all at a distance on a secure system. Expanding access to healthcare delivered through telehealth will help to address some of Alaska's unique challenges due to our large geography, rural and aging communities, and statewide addiction epidemic. Telehealth can help Alaska improve access to healthcare, improve clinical outcomes and reduce health care costs. 4:45:29 PM CO-CHAIR LEDOUX sought clarification on what it means for a patient to be "monitored." REPRESENTATIVE SPOHNHOLZ related a personal anecdote to illustrate "self-monitoring" via telehealth. She explained that it's a method of transmitting information to a doctor without having to be there in person, adding that it's a way to use technology to improve access to care and reduce some of the burden of time and travel that comes with monitoring healthcare. CO-CHAIR LEDOUX asked if insurance would cover a consultation via telehealth. REPRESENTATIVE SPOHNHOLZ answered yes, consultations could be covered under insurance if this bill were to pass. She noted that some insurers in Alaska already cover telehealth, like Medicaid and tribal health, but not all private insurers do. 4:50:02 PM REPRESENTATIVE SPOHNHOLZ returned to her introduction of the bill. She stated that HB 29 would increase access to healthcare in Alaska, especially for rural communities, without having to travel for it. Referencing SB 74, she said one of the main reasons that telehealth coverage was included was to increase access to substance abuse and behavioral health treatment for individuals in rural Alaska. She said not every community can have their own behavioral healthcare provider; however, they could get access to telehealth care to speak with a substance abuse counselor, for example. She noted that Health Insurance Portability and Accountability Act (HIPAA) compliance is the reason special technology is used in telehealth communication. She offered her belief that HB 29 will reduce unnecessary medical travel, as well as unnecessary emergency room visits. She opined that even in urban communities where access to a doctor is readily available, telehealth is a better option than going in person. 4:53:29 PM BERNICE NISBETT, Staff, Representative Ivy Spohnholz, Alaska State Legislature, on behalf of Representative Spohnholz, prime sponsor of HB 29, presented the sectional analysis. She informed the committee that section 1 amends AS 21.42.422 to require insurance coverage for health benefits provided through telehealth technology. Section 2 provides the definitions for health care insurer and telehealth. Finally, sections 3 through 4, she said, speak to the insurance plans and the effective date, which is July 1, 2020. 4:55:08 PM REPRESENTATIVE FIELDS asked if the state of Alaska has quantified the amount of money spent on weekend ER or urgent care visits and how much money could be saved by using telehealth instead. REPRESENTATIVE SPOHNHOLZ replied that the state has not been able to quantify cost-savings, adding that there is cost avoidance, but there's no analysis that tracks the reduction in ER visits with the introduction of new telehealth services. She clarified that HB 29 is not covered by the Alaska Care plan because it's federally regulated. REPRESENTATIVE FIELDS asked what the potential savings are for plans covered by this bill. 4:58:31 PM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community & Economic Development, replied she did not have that answer right now. 4:58:49 PM REPRESENTATIVE STUTES asked if any "strictly telehealth medical facilities" currently exist. REPRESENTATIVE SPOHNHOLZ confirmed that they do, including Capstone Express and Teladoc. REPRESENTATIVE STUTES questioned whether these facilities use FaceTime. REPRESENTATIVE SPOHNHOLZ replied that they don't use FaceTime because it's not HIPAA compliant; however, there are several similar video conferencing technologies that are readily available to them. 5:01:09 PM REPRESENTATIVE HANNAN asked how many insurance companies currently use telehealth in Alaska. MS. WING-HEIER offered her understanding that currently, insurance companies are split on offering this as a benefit, adding that the reimbursement is what's in question. 5:03:01 PM MS. WING-HEIER, responding to a follow-up question from Representative Hannan, said she sees telehealth as an excellent way to allow innovation and reduce the cost of healthcare in Alaska, while increasing access to it. CO-CHAIR LEDOUX sought clarification on how someone would reach their doctor after hours via telehealth communication. REPRESENTATIVE SPOHNHOLZ explained that it depends on the clinic and the individual provider, noting that Teladoc, for example, is available 24/7. CO-CHAIR LEDOUX asked why FaceTime isn't HIPAA compliant. 5:07:08 PM WADE ERICKSON, MD, Capstone Family Medicine, replied that HIPAA compliance requires certain encryption standards that FaceTime doesn't have. CO-CHAIR LEDOUX asked if a regular telephone or cellphone can be used. DR. ERICKSON answered yes. He said it's the app on the phone that makes the difference. 5:08:12 PM CO-CHAIR LEDOUX announced that HB 29 was held over. 5:08:31 PM CO-CHAIR LEDOUX ADJOURNMENT There being no further business before the committee, the House Labor and Commerce Standing Committee meeting was adjourned at [5:08] p.m.

Document Name Date/Time Subjects
SB 29 Sponsor Statement.pdf HL&C 4/22/2019 3:15:00 PM
HL&C 4/24/2019 3:15:00 PM
SB 29
SB 29 Version A.pdf HL&C 4/22/2019 3:15:00 PM
HL&C 4/24/2019 3:15:00 PM
SB 29
SB 29 Fiscal Note.pdf HL&C 4/22/2019 3:15:00 PM
HL&C 4/24/2019 3:15:00 PM
SB 29
SB 29 Board of Marine Pilots Audit.pdf HL&C 4/22/2019 3:15:00 PM
HL&C 4/24/2019 3:15:00 PM
SB 29
SB 29 - Letter of Support SEAPA.pdf HL&C 4/24/2019 3:15:00 PM
SL&C 2/7/2019 1:30:00 PM
SB 29
SB36 Sponsor Statement 1-28-19.pdf HL&C 4/24/2019 3:15:00 PM
SFIN 3/1/2019 9:00:00 AM
SL&C 2/7/2019 1:30:00 PM
SB 36
SB36 Ver. A.PDF HL&C 4/24/2019 3:15:00 PM
SL&C 2/7/2019 1:30:00 PM
SB 36
SB36 Fiscal Note - SB036-DCCED-CBPL-02-01-19.pdf HL&C 4/24/2019 3:15:00 PM
SL&C 2/7/2019 1:30:00 PM
SB 36
SB36 Supporting Document Division of Legislative Audit Sunset Review April 2017.pdf HL&C 4/24/2019 3:15:00 PM
SFIN 3/1/2019 9:00:00 AM
SL&C 2/7/2019 1:30:00 PM
SB 36
SB36 Letter of Support BON 2-14-19.pdf HL&C 4/24/2019 3:15:00 PM
SFIN 3/1/2019 9:00:00 AM
SB 36
SB36 Letter of Support Farnstrom 2-26-19.pdf HL&C 4/24/2019 3:15:00 PM
SFIN 3/1/2019 9:00:00 AM
SB 36
SB36 Letter of Support AK Nurses Assn 2-27-19.pdf HL&C 4/24/2019 3:15:00 PM
SFIN 3/1/2019 9:00:00 AM
SB 36
SB 36 senate finance questions.pdf HL&C 4/24/2019 3:15:00 PM
SFIN 3/1/2019 9:00:00 AM
SB 36
SB 36 Letter of Support APRN 3-4-19.pdf HL&C 4/24/2019 3:15:00 PM
SFIN 3/13/2019 9:00:00 AM
SB 36
SB36 Supporting Document BON Roster 3-29-19.pdf HL&C 4/22/2019 3:15:00 PM
HL&C 4/24/2019 3:15:00 PM
SB 36
SB36 Bundled Letters of Support.pdf HL&C 4/22/2019 3:15:00 PM
HL&C 4/24/2019 3:15:00 PM
SB 36
HB 24.Sponsor.pdf HL&C 4/24/2019 3:15:00 PM
HB 24
HB 24.Bill version A.pdf HL&C 4/24/2019 3:15:00 PM
HB 24
HB 24.Sectional.pdf HL&C 4/24/2019 3:15:00 PM
HB 24
HB 24.Fiscal Note DEED.pdf HL&C 4/24/2019 3:15:00 PM
HB 24
HB 24.Backup Immersion Student Acheivement.pdf HL&C 4/24/2019 3:15:00 PM
HB 24
HB 24.Backup Support Letter Leslie Harper.pdf HL&C 4/24/2019 3:15:00 PM
HL&C 2/17/2020 3:15:00 PM
HB 24
HB 24.Backup Additional Support Letter Margi Dashevsky.pdf HL&C 4/24/2019 3:15:00 PM
HL&C 2/17/2020 3:15:00 PM
HB 24
HB 24.Backup Updated Support Letters 4.24.19.pdf HL&C 4/24/2019 3:15:00 PM
HB 24
HB 97.Sponsor.pdf HL&C 4/24/2019 3:15:00 PM
HB 97
HB 97.Bill Version U.PDF HL&C 4/24/2019 3:15:00 PM
HB 97
HB 97.Fiscal DCCED.pdf HL&C 4/24/2019 3:15:00 PM
HB 97
HB 97.Sectional.pdf HL&C 4/24/2019 3:15:00 PM
HB 97
HB 97.Summary of Changes Version A to Version U.pdf HL&C 4/24/2019 3:15:00 PM
HB 97
HB 97.Bill Version S CS for Adoption.pdf HL&C 4/24/2019 3:15:00 PM
HB 97
HB 97. Summary of Changes Version U to Verison S.pdf HL&C 4/24/2019 3:15:00 PM
HB 97
HB 97.Backup Support Letter ASHNHA.pdf HL&C 4/24/2019 3:15:00 PM
HB 97
HB 29.Sponsor.pdf HL&C 4/24/2019 3:15:00 PM
SHSS 2/19/2020 1:30:00 PM
HB 29
HB 29.Bill Version A.PDF HL&C 4/24/2019 3:15:00 PM
SHSS 2/14/2020 1:30:00 PM
SHSS 2/19/2020 1:30:00 PM
HB 29
HB 29.Fiscal Note.pdf HL&C 4/24/2019 3:15:00 PM
SHSS 2/14/2020 1:30:00 PM
SHSS 2/19/2020 1:30:00 PM
HB 29
HB 29.Presentation.pdf HL&C 4/24/2019 3:15:00 PM
SHSS 2/14/2020 1:30:00 PM
SHSS 2/19/2020 1:30:00 PM
HB 29
HB 29.Sectional.pdf HL&C 4/24/2019 3:15:00 PM
SHSS 2/14/2020 1:30:00 PM
SHSS 2/19/2020 1:30:00 PM
HB 29
HB 29.Backup Letters of Support.pdf HL&C 4/24/2019 3:15:00 PM
SHSS 2/14/2020 1:30:00 PM
SHSS 2/19/2020 1:30:00 PM
HB 29
HB 29.Backup ADN Article.pdf HL&C 4/24/2019 3:15:00 PM
SHSS 2/14/2020 1:30:00 PM
SHSS 2/19/2020 1:30:00 PM
HB 29