Legislature(2021 - 2022)BUTROVICH 205

04/20/2021 01:30 PM HEALTH & SOCIAL SERVICES

Note: the audio and video recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.

Download Mp3. <- Right click and save file as

* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 67 NURSING: LICENSURE; MULTISTATE COMPACT TELECONFERENCED
Failed to Move Out of Committee
+= SB 78 HEALTH CARE SERVICES BY TELEHEALTH TELECONFERENCED
Moved CSSB 78(HSS) Out of Committee
+= SB 80 PUBLIC SCHOOLS: MENTAL HEALTH EDUCATION TELECONFERENCED
Moved CSSB 80(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         April 20, 2021                                                                                         
                           1:32 p.m.                                                                                            
                                                                                                                                
                             DRAFT                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator David Wilson, Chair                                                                                                     
Senator Shelley Hughes, Vice Chair                                                                                              
Senator Mia Costello                                                                                                            
Senator Lora Reinbold                                                                                                           
Senator Tom Begich                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 67                                                                                                              
"An Act relating to the licensure of nursing professionals;                                                                     
relating to a multistate nurse licensure compact; and providing                                                                 
for an effective date."                                                                                                         
                                                                                                                                
     - FAILED TO MOVE OUT OF COMMITTEE                                                                                          
                                                                                                                                
SENATE BILL NO. 78                                                                                                              
"An Act relating to telehealth."                                                                                                
                                                                                                                                
     - MOVED CSSB 78(HSS) OUT OF COMMITTEE                                                                                      
                                                                                                                                
SENATE BILL NO. 80                                                                                                              
"An Act relating to mental health education."                                                                                   
                                                                                                                                
     - MOVED CSSB 80(HSS) OUT OF COMMITTEE                                                                                      
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB  67                                                                                                                  
SHORT TITLE: NURSING: LICENSURE; MULTISTATE COMPACT                                                                             
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
02/03/21       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/03/21       (S)       HSS, L&C                                                                                               
02/23/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
02/23/21       (S)       Heard & Held                                                                                           
02/23/21       (S)       MINUTE(HSS)                                                                                            
02/25/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
02/25/21       (S)       -- Public Testimony --                                                                                 
04/15/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/15/21       (S)       Heard & Held                                                                                           
04/15/21       (S)       MINUTE(HSS)                                                                                            
04/20/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  78                                                                                                                  
SHORT TITLE: HEALTH CARE SERVICES BY TELEHEALTH                                                                                 
SPONSOR(s): LABOR & COMMERCE                                                                                                    
                                                                                                                                
02/10/21       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/10/21       (S)       HSS, L&C                                                                                               
03/02/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/02/21       (S)       Heard & Held                                                                                           
03/02/21       (S)       MINUTE(HSS)                                                                                            
04/09/21       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
04/09/21       (S)       -- MEETING CANCELED --                                                                                 
04/15/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/15/21       (S)       Scheduled but Not Heard                                                                                
04/20/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  80                                                                                                                  
SHORT TITLE: PUBLIC SCHOOLS: MENTAL HEALTH EDUCATION                                                                            
SPONSOR(s): GRAY-JACKSON                                                                                                        
                                                                                                                                
02/12/21       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/12/21       (S)       EDC, HSS, FIN                                                                                          
03/10/21       (S)       EDC AT 9:00 AM BUTROVICH 205                                                                           
03/10/21       (S)       Heard & Held                                                                                           
03/10/21       (S)       MINUTE(EDC)                                                                                            
03/19/21       (S)       EDC AT 9:00 AM BUTROVICH 205                                                                           
03/19/21       (S)       -- Invited & Public Testimony --                                                                       
03/22/21       (S)       EDC AT 9:00 AM BUTROVICH 205                                                                           
03/22/21       (S)       Moved CSSB 80(EDC) Out of Committee                                                                    
03/22/21       (S)       MINUTE(EDC)                                                                                            
03/24/21       (S)       EDC RPT CS  1DP 2NR SAME TITLE                                                                         
03/24/21       (S)       NR: HOLLAND, HUGHES                                                                                    
03/24/21       (S)       DP: BEGICH                                                                                             
04/06/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/06/21       (S)       Heard & Held                                                                                           
04/06/21       (S)       MINUTE(HSS)                                                                                            
04/15/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/15/21       (S)       Scheduled but Not Heard                                                                                
04/20/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
SARA CHAMBERS, Director                                                                                                         
Division of Corporations, Business and Professional Licensing                                                                   
Department of Commerce, Community and Economic Development                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified and answered questions on SB 67.                                                                
                                                                                                                                
REBECCA Fotsch, Director                                                                                                        
State Advocacy and Legislative Affairs                                                                                          
National Council of State Boards of Nursing                                                                                     
Chicago, Illinois                                                                                                               
POSITION STATEMENT: Answered questions on SB 67.                                                                              
                                                                                                                                
DANETTE SCHLOEDER, Chair                                                                                                        
Alaska Board of Nursing                                                                                                         
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered questions related to SB 67.                                                                      
                                                                                                                                
KATIE MCCALL, Staff                                                                                                             
Senator Mia Costello                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented and overview of SB 78.                                                                          
                                                                                                                                
SENATOR ELVI GRAY-JACKSON                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of SB 80.                                                                                         
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:32:36 PM                                                                                                                    
CHAIR DAVID WILSON  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:32 p.m.  Present at the                                                               
call to  order were Senators Costello,  Reinbold, Begich, Hughes,                                                               
and Chair Wilson.                                                                                                               
                                                                                                                                
                                                                                                                              
         SB  67-NURSING: LICENSURE; MULTISTATE COMPACT                                                                      
                                                                                                                                
1:33:18 PM                                                                                                                    
CHAIR WILSON announced the consideration of SENATE BILL NO. 67                                                                  
"An Act relating to the licensure of nursing professionals;                                                                     
relating to  a multistate nurse licensure  compact; and providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
He  noted the  committee  heard an  overview of  the  bill and  a                                                               
sectional  analysis   and  took  public  testimony   at  previous                                                               
hearings.                                                                                                                       
                                                                                                                                
CHAIR WILSON  recalled the committee began  the amendment process                                                               
on April 15. There was a  motion pending to adopt Amendment 4 and                                                               
an  objection for  the purpose  of discussion.  He asked  Senator                                                               
Begich to refresh the committee's memories about the amendment.                                                                 
                                                                                                                                
1:34:30 PM                                                                                                                    
SENATOR BEGICH stated  Amendment 4, under AS  08.68.330, adds the                                                               
requirement   that   multistate  licensed   nurses   successfully                                                               
complete  two  hours of  board  approved  Alaska Native  cultures                                                               
training. He noted  that Alaska is unique,  as twenty-one percent                                                               
of its population is comprised of indigenous peoples.                                                                           
                                                                                                                                
CHAIR  WILSON remarked  that the  purpose  of the  meeting is  to                                                               
discuss  whether  the  amendments   will  negatively  impact  the                                                               
nursing compact.                                                                                                                
                                                                                                                                
1:35:40 PM                                                                                                                    
SARA CHAMBERS,  Director, Division of Corporations,  Business and                                                               
Professional  Licensing, Department  of  Commerce, Community  and                                                               
Economic  Development,  Juneau,  Alaska,  stated  a  foundational                                                               
concept  of the  Nurse  Licensure Compact  (NLC)  is that  states                                                               
cannot  impose additional  preemployment restrictions  on nurses.                                                               
Amendment  4   would  be  a   restriction  and  kill   the  bill.                                                               
Previously,  members  inquired  whether  the  training  could  be                                                               
required after a  nurse is hired. She suggested  Ms. Fotsch speak                                                               
to that consideration.                                                                                                          
                                                                                                                                
1:37:28 PM                                                                                                                    
REBECCA   Fotsch,  Director,   State  Advocacy   and  Legislative                                                               
Affairs, National  Council of State  Boards of  Nursing, Chicago,                                                               
Illinois, commented  that she could  check with the  attorney for                                                               
the  Nurse  Licensure  Compact (NLC)  to  determine  whether  the                                                               
amendment  would  be considered  a  material  deviation from  the                                                               
agreement.  The  requirement  is   a  problem  because  it  would                                                               
decrease  efficiency and  fluid  mobility. Nurses  would need  to                                                               
keep track of what each state requires.                                                                                         
                                                                                                                                
SENATOR  REINBOLD commented  that  Amendment 4  is respectful  to                                                               
Alaska Natives  and people living  in remote areas, but  she does                                                               
not like  to yield authority to  a compact she has  not seen. She                                                               
asserted  training  could  be  accomplished  during  the  nurse's                                                               
flight  to  Alaska. She  does  not  like  the compact's  lack  of                                                               
flexibility. She will vote for the amendment.                                                                                   
                                                                                                                                
1:39:52 PM                                                                                                                    
SENATOR BEGICH stated that a  state cedes its ability to regulate                                                               
nurses when  it joins  the compact.  His goal  is to  protect the                                                               
state's  interest. The  state will  not be  able to  make changes                                                               
unless every  state in  the compact accepts  it. He  is concerned                                                               
that the state would be  surrendering sovereignty and expressed a                                                               
desire  to have  an attorney  determine if  Amendment 4  could be                                                               
accepted by the compact.                                                                                                        
                                                                                                                                
CHAIR WILSON  noted nurses licensed  in Alaska currently  are not                                                               
required to  take a  course in Alaska  Native cultures.  He asked                                                               
Danette Schloeder to comment.                                                                                                   
                                                                                                                                
1:41:59 PM                                                                                                                    
DANETTE  SCHLOEDER, Chair,  Alaska Board  of Nursing,  Anchorage,                                                               
Alaska, replied correct;  Amendment 4 would only  apply to nurses                                                               
working under  a multistate license  and not nurses who  chose to                                                               
have  a single  state license.  She  said the  value of  cultural                                                               
education  would  benefit  all  healthcare  providers,  not  just                                                               
multistate licensed nurses.                                                                                                     
                                                                                                                                
SENATOR HUGHES  expressed disappointment that the  department had                                                               
not  learned whether  Amendment  4  would be  a  problem for  the                                                               
compact. Many nurses  in her district want  a multistate license.                                                               
She  agreed with  Ms. Schloeder  that cultural  training for  all                                                               
healthcare  providers  would be  ideal,  but  it  is not  in  the                                                               
committee's purview.  She remarked that  problems with SB  67 can                                                               
be addressed in the next committee of referral.                                                                                 
                                                                                                                                
1:44:04 PM                                                                                                                    
CHAIR   WILSON  removed   his  objection;   finding  no   further                                                               
objection, Amendment 4 passed.                                                                                                  
                                                                                                                                
He asked Ms. Chambers if she had any final comments.                                                                            
                                                                                                                                
MS. CHAMBERS  replied that there  are misunderstandings  about SB
67.  She clarified  that the  entire compact  is included  in the                                                               
bill. The bill document, SB 67, is the compact.                                                                                 
                                                                                                                                
She  continued that  it is  not  true that  entering the  compact                                                               
causes the  state to lose its  ability to govern the  practice of                                                               
nursing. The  Alaska Board  of Nursing  governs the  practice and                                                               
discipline of nursing in Alaska.  The board can adopt regulations                                                               
to respond to needs in the practice of nursing.                                                                                 
                                                                                                                                
Most of Alaska's  nurses are from out of state.  There are twenty                                                               
thousand  nurses  in  the  state  of Alaska.  They  are  not  all                                                               
residents. Currently,  the department  does not require  what the                                                               
members are  concerned about. The  multistate license  provides a                                                               
faster  way  for nurses,  who  qualify  at higher  standards,  to                                                               
practice  in  Alaska. That  is  all  it  does;  the rest  of  the                                                               
jurisdiction stays with the Alaska Board of Nursing.                                                                            
                                                                                                                                
She  would   like  to   alleviate  concerns,   misunderstands  or                                                               
questions the committee  has. SB 67 gets  highly qualified nurses                                                               
to Alaska practicing  under the jurisdiction of  the Alaska Board                                                               
of Nursing.                                                                                                                     
                                                                                                                                
1:46:58 PM                                                                                                                    
SENATOR BEGICH challenged the claim  that most of Alaska's nurses                                                               
are from outside the state  and requested evidence. The committee                                                               
was  informed that  the state  cannot amend  the compact  without                                                               
approval from all  compact states. He contended  that the compact                                                               
would disallow any regulatory changes  that materially impact the                                                               
agreement  and  the  legislature  would  not  be  able  to  amend                                                               
statutes without  approval. He asked  Ms. Chambers to  explain if                                                               
he is wrong.                                                                                                                    
                                                                                                                                
SENATOR REINBOLD agreed that testimony  was conflicting. She will                                                               
vote no on SB 67  because it undermines legislative authority and                                                               
decreases  state  sovereignty.  The Alaska  Alliance  on  Retired                                                               
Americans,  the  American Federation  of  Labor  and Congress  of                                                               
Industrial   Organizations  (AFL-CIO)   and  the   Alaska  Nurses                                                               
Association provided solid reasons for voting no on SB 67.                                                                      
                                                                                                                                
CHAIR WILSON solicited a motion to move the bill from committee.                                                                
                                                                                                                                
1:49:41 PM                                                                                                                    
SENATOR HUGHES moved  to report SB 67, work  order 32-GS1603\A as                                                               
amended,  from  committee  with  individual  recommendations  and                                                               
attached fiscal note(s).                                                                                                        
                                                                                                                                
1:49:50 PM                                                                                                                    
SENATOR REINBOLD objected.                                                                                                      
                                                                                                                                
1:50:16 PM                                                                                                                    
A roll call  vote was taken. Senators Hughes and  Wilson voted in                                                               
favor of the  motion and Senators Costello,  Reinbold, and Begich                                                               
voted  against it.  Therefore, SB  67  as amended,  failed to  be                                                               
reported from the Senate Health  and Social Services Committee by                                                               
a 2:3 vote.                                                                                                                     
                                                                                                                                
           SB  78-HEALTH CARE SERVICES BY TELEHEALTH                                                                        
                                                                                                                                
1:50:28 PM                                                                                                                    
CHAIR WILSON  announced the consideration  of SENATE BILL  NO. 78                                                               
"An Act relating to telehealth."                                                                                                
                                                                                                                                
SENATOR  COSTELLO   stated  that  Governor   Dunleavy  introduced                                                               
legislation extending the  disaster declaration retroactively and                                                               
into the future. She opined that  Alaskans are ready to move into                                                               
a recovery  phase so  it would  be better to  make laws  that are                                                               
COVID aware. The Labor and  Commerce Committee introduced a suite                                                               
of bills  to determine whether  practices, which  began following                                                               
the disaster declaration, would be  allowed to continue. SB 78 is                                                               
one of those bills.                                                                                                             
                                                                                                                                
1:52:38 PM                                                                                                                    
KATIE  MCCALL,   Staff,  Senator   Mia  Costello,   Alaska  State                                                               
Legislature, Juneau, Alaska, stated SB  78 was taken from Section                                                               
6  of  the  Governor's  disaster   declaration  bill.  It  allows                                                               
licensed  healthcare providers  and  nurses  to provide  services                                                               
through telehealth in their licensed field.                                                                                     
                                                                                                                                
1:53:56 PM                                                                                                                    
CHAIR WILSON moved Amendment 1.                                                                                                 
                                                                                                                                
                                                                                                                                
                          AMENDMENT 1                                                                                       
                                                                                                                                
                                               32-LS0532\A.1                                                                    
                                                      Fisher                                                                    
                                                     4/14/21                                                                    
                                                                                                                                
     OFFERED IN THE SENATE                 BY SENATOR WILSON                                                                    
        TO: SB 78                                                                                                               
                                                                                                                                
     Page 1, following line 2:                                                                                                  
          Insert new bill sections to read:                                                                                     
        "* Section  1. AS 08.15 is  amended by adding  a new                                                                
     section to read:                                                                                                           
          Sec. 08.15.045. Telehealth. (a) A person licensed                                                                   
     under  this  chapter  may  practice  behavior  analysis                                                                    
     through  telehealth as  defined  in AS 47.05.270(e).  A                                                                    
     person  licensed  to   practice  behavior  analysis  in                                                                    
     another  jurisdiction  may practice  behavior  analysis                                                                    
     through telehealth with a patient  in this state if the                                                                    
     person's   license  is   in  good   standing  in   that                                                                    
     jurisdiction.                                                                                                              
          (b)  If a person licensed to practice behavior                                                                        
     analysis  determines  in  the course  of  a  telehealth                                                                    
     encounter  with  a  patient  that  the  encounter  will                                                                    
     extend  beyond  the   licensee's  authorized  scope  of                                                                    
     practice, the  licensee shall  advise the  patient that                                                                    
     the licensee is not  authorized to provide the services                                                                    
     to the  patient, recommend that the  patient contact an                                                                    
     appropriate provider, and  terminate the encounter. The                                                                    
     licensee may  not charge  for services  provided during                                                                    
     an encounter described in this subsection.                                                                                 
          (c)  A fee for a service provided through                                                                             
     telehealth under  this section  must be  reasonable and                                                                    
     consistent with the ordinary  fee typically charged for                                                                    
     that  service and  may not  be more  than five  percent                                                                    
     above  the  ordinary  fee typically  charged  for  that                                                                    
     service.                                                                                                                   
        *  Sec.  2. AS 08.29  is  amended  by adding  a  new                                                                  
     section to article 3 to read:                                                                                              
          Sec. 08.29.240. Telehealth. (a) A person licensed                                                                   
     under   this   chapter    may   practice   professional                                                                    
     counseling   through    telehealth   as    defined   in                                                                    
     AS 47.05.270(e).   A   person  licensed   to   practice                                                                    
     professional  counseling  in another  jurisdiction  may                                                                    
     practice  professional  counseling  through  telehealth                                                                    
     with a client in this  state if the person's license is                                                                    
     in good standing in that jurisdiction.                                                                                     
          (b)  If a person licensed to practice                                                                                 
     professional counseling  determines in the course  of a                                                                    
     telehealth encounter  with a client that  the encounter                                                                    
     will extend  beyond the scope  of practice or  scope of                                                                    
     services  permitted  under  (a) of  this  section,  the                                                                    
     licensee shall  advise the client that  the licensee is                                                                    
     not authorized  to provide the services  to the client,                                                                    
     recommend  that  the   client  contact  an  appropriate                                                                    
     provider,  and terminate  the  encounter. The  licensee                                                                    
     may  not   charge  for  services  provided   during  an                                                                    
     encounter described in this subsection.                                                                                    
          (c)  A fee for a service provided through                                                                             
     telehealth under  this section  must be  reasonable and                                                                    
     consistent with the ordinary  fee typically charged for                                                                    
     that  service and  may not  be more  than five  percent                                                                    
     above  the  ordinary  fee typically  charged  for  that                                                                    
     service.                                                                                                                   
        *  Sec.  3. AS 08.63  is  amended  by adding  a  new                                                                  
     section to read:                                                                                                           
          Sec. 08.63.250. Telehealth. (a) A person licensed                                                                   
     under  this chapter  may  practice  marital and  family                                                                    
     therapy    through    telehealth    as    defined    in                                                                    
     AS 47.05.270(e). A person  licensed to practice marital                                                                    
     and   family  therapy   in  another   jurisdiction  may                                                                    
     practice marital and  family therapy through telehealth                                                                    
     with a client in this  state if the person's license is                                                                    
     in good standing in that jurisdiction.                                                                                     
          (b)  If a person licensed to practice marital and                                                                     
     family   therapy  determines   in  the   course  of   a                                                                    
     telehealth encounter  with a client that  the encounter                                                                    
     will extend  beyond the scope  of practice or  scope of                                                                    
     services  permitted  under  (a) of  this  section,  the                                                                    
     licensee shall  advise the client that  the licensee is                                                                    
     not authorized  to provide the services  to the client,                                                                    
     recommend  that  the   client  contact  an  appropriate                                                                    
     provider,  and terminate  the  encounter. The  licensee                                                                    
     may  not   charge  for  services  provided   during  an                                                                    
     encounter described in this subsection.                                                                                    
          (c)  A fee for a service provided through                                                                             
     telehealth under  this section  must be  reasonable and                                                                    
     consistent with the ordinary  fee typically charged for                                                                    
     that  service and  may not  be more  than five  percent                                                                    
     above  the  ordinary  fee typically  charged  for  that                                                                    
     service."                                                                                                                  
                                                                                                                                
     Page 1, line 3:                                                                                                            
          Delete "Section 1"                                                                                                  
          Insert "Sec. 4"                                                                                                     
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                              
     Page 3, following line 31:                                                                                                 
     Insert a new bill section to read:                                                                                         
        "*  Sec. 8.  AS 08.86  is amended  by  adding a  new                                                                
     section to article 6 to read:                                                                                              
          Sec. 08.86.225. Telehealth. (a) A psychologist or                                                                   
     psychological  associate  licensed under  this  chapter                                                                    
     may  practice   psychology  or   provide  psychological                                                                    
     services, as applicable,  through telehealth as defined                                                                    
     in  AS 47.05.270(e).  A  person  licensed  to  practice                                                                    
     psychology   or  provide   psychological  services   in                                                                    
     another   jurisdiction  may   practice  psychology   or                                                                    
     provide psychological services  through telehealth with                                                                    
     a client  in this state  if the person's license  is in                                                                    
     good standing in that jurisdiction.                                                                                        
          (b)  If a person licensed to practice psychology                                                                      
     or  provide psychological  services  determines in  the                                                                    
     course  of a  telehealth encounter  with a  client that                                                                    
     the encounter will extend beyond  the scope of practice                                                                    
     or  scope  of  services  permitted under  (a)  of  this                                                                    
     section, the licensee shall advise  the client that the                                                                    
     licensee is  not authorized to provide  the services to                                                                    
     the  client,  recommend  that  the  client  contact  an                                                                    
     appropriate provider, and  terminate the encounter. The                                                                    
     licensee may  not charge  for services  provided during                                                                    
     an encounter described in this subsection.                                                                                 
          (c)  A fee for a service provided through                                                                             
     telehealth under  this section  must be  reasonable and                                                                    
     consistent with the ordinary  fee typically charged for                                                                    
     that  service and  may not  be more  than five  percent                                                                    
     above  the  ordinary  fee typically  charged  for  that                                                                    
     service."                                                                                                                  
                                                                                                                                
SENATOR HUGHES objected for purposes of discussion.                                                                             
                                                                                                                                
1:54:09 PM                                                                                                                    
CHAIR WILSON  explained that SB  78 attempts  to fix a  parity in                                                               
Alaska's  healthcare services  by allowing  behavioral healthcare                                                               
providers to participate in telehealth  services. There is a need                                                               
to  change the  behavioral healthcare  section of  the Governor's                                                               
disaster declaration bill  to codified law. He stated  there is a                                                               
follow  up amendment  regarding  behavioral healthcare  providers                                                               
that removes the pay parity section.                                                                                            
                                                                                                                                
1:55:11 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
1:56:21 PM                                                                                                                    
CHAIR WILSON reconvened the meeting.                                                                                            
                                                                                                                                
SENATOR REINBOLD  stated she  supports telehealth.  She continues                                                               
to be  a strong  proponent of  the established  patient in-person                                                               
meeting  requirement.  She commented  that  if  any members  have                                                               
conflicts of interest,  they need to be forthright and  put it on                                                               
the record.                                                                                                                     
                                                                                                                                
1:57:21 PM                                                                                                                    
SENATOR HUGHES withdrew her objection.                                                                                          
                                                                                                                                
1:57:28 PM                                                                                                                    
CHAIR WILSON  asked if there  was further objection  to Amendment                                                               
1; finding no further objection, Amendment 1 passed.                                                                            
                                                                                                                                
1:57:38 PM                                                                                                                    
SENATOR HUGHES moved Amendment 2.                                                                                               
                                                                                                                                
                                                                                                                                
                          AMENDMENT 2                                                                                       
                                                                                                                                
                                               32-LS0532\A.2                                                                    
                                                      Fisher                                                                    
                                                     4/12/21                                                                    
                                                                                                                                
     OFFERED IN THE SENATE                 BY SENATOR HUGHES                                                                    
        TO: SB 78                                                                                                               
                                                                                                                                
     Page 2, lines 22 - 24:                                                                                                     
          Delete "consistent with the ordinary fees                                                                             
     typically charged for that service  and may not be more                                                                    
     than  five percent  above the  ordinary fees  typically                                                                    
     charged for that service"                                                                                                  
          Insert "may not exceed the ordinary fees                                                                              
     typically charged for that service"                                                                                        
                                                                                                                                
     Page 3, lines 25 - 27:                                                                                                     
          Delete "consistent with the ordinary fees                                                                             
     typically charged for that service  and may not be more                                                                    
     than  five percent  above the  ordinary fees  typically                                                                    
     charged for that service"                                                                                                  
          Insert "may not exceed the ordinary fees                                                                              
     typically charged for that service"                                                                                        
                                                                                                                                
CHAIR WILSON objected for purposes of discussion.                                                                               
                                                                                                                                
1:57:52 PM                                                                                                                    
SENATOR HUGHES  read Amendment  2 and stated  there is  no reason                                                               
for  a telehealth  provider's fee  to be  more than  an in-office                                                               
visit. Telehealth  is a  savings to  the provider,  requires less                                                               
staff and appointments are typically  shorter. The purpose of the                                                               
amendment is to remove the  additional five percent fee allowance                                                               
because there is no justification for it.                                                                                       
                                                                                                                                
SENATOR COSTELLO  stated she supports  Amendment 2. She  asked if                                                               
Amendment  2  was  written  with  contemplation  of  Amendment  1                                                               
passing  so that  language  regarding the  five  percent fee  was                                                               
consistent.                                                                                                                     
                                                                                                                                
CHAIR WILSON replied that for  the record Amendment 2 would cover                                                               
both  the bill  and Amendment  1. Drafters  at Legislative  Legal                                                               
Services will make the conforming changes.                                                                                      
                                                                                                                                
2:00:00 PM                                                                                                                    
CHAIR  WILSON  withdrew his  objection  and  asked if  there  was                                                               
further objection; finding none, Amendment 2 passed.                                                                            
                                                                                                                                
SENATOR REINBOLD  stated she  understands the  need for  the bill                                                               
but struggled with  page 3 line 16-18 and line  12, which removes                                                               
the established  provider requirement to meet  in-person at least                                                               
once. She is unsure  how she will vote on the  floor but will not                                                               
hold up the bill.                                                                                                               
                                                                                                                                
SENATOR HUGHES asked if the  Alaska Medical Association commented                                                               
on  the removal  of  the established  patient  requirement of  at                                                               
least one in-person  visit. An in-person exam  is foundational to                                                               
most medical care.  She asked if there are  restrictions in place                                                               
prohibiting  telehealth providers  from  diagnosing and  treating                                                               
conditions that should be done in-person.                                                                                       
                                                                                                                                
2:02:20 PM                                                                                                                    
SENATOR  COSTELLO  responded  that  in  context  of  last  year's                                                               
disaster  declaration,  the  state  was allowed  to  waive  every                                                               
regulation and  law, which is  why the environment of  a disaster                                                               
should be  seriously considered.  She stated  she spoke  with the                                                               
Alaska Medical Association. SB 78  was drafted to address changes                                                               
brought about by the disaster declaration.                                                                                      
                                                                                                                                
Changes  to Alaska  hire was  one of  those concerns.  She opined                                                               
that  she  did not  necessarily  want  people  to get  care  from                                                               
doctors  who  are   not  licensed  in  Alaska.   In  her  initial                                                               
discussion  with  the state  administration,  she  was told  some                                                               
Alaskans were established  patients of out of  state doctors. Due                                                               
to  the COVID  environment, they  could  not fly  outside of  the                                                               
state  to  receive  care. Instead,  they  received  care  through                                                               
telemedicine.  In-person visits  are also  valued. She  does want                                                               
Alaskans to  see Alaska licensed  doctors. SB  78 will go  to the                                                               
Labor and  Commerce Committee next. It  is her intent to  place a                                                               
sunset date  on the bill. She  stated she will work  with Senator                                                               
Begich's office on language related to Alaska hire.                                                                             
                                                                                                                                
She commented that the telehealth  measures that were passed were                                                               
of value  during the COVID  time period because they  allowed the                                                               
elderly  and fragile  to continue  receiving care.  Many Alaskans                                                               
like  receiving mental  health treatments  online. Telehealth  is                                                               
something to  appreciate. SB 78 tries  to bridge the gap  of what                                                               
was done under  the pandemic environment and how  we move forward                                                               
without a disaster declaration. She  stated she will consider the                                                               
points made and  intents to make improvements to  the bill before                                                               
it goes to the floor.                                                                                                           
                                                                                                                                
2:05:42 PM                                                                                                                    
SENATOR REINBOLD  shared that  she is  not in  favor of  the bill                                                               
because the Alaska  State Medical Association is  not. She opined                                                               
that the  disaster declaration  by the  Governor should  not have                                                               
lasted more than  30 days and might have been  an abuse of power.                                                               
Waiving  statutes  and regulations  should  be  done through  the                                                               
administrative  regulation  review   committee  with  legislature                                                               
approval.                                                                                                                       
                                                                                                                                
SENATOR BEGICH asked  for the word jurisdiction to  be defined in                                                               
Section 2  line 11 and Section  4 line 13    14. He will  vote to                                                               
move SB 78.                                                                                                                     
                                                                                                                                
2:08:21 PM                                                                                                                    
SENATOR HUGHES  stated she will  support SB 78. She  stated there                                                               
is a wide range of services  providers can offer; not all of them                                                               
are appropriate  without an  in-person physical  examination. She                                                               
respects the Alaska  Medical Association and opined  that this is                                                               
a  concern  for  them.  She  asked that  a  providers   scope  of                                                               
practice  be limited  to  only  services that  do  not require  a                                                               
physical exam.                                                                                                                  
                                                                                                                                
CHAIR WILSON noted that Labor  and Commerce is the next committee                                                               
of  referral,  and  the  intent  is to  move  the  bill  so  that                                                               
committee tcan continue refining it.                                                                                            
                                                                                                                                
2:10:29 PM                                                                                                                    
CHAIR WILSON solicited a motion to move the bill from committee.                                                                
                                                                                                                                
2:10:41 PM                                                                                                                    
SENATOR HUGHES  moved SB 78,  work order 32-LS0532\A  as amended,                                                               
from  committee  with  individual  recommendations  and  attached                                                               
fiscal notes (s).                                                                                                               
                                                                                                                                
2:10:48 PM                                                                                                                    
SENATOR REINBOLD objected.                                                                                                      
                                                                                                                                
2:10:52 PM                                                                                                                    
A roll  call vote was  taken. Senators Begich,  Hughes, Costello,                                                               
and Wilson  voted in  favor of  reporting SB  78 as  amended from                                                               
committee and Senator Reinbold voted against it. Therefore, the                                                                 
motion passed by a 4:1 vote.                                                                                                    
                                                                                                                                
CHAIR WILSON reported SB 78 as amended from the Senate Health                                                                   
and Social Services Standing Committee.                                                                                         
                                                                                                                                
2:11:33 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
                                                                                                                              
         SB  80-PUBLIC SCHOOLS: MENTAL HEALTH EDUCATION                                                                     
                                                                                                                                
2:14:28 PM                                                                                                                    
CHAIR WILSON announced the consideration SENATE BILL NO. 80                                                                     
 "An Act relating to mental health education."                                                                                  
                                                                                                                                
An overview of the bill, sectional analysis and public testimony                                                                
were heard on April 6.                                                                                                          
                                                                                                                                
SENATOR ELVI GRAY-JACKSON, Alaska State Legislature, Juneau,                                                                    
Alaska, read her sponsor statement:                                                                                             
                                                                                                                                
     SB 80  amends the existing health  education curriculum                                                                    
     statute to  include mental health curriculum  in all K-                                                                    
     12 health classrooms to  adequately educate students on                                                                    
     vital   information   pertaining   to   mental   health                                                                    
     symptoms,  resources,  and  treatment.  Currently,  the                                                                    
     health  curriculum  guidelines include  prevention  and                                                                    
     treatment  of diseases;  learning  about "good"  health                                                                    
     practices  including   diet,  exercise,   and  personal                                                                    
     hygiene;  and "bad"  health  habits  such as  substance                                                                    
     abuse, alcoholism, and patterns  of physical abuse. But                                                                    
     the guidelines do not  address mental health. Following                                                                    
     passage of  SB80, the Alaska  State Board  of Education                                                                    
     and  Early Development  and  the  Alaska Department  of                                                                    
     Education  and Early  Development  (DEED) will  develop                                                                    
     guidelines   for  instruction   in  mental   health  in                                                                    
     consultation with  the Alaska Department of  Health and                                                                    
     Social   Services   (DHSS)   and   representatives   of                                                                    
     national,    state,    and   tribal    mental    health                                                                    
     organizations. Such organizations  include, but are not                                                                    
     limited  to,   the  National  Council   for  Behavioral                                                                    
     Health,   Providence   Health  and   Services   Alaska,                                                                    
     Southcentral  Foundation,  Anchorage  Community  Mental                                                                    
     Health  Services, Inc.,  North  Star Behavioral  Health                                                                    
     System,  and the  National  Alliance  on Mental  Health                                                                    
     Illness  Alaska. The  standards  will  be developed  in                                                                    
     consultation  with   counselors,  educators,  students,                                                                    
     administrators, and  other mental  health organizations                                                                    
     to  form   effective  guidelines  for   school  boards,                                                                    
     teachers,  and  students.  After  standards  have  been                                                                    
     developed,  the Alaska  State  Board  of Education  and                                                                    
     Early  Development and  DEED  will  be responsible  for                                                                    
     implementation throughout the  Alaska school system. As                                                                    
     with  existing health  education curriculum,  the DEED,                                                                    
     the  DHSS, and  the  Council on  Domestic Violence  and                                                                    
     Sexual  Assault will  provide  technical assistance  to                                                                    
     school districts in the  development of personal safety                                                                    
     curricula.   An   existing  school   health   education                                                                    
     specialist  position will  assist  in coordinating  the                                                                    
     program statewide.  The State  has a  responsibility to                                                                    
     treat the current  mental health crisis in  Alaska as a                                                                    
     serious public health issue.  By creating mental health                                                                    
     education standards and encouraging  schools to teach a                                                                    
     mental  health curriculum,  SB80 aims  to decrease  the                                                                    
     stigma  surrounding   mental  illnesses   and  increase                                                                    
     students'  knowledge  of   mental  health,  encouraging                                                                    
     conversation around and understanding of the issue.                                                                        
                                                                                                                                
2:17:31 PM                                                                                                                    
SENATOR GRAY-JACKSON  recalled there was an  amendment by Senator                                                               
Begich that changed the bill.                                                                                                   
                                                                                                                                
SENATOR BEGICH  replied that  language was  made more  general so                                                               
more entities  could participate  in creating the  curriculum. It                                                               
was confirmed  in the [education]  committee that  the Department                                                               
of Education  and Early Development (DEED)  would oversee writing                                                               
the curriculum.                                                                                                                 
                                                                                                                                
SENATOR  HUGHES  mentioned  that  she  was  concerned  about  age                                                               
appropriateness of  curriculum content  and young  children being                                                               
unduly influenced.                                                                                                              
                                                                                                                                
SENATOR  GRAY-JACKSON responded  the  amendment was  made in  the                                                               
education  committee   and  that   during  the   meeting  several                                                               
questions were  asked. She stated  her office  provided follow-up                                                               
answers to all questions asked by the education committee.                                                                      
                                                                                                                                
SENATOR  REINBOLD  informed members  that  she  did research  and                                                               
found  there  are  organizations,  such as  the  Alaska  Parental                                                               
Rights organization,  that oppose  the bill. She  determined that                                                               
the bill  crosses the domain  of family boundaries.  She believes                                                               
parents should  focus on  a child's  mental capacity,  health and                                                               
sexuality  and  let  schools  focus   on  education.  Content  in                                                               
education  is being  increasingly infiltrated  by social,  sexual                                                               
and  political  agendas  that can  harm  children  and  undermine                                                               
parental rights.                                                                                                                
                                                                                                                                
2:22:33 PM                                                                                                                    
CHAIR WILSON moved Amendment 1.                                                                                                 
                                                                                                                                
                          AMENDMENT 1                                                                                       
                                                                                                                                
                                               32-LS0514\B.4                                                                    
                                                       Klein                                                                    
                                                     4/12/21                                                                    
                                                                                                                                
     OFFERED IN THE SENATE                 BY SENATOR WILSON                                                                    
        TO: CSSB 80(EDC)                                                                                                        
                                                                                                                                
     Page 2, following line 17:                                                                                                 
          Insert a new bill section to read:                                                                                  
        "* Sec. 4.  AS 14.30.360 is amended by  adding a new                                                                
     subsection to read:                                                                                                        
          (e)  A district may not instruct a student in                                                                         
     mental health as part of  a program in health education                                                                    
     under  (a) of  this  section  without informed  consent                                                                    
     from  the student's  parent or  guardian. The  district                                                                    
     shall  inform the  child's parent  or guardian,  in the                                                                    
     native  language  of the  parent  or  guardian, of  the                                                                    
     time,   date,  and   content  of   the  mental   health                                                                    
     instruction,  that  consent   is  voluntary,  and  that                                                                    
     consent may be revoked  at any time. Before instructing                                                                    
     a student  in mental health, the  district shall obtain                                                                    
     written consent from the  parent or guardian indicating                                                                    
     that the  parent or guardian understands  and agrees to                                                                    
     the  student's  participation   in  the  mental  health                                                                    
     instruction."                                                                                                              
                                                                                                                                
     Renumber the following bill section accordingly.                                                                           
                                                                                                                                
2:22:42 PM                                                                                                                    
SENATOR HUGHES objected for purposes of discussion.                                                                             
                                                                                                                                
CHAIR WILSON  stated Amendment 1 would  start on page 2  line 17.                                                               
He  read  Amendment  1.  He  stated  he  supports  mental  health                                                               
education  in  the  schools, but  constituents  desired  to  have                                                               
parents be informed of curriculum  content and provide permission                                                               
to attend.                                                                                                                      
                                                                                                                                
SENATOR REINBOLD  asked if the  program would be  opt-in elective                                                               
only, with parental permission.                                                                                                 
                                                                                                                                
CHAIR WILSON replied yes; that is the intent of the amendment.                                                                  
                                                                                                                                
SENATOR HUGHES  stated she  heard the  same request  from parents                                                               
and had  a similar bill  in place.  She thanked Chair  Wilson for                                                               
bringing his amendment forward.                                                                                                 
                                                                                                                                
SENATOR COSTELLO  commented that she  also had been  contacted by                                                               
parents and  had been  working on  an amendment  before realizing                                                               
Chair Wilson had an amendment in place.                                                                                         
                                                                                                                                
SENATOR BEGICH commented  that Amendment 1 seems  like and option                                                               
on top of an option. The  bill creates the option for each school                                                               
district  to provide  mental  health as  part  of its  healthcare                                                               
education.  Other elements  of health  education  do not  require                                                               
parental consent. He understands but  does not support the opt-in                                                               
requirement. He does not see how  the bill is a threat to parents                                                               
or students.  He opposes the  idea because students most  in need                                                               
can be  kept from  the curriculum. However,  he will  support the                                                               
amendment.                                                                                                                      
                                                                                                                                
2:27:03 PM                                                                                                                    
SENATOR HUGHES removed her objection.                                                                                           
                                                                                                                                
CHAIR WILSON asked if there  was further objection; finding none,                                                               
Amendment 1 was passed.                                                                                                         
                                                                                                                                
SENATOR HUGHES  stated she appreciates  the heart of  the sponsor                                                               
and  students but  has concerns  about  the bill.  The bill,  not                                                               
passing, does not  prevent local school boards  from developing a                                                               
mental health curriculum. She  wants mental health destigmatized,                                                               
and students  informed on mental  health resources. The  scope of                                                               
the  bill  is  too  wide. Pinning  mental  health  in  adolescent                                                               
education  narrowly to  depression and  suicide would  be better.                                                               
The bill  has a de-preparing  curriculum that is not  required to                                                               
be  used by  districts. Curriculum  prepared at  the state  level                                                               
loses local control. She believes  mental health education should                                                               
be at the district level.                                                                                                       
                                                                                                                                
2:29:20 PM                                                                                                                    
CHAIR WILSON solicited a motion to move the bill from committee.                                                                
                                                                                                                                
SENATOR HUGHES moved to report  the proposed committee substitute                                                               
(CS)  for  SB  80,  work   order  32-LS0514\B  as  amended,  from                                                               
committee  with individual  recommendations  and attached  fiscal                                                               
notes (s).                                                                                                                      
                                                                                                                                
SENATOR HUGHES objected.                                                                                                        
                                                                                                                                
CHAIR WILSON asked for a roll call vote.                                                                                        
                                                                                                                                
2:29:43 PM                                                                                                                    
A  roll  call vote  was  taken.  Senators Costello,  Begich,  and                                                               
Wilson  voted  in  favor  of  reporting SB  80  as  amended  from                                                               
committee  and Senators  Hughes  and Reinbold  voted against  it.                                                               
Therefore, the motion passed by a 3:2 vote.                                                                                     
                                                                                                                                
CHAIR WILSON  stated CSSB  80(HSS) was  reported from  the Senate                                                               
Health and Social Services Standing Committee.                                                                                  
                                                                                                                                
2:30:50 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Wilson adjourned  the Senate  Health  and Social  Services                                                               
Standing Committee meeting at 2:30 p.m.                                                                                         

Document Name Date/Time Subjects
SB 78 NORD Ltr of Support.pdf SHSS 4/20/2021 1:30:00 PM
SB 78
SB 80 Public Input 4.20.21 Redacted.pdf SHSS 4/20/2021 1:30:00 PM
SB 80
SB 78 Adopted Amendments 4.20.21.pdf SHSS 4/20/2021 1:30:00 PM
SB 78
SB 80 Amendment B.4 Wilson.pdf SHSS 4/20/2021 1:30:00 PM
SB 80