Legislature(2023 - 2024)DAVIS 106
03/28/2023 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Overview(s): Growing the Healthcare Workforce Pipeline from School to Career | |
| HB57 | |
| HB112 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 57 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 112 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 28, 2023
3:04 p.m.
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative Dan Saddler
Representative Jesse Sumner
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
Representative CJ McCormick
COMMITTEE CALENDAR
OVERVIEW(S): GROWING THE HEALTHCARE WORKFORCE PIPELINE FROM
SCHOOL TO CAREER
- HEARD
HOUSE BILL NO. 57
"An Act relating to review organizations and permitting an
emergency medical services provider to establish a review
organization; and relating to patient records."
- MOVED HB 57 OUT OF COMMITTEE
HOUSE BILL NO. 112
"An Act relating to the Board of Pharmacy; relating to the
practice of pharmacy; relating to pharmacies; relating to
prescription drug manufacturers; relating to prescriptions for
epinephrine; relating to the administration of epinephrine; and
providing for an effective date."
- MOVED HB 112 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 57
SHORT TITLE: EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
SPONSOR(s): REPRESENTATIVE(s) WRIGHT
02/03/23 (H) READ THE FIRST TIME - REFERRALS
02/03/23 (H) L&C, HSS
02/17/23 (H) L&C AT 3:15 PM BARNES 124
02/17/23 (H) Heard & Held
02/17/23 (H) MINUTE(L&C)
03/03/23 (H) L&C AT 3:15 PM BARNES 124
03/03/23 (H) Moved HB 57 Out of Committee
03/03/23 (H) MINUTE(L&C)
03/06/23 (H) L&C RPT 4DP 1NR
03/06/23 (H) DP: SADDLER, PRAX, RUFFRIDGE, SUMNER
03/06/23 (H) NR: CARRICK
03/21/23 (H) HSS AT 3:00 PM DAVIS 106
03/21/23 (H) Heard & Held
03/21/23 (H) MINUTE(HSS)
03/28/23 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 112
SHORT TITLE: PROFESSION OF PHARMACY
SPONSOR(s): REPRESENTATIVE(s) RUFFRIDGE
03/13/23 (H) READ THE FIRST TIME - REFERRALS
03/13/23 (H) HSS, L&C
03/23/23 (H) HSS AT 3:00 PM DAVIS 106
03/23/23 (H) Heard & Held
03/23/23 (H) MINUTE(HSS)
03/28/23 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
MISSY FRAZE, Director
Career and Technical Education
King Tech Highschool
Anchorage School District
Anchorage, Alaska
POSITION STATEMENT: Gave a PowerPoint presentation, titled
"Apprenticeship and Work-Based Learning" during the overview on
growing the health care workforce.
ANDREA ANDRASCHKO, Assistant Professor
Business Administration, Health Occupations, and Health Sciences
Alaska Pacific University
Anchorage, Alaska
POSITION STATEMENT: Presented during the overview on growing
the health care workforce.
TRISH ZUGG, Administrator
Career and Technical Education Program
Matanuska-Susitna Borough School District
Palmer, Alaska
POSITION STATEMENT: Presented during the overview on growing
the health care workforce.
GLORIA BURNETT, Director
Alaska Center for Rural Health and Health Workforce
Nome, Alaska
POSITION STATEMENT: Presented during the overview on growing
the health care workforce.
REPRESENTATIVE STANLEY WRIGHT
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As the prime sponsor, presented HB 57.
PI GIORDAN-RANDAL, Staff
Representative Stanley Wright
Juneau, Alaska
POSITION STATEMENT: On behalf of Representative Wright, prime
sponsor, presented the sectional analysis for HB 57.
MARK JOHNSON, representing self
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 57.
ASHLEY SCHABER, Pharm D, MBA, BCPS, NCPS
Board of Pharmacy
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community, and Economic Development
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
112.
DUANE WOOD, representing self
Prince of Wales Island, Alaska
POSITION STATEMENT: Testified in support of HB 112.
AMITY WINBORG, representing self
Chugiak, Alaska
POSITION STATEMENT: Testified in support of HB 112.
BARRY CHRISTENSEN, RPh, Co-Chair
Legislative Committee
Alaska Pharmacist Association
Ketchikan, Alaska
POSITION STATEMENT: Testified in support of HB 112.
SCOTT WATTS, representing self
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 112.
ACTION NARRATIVE
3:04:59 PM
CHAIR MIKE PRAX called the House Health and Social Services
Standing Committee meeting to order at 3:04 p.m.
Representatives Ruffridge, Sumner, Fields, Mina, and Prax were
present at the call to order. Representative Saddler arrived as
the meeting was in progress.
^OVERVIEW(S): Growing the Healthcare Workforce Pipeline from
School to Career
OVERVIEW(S): Growing the Healthcare Workforce Pipeline from
School to Career
3:06:01 PM
CHAIR PRAX announced that the first order of business would be
the overview on growing the healthcare workforce pipeline from
school to career.
3:07:06 PM
MISSY FRAZE, Career and Technical Education Director, King Tech
Highschool, Anchorage School District (ASD), gave a PowerPoint
presentation, titled "Apprenticeship and Work-Based Learning"
[hardcopy included in the committee packet]. She reviewed the
career pathways offered by ASD, as seen on slide 2. This
includes health care career options provided in five high
schools and the options for industry certification and dual
enrollment. On slide 3, she pointed to a future program for
pharmacy technicians; however, she added that for this there
would need to be regulation changes. She discussed the age
requirement that companies have for some jobs in the health care
sector, and in order to expand the health care workforce, she
suggested the possibility of companies changing this internal
policy. She pointed out that youth who begin a career earlier
in life in Alaska are more likely to stay in Alaska.
3:12:56 PM
MS. FRAZE discussed the need for a "state vision" concerning
work-based learning and workforce development. She discussed
the challenges to this, as seen on slide 4. This includes the
lack of a coordinated cross-agency vision, the lack of data to
measure effective work-based learning, and the need for policy
changes.
MS. FRAZE moved to slide 5, which addressed how the legislature
could help. The slide listed: work with governor to create a
statewide coalition; use examples from proven agencies like the
National Governors Association or Jobs for the Future to create
a system; increase cross-agency participation to support
business and education; and fund education and workforce
development.
3:18:08 PM
REPRESENTATIVE MINA questioned the top three careers that
students are interested in pursuing through apprenticeships.
MS. FRAZE answered that there are 22 students in King Tech's
pharmacy technician program, and according to the teacher, 30
percent of the students are interested in having a career as a
pharmacy technician. She pointed out that, while the field may
not be a long-term career choice, it is an entry into a career
pathway. She said students have been asked about internships,
but students are not interested because there would be no pay.
REPRESENTATIVE MINA offered her understanding that
apprenticeships in the health care industry would focus on entry
level positions. She pointed out the nurse shortages and asked
how the school-based apprenticeships would work with this need.
MS. FRAZE explained that attaining a certified nursing assistant
(CNA) certification would be required to get a nursing degree;
therefore, having students in this program would help address
the problem. She said that any of the career pathways and
apprenticeships could provide the certification, and this would
allow the student to work while studying. In response to
whether health care jobs would hire minors, she stated that this
would be community dependent. She relayed that care centers in
Valdez and Kodiak are looking to hire CNAs, while in Anchorage
food service attendants are needed. She said that these jobs
would be the starting point for employing minors. She noted
that there are not many health care employers who are interested
in hiring minors.
3:24:36 PM
REPRESENTATIVE SADDLER questioned the jobs that would require
entities to change internal policies.
MS. FRAZE answered that this would include CNAs and room
attendants.
REPRESENTATIVE SADDLER, in relation to the lack of data to
measure progress, questioned the data used to set up the five
vocational programs for high school students in ASD. He
questioned how it was decided that pharmacy technicians,
emergency medical technicians (EMTs), CNAs, and biomedical
innovations would the appropriate initial programs.
MS. FRAZE responded that general workforce data was used to
determine demand. She said that pharmacy technician jobs in
Anchorage are in demand. In response to a follow up question,
she explained that the data was pulled from the Department of
Labor, as well as data from the Anchorage Economic Development
Corporation.
3:27:08 PM
CHAIR PRAX, referencing the need to change regulations,
questioned whether there has been any action on this.
MS. FRAZE answered that the changes needed are specific for
pharmacy technicians, as the regulation requires technicians to
be 18 years old and have a high school diploma. She explained
that the change would allow high school students to do
apprenticeships while in school. In response to a follow-up
question, she stated that the age requirement is set by the
state, and almost all states do this.
CHAIR PRAX questioned the meaning of "cross-agency," as used in
the presentation.
MS. FRAZE explained that "cross-agency" coordination would
include the Department of Education, the Department of Labor and
Workforce Development, and the Department of Commerce,
Community, and Economic Development to collaboratively work
together statewide.
3:31:14 PM
ANDREA ANDRASCHKO, Assistant Professor, Business Administration,
Health Occupations, and Health Sciences, Alaska Pacific
University (APU), presented during the overview on growing the
health care workforce. She explained that APU partners with the
Alaska Primary Care Association (APCA) to provide college
credits for students doing apprenticeships. She said the
program aligns with the associate degrees, bachelor's degrees,
and master's degrees, allowing students to start careers
straight out of high school. She stated that students can come
back to take classes to get an associate or bachelor's degree.
She stated that APU is interested in working with as many
organizations as possible to encourage the program.
3:34:45 PM
REPRESENTATIVE MINA shared that in her district there are a good
amount of immigrants and refugees who struggle getting
registered for college, as their high school diplomas are from a
different country.
MS. ANDRASCHKO responded that there are processes in place to
verify international diplomas. In response to a follow-up
question regarding the registration process, she explained that
there is an online registration system and hands-on assistance
options. She expressed uncertainty whether APU provides
language assistance.
3:37:42 PM
REPRESENTATIVE SADDLER questioned whether the class work would
be the same for a student in a two-year associate degree program
as it would be for a student who moves from a two-year to a
four-year degree program.
MS. ANDRASCHKO answered that it is configured so students who
are in an associate degree program would also be working towards
a bachelor's degree.
REPRESENTATIVE SADDLER questioned the transferability of
credits, as in the example of an associate level student's
ability to transfer credits from APU to the University of Alaska
Anchorage (UAA).
MS. ANDRASCHKO expressed the understanding that credits would be
compatible in both directions; however, she acknowledged that
this is not a full answer. She offered to report back to the
committee.
3:40:28 PM
CHAIR PRAX asked if APU programs are open to high school-age
students.
MS. ANDRASCHKO responded that APU has the Early Honors Program,
which works with high school-age students, and this is similar
to UAA's Middle College School. She continued that for
apprenticeship programs, a high school diploma would be
required, but APU does have college courses that high school
students can take. In response to a follow-up question, she
stated that APU only has a partnership with APCA; however, she
offered that APU is open to working with any organization that
aligns with the program.
3:42:30 PM
REPRESENTATIVE FIELDS offered the understanding that the
Alliance for Physician Certification and Advancement and the
American Heart Association are involved with the Good Jobs
Challenge grant program. He suggested that this would create
more apprenticeship opportunities for hospitals and long-term
care facilities because hospitals could leverage this
infrastructure, with APU and UAA providing the training.
3:44:23 PM
The committee took an at-ease from 3:44 p.m. to 3:45 p.m. [due
to technical difficulties].
3:45:31 PM
TRISH ZUGG, Administrator, Career and Technical Education
Program, Matanuska-Susitna (Mat-Su) Borough School District,
presented during the overview on growing the health care
workforce. She disclosed that she serves on the governor's
Alaska Workforce Investment Board, as well as on the Alaska
Commission on Postsecondary Education. She stated that at the
school district she oversees the district's career and technical
education (CTE) program, which has the Health Pathway program.
She pointed out that within this program there has been a CNA
program for 20 years, which is board certified. She added that
at full capacity, the program can graduate 80 students a year.
To have exposure to the health care environment, she explained
that the CNA students perform clinicals at hospitals in the
Anchorage and Mat-Su boroughs. She stated that this leads to
students attaining internships and pre-apprenticeships at the
facilities where they work. She listed some of the other
programs offered, such as for pharmacy technicians and dental
assistants.
MS. ZUGG discussed the expansion of programs in the district and
pointed out the opening of the Houston High School, which has a
full-time healthcare instructor. She added that the district is
a sub-recipient of the Good Jobs Challenge grant, which has
enabled an expansion in instruction and the hiring of a work-
based learning coordinator. Also, as part of the growth
potential, she said there is work on developing programs for
behavior health assistants, personal care assistants, physical
care assistants, and surgical technicians. She pointed out
that, since the program is board certified, high school students
would come out of school with credentials.
MS. ZUGG gave examples of students who have succeeded in the
program, as one student is now a doctor on Joint-Base Elmendorf
Richardson and two students in the pharmacy technician program
are becoming pharmacists. She noted that HB 31, which addresses
the Alaska Performance Scholarship, would allow local students
to use these funds in a more modernized fashion.
3:53:40 PM
REPRESENTATIVE FIELDS asked whether the Good Jobs Challenge
funding is supporting the work-based learning coordinator for
the Mat-Su school district.
MS. ZUGG explained that the districts are sub-recipients, so
secondary partners would receive part of the grant. She
continued that over 3 years the Mat-Su district would receive
$300,000 in funding, which is not enough for a full-time
coordinator; therefore, the funding will be used towards a part-
time position.
REPRESENTATIVE FIELDS suggested that the $3 million in funding
the legislature added for CTE could help in providing a full-
time work-based coordinator.
3:55:03 PM
REPRESENTATIVE MINA inquired as to whether there are any student
vacancies in the program.
MS. ZUGG answered that there has been a marketing campaign to
get federal funds through the Perkins Act for CTE. She stated
that to qualify for the funding, a comprehensive local needs
assessment is required, and from this assessment it was found
that stakeholders in the community need to be better informed
about the CTE options available. She said there has been
outreach with high schools about CTE offerings. She discussed
efforts at engaging students better. She expressed the hope
that one day the problem would be that too many students want to
participate. She added that some of the areas of career tech
are at capacity.
REPRESENTATIVE MINA commended the school district for its
investment and outreach on these programs. She questioned
whether students are helped with class scheduling with
apprenticeships.
MS. ZUGG responded that the district has the Four C's Program:
college, career, community, and credit, which is held at the end
of the day, Tuesdays through Fridays. She stated that this is
when all the stakeholders and teachers are engaged in transition
planning with students to help them map out high school. In
response to a follow-up question concerning scheduling with
apprenticeship programs, she opined that scheduling is always a
challenge with students. She said ASD has a goal that all
students graduate college, career, and life ready. She
explained that less than 50 percent of all students choose a CTE
pathway.
4:02:46 PM
GLORIA BURNETT, Director, Alaska Center for Rural Health and
Health Workforce, presented during the overview on growing the
health care workforce. She shared that she operates the Area
Health Education Centers (AHEC) program, which is federally
funded through the Health Resources and Services Administration.
She stated that these funds are dedicated to statewide workforce
development, with a focus on rural and underserved communities.
She explained that most healthcare providers are trained in
urban settings; therefore, more likely to work in an urban
setting. She suggested that this leaves a workforce
distribution problem. She pointed out that local individuals
who train locally are more likely to stay in the community. She
noted that it is hard to run distance programs because of [poor
internet connectivity] in rural communities, so there is a lack
of health science education there; however, AHEC provides
support to fill in the gaps. She said that the Good Jobs
Challenge provides an opportunity to expand pre-apprenticeship
academy work. She suggested that the health care community has
come a long way in accepting apprenticeships, and the Good Jobs
Challenge will further help in making the health care program an
embedded pathway. She maintained that if there were triple the
graduates in the state, there still would be an insufficient
amount of health care providers. She stated that the center is
capitalizing on what is being built in the urban centers and
bringing this to rural sites. She added that the COVID-19
funding that came to AHEC was used for middle school programing,
which helped expose these children to careers early.
4:09:52 PM
REPRESENTATIVE FIELDS asked how many students are not reached by
AHEC.
MS. BURNETT explained that there are six regional centers across
the state, with only two centers having more than one staff.
She surmised that if centers had more staffing, the number of
students who could be reached would increase. She offered to
follow up and provide members with her annual report and
information regarding capacity. She stated that if there were
more staffing in the regional centers, students who could be
reached would go from 1,500 a year to 3,000 a year. She said
that the current demand cannot be met, and the program has had
to turn away from sending instructors to some communities.
4:12:50 PM
REPRESENTATIVE MINA asked what percentage of applicants get
approved in an apprenticeship program.
MS. BURNETT responded that every apprenticeship has its own
individual host organization. She said that there are about 250
successful path-academy participants per quarter, with more pre-
apprentices than apprenticeships set up; however, while some
students may not be going into apprenticeships, they are getting
hired. She shared that the program holds mock interviews with
local providers and students, with students often getting
multiple job offers at the end.
4:15:35 PM
The committee took an at-ease from 4:15 p.m. to 4:17 p.m.
HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
4:17:27 PM
CHAIR PRAX announced that the next order of business would be
HOUSE BILL NO. 57, "An Act relating to review organizations and
permitting an emergency medical services provider to establish a
review organization; and relating to patient records."
4:18:31 PM
PI GIORDAN-RANDAL, Staff, Representative Stanley Wright, on
behalf of Representative Wright, prime sponsor, presented the
sectional analysis for HB 57 [copy included in the committee
packet], which read as follows [original punctuation provided]:
Section I:
Amends AS 18.23.070(1) to Include EMT's, dispatchers,
and paramedics in the definition of "health care
provider" for the purpose of peer review protection.
Section II:
Amends the definition of "healthcare provider" in AS
18.23.070(3) to include EMS agencies and employees who
are conducting peer review activities.
Section III:
AS 18.23.070(5) is amended to include emergency
medical services agencies and employees under the
definition of a "review organization"
4:19:47 PM
CHAIR PRAX opened public testimony on HB 57.
4:20:12 PM
MARK JOHNSON, representing self, shared that he is retired, and
he had been the chief of emergency medical services (EMSs) in
the state from 1979 to 2004. He advised that at that time,
quality was promoted by testing, continuing education, and
oversight by physicians. He expressed the opinion that HB 57
would take quality to the next level. He said that EMS response
times are critical, with decisions being made quickly. He
advised that it is valuable to review responses afterwards,
which HB 57 would provide. He observed that it is fitting the
hearing is in the Bettye Davis room because she had co-sponsored
trauma system legislation, and this had improved trauma care in
the state.
4:23:32 PM
CHAIR PRAX, after ascertaining that there was no one else who
wished to testify, closed public testimony.
4:23:48 PM
The committee took an at-ease from 4:23 p.m. to 4:24 p.m.
4:24:57 PM
REPRESENTATIVE RUFFRIDGE moved to report HB 57 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 57 was reported out of the
House Health and Social Services Standing Committee.
4:25:39 PM
The committee took an at-ease from 4:25 p.m. to 4:27 p.m.
HB 112-PROFESSION OF PHARMACY
4:27:51 PM
CHAIR PRAX announced that the final order of business would be
HOUSE BILL NO. 112, "An Act relating to the Board of Pharmacy;
relating to the practice of pharmacy; relating to pharmacies;
relating to prescription drug manufacturers; relating to
prescriptions for epinephrine; relating to the administration of
epinephrine; and providing for an effective date."
4:28:10 PM
REPRESENTATIVE RUFFRIDGE, as prime sponsor, explained that after
a multiple-year process of examining regulatory updates, HB 112
would change the statute. At the request of the governor, he
said that regulations had been reviewed, and areas that needed
changes were found.
4:29:20 PM
REPRESENTATIVE FIELDS reiterated that it would be helpful if
work-based learning programs for pharmacy technicians allowed
those under 18 years of age to work. He asked whether the Board
of Pharmacy would need to update these regulations.
REPRESENTATIVE RUFFRIDGE answered that current regulations for
pharmacy technicians require the person to be 18 years of age
and have a high school diploma. He continued that statute
allows the Board of Pharmacy to control licensing regulations
for pharmacy technicians. He said that other than having the
board adjust the regulations, there would be no other barriers.
4:30:48 PM
ASHLEY SCHABER, Pharm D, MBA, BCPS, NCPS, Board of Pharmacy,
Division of Corporations, Business and Professional Licensing,
Department of Commerce, Community, and Economic Development,
said that the changes requested would be regulatory; therefore,
this would not require a change in statute. In response to a
question from Representative Ruffridge, she answered that the
board is already discussing the regulatory changes, as this
would optimize the workforce by increasing pharmacy technician
training.
4:32:18 PM
CHAIR PRAX opened public testimony on HB 112.
4:32:43 PM
DUANE WOOD, representing self, shared that he is a lifelong
Alaskan, and a third-year pharmacy student who is working as a
volunteer in rural emergency medicine on Prince of Wales Island.
He said that he plans to work as a pharmacist in the state after
he graduates. He explained that changes in the proposed bill
would improve the ability of patients and the community to be
served. He shared a personal story about a fatal allergy a
friend had and how an EpiPen had saved the person's life. He
pointed out that HB 112 would improve access to EpiPens by
allowing pharmacists to prescribe them. He urged members to
approve HB 112.
4:35:00 PM
AMITY WINBORG, representing self, shared that she is a third-
year pharmacy student in the joint doctorate pharmacy program at
University of Alaska and Idaho State University. She said she
has lived in Alaska for 20 years and has worked in both
community and hospital pharmacies. She advised that HB 112
would positively impact patients. She explained that patient
safety has been at the forefront of her pharmacy training, which
has led to new health initiatives, like HB 112. She stated that
creating a pharmacy technician seat on the Board of Pharmacy
would ensure that multiple viewpoints are being represented.
She explained that HB 112 would increase patient safety by
ensuring that the board could regulate qualifications and
entities. She reiterated that it would also increase patient
access to EpiPens by allowing pharmacies to prescribe and
dispense them.
4:37:29 PM
BARRY CHRISTENSEN, RPh, Co-Chair, Legislative Committee, Alaska
Pharmacist Association, shared that he has owned and operated
Island Pharmacy for 49 years. He testified in support of HB 112
on behalf of the Alaska Pharmacist Association.
4:38:36 PM
SCOTT WATTS, representing self, stated that he is a pharmacist
and supports HB 112. He explained that, as a pharmacist for 33
years in Juneau, he can attest to the changes the profession has
seen. He highlighted that the bill would add a pharmacy
technician to the board and increase access to EpiPens. He
added that the bill would also provide the power to the board to
support the Drug Supply Chain and Security Act.
4:41:03 PM
CHAIR PRAX, after ascertaining that there was no one else who
wished to testify, closed public testimony.
4:42:12 PM
REPRESENTATIVE RUFFRIDGE moved to report HB 112 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 112 was reported out of the
House Health and Social Services Standing Committee.
4:42:38 PM
The committee took an at-ease from 4:42 p.m. to 4:44 p.m.
4:44:42 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:44 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| APU Health Occupations Presentation.pptx |
HHSS 3/28/2023 3:00:00 PM |
Overview: Health Care Workforce |
| Health and Human Panel ASD Missy Fraze.pptx |
HHSS 3/28/2023 3:00:00 PM |
Healthcare Workforce Pres. |