02/06/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB115 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 115 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 6, 2024
3:33 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator Forrest Dunbar
Senator Cathy Giessel
MEMBERS ABSENT
Senator James Kaufman, Vice Chair
Senator Löki Tobin
COMMITTEE CALENDAR
SENATE BILL NO. 115
"An Act relating to physician assistants; relating to
physicians; and relating to health care insurance policies."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 115
SHORT TITLE: PHYSICIAN ASSISTANT SCOPE OF PRACTICE
SPONSOR(s): SENATOR(s) TOBIN BY REQUEST
03/27/23 (S) READ THE FIRST TIME - REFERRALS
03/27/23 (S) HSS, L&C
01/23/24 (S) HSS AT 3:30 PM BUTROVICH 205
01/23/24 (S) Heard & Held
01/23/24 (S) MINUTE(HSS)
02/06/24 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
JULIA FONOV, Staff
Senator David Wilson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided a summary of changes for SB 115.
MACKENZIE POPE, Staff
Senator Löki Tobin
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided a statement on behalf of Senator
Tobin, sponsor of SB 115.
NOAH SHIELDS, Chair
Board of Marital and Family Therapy
Kenai, Alaska
POSITION STATEMENT: Answered questions pertaining to SB 115.
ACTION NARRATIVE
3:33:29 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:33 p.m. Present at the
call to order were Senators Dunbar, Giessel, and Chair Wilson.
SB 115-PHYSICIAN ASSISTANT SCOPE OF PRACTICE
3:33:55 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 115
"An Act relating to physician assistants; relating to
physicians; and relating to health care insurance policies."
3:34:06 PM
CHAIR WILSON stated the committee would consider a committee
substitute.
3:34:16 PM
At ease
3:34:23 PM
CHAIR WILSON reconvened the meeting.
CHAIR WILSON moved to adopt the committee substitute (CS) for SB
115, work order 33-LS0542\S, as the working document.
3:34:35 PM
SENATOR GIESSEL objected for purposes of discussion.
3:34:49 PM
JULIA FONOV, Staff, Senator David Wilson, Alaska State
Legislature, Juneau, Alaska, provided a summary of changes for
SB 115, version B to S, as follows:
[Original punctuation provided.]
The Work Draft for CS for Senate Bill 115 (HSS)
contains additions that the Board of Marital and
Family Therapy approved and recommended to update AS
8.63, Board of Marital and Family Therapy, regarding
Marital and Family Therapy licenses to practice.
These changes were reviewed by the Department of
Commerce, Community, and Economic Development and they
have expressed their support for this committee
substitute.
Page 1, Line 1, following inserts: "relating to
marital and family therapists;"
And then this committee substitute inserts 5 new
sections and inserts changes to physician assistant
definitions.
Page 1, following line 3, inserts Section 1:
• Removes courses so that required instruction is just
defined by the number of semesters or quarter hours
needed.
• Removes the word "one year" so that supervised
clinical practice requirements are defined by nine
semester or 12 quarter hours.
• Allows supervision to be in Alaska or another
jurisdiction.
• Creates a new subsection that the 100 hours of
individual supervision must be approved by the board.
• Creates a new subsection that the 100 hours of group
supervision can be either individual or a combination
of group supervision hours.
Page 2, line 30, inserts Section 2:
• Removes the word courses and replaces it with course
work
Page 3, line 7, inserts Section 3:
• Amends the expiration for supervised practice licenses
so they may be extended because of extenuating
circumstances at the discretion of the board.
Page 3, line 11, inserts Section 4:
• Amends the definition of "supervision" to remove the
requirement for it to be "face-to-face" and instead
require it to be "synchronous"; and to update audio
and video tapes to be audio and video recordings.
Page 3, line 16:
• Renames "Section 1" to "Section 5" and it renumbers
the following bill sections accordingly.
Page 3, line 17:
• The word "Regulation" is removed and replaced with
"Licensure and scope of practice" for physician
assistants.
• Page 3, line 23, inserts the word "in this section
• Page 3, line 24 removes the word "the" and replaces it
with "a"
Page 4, line 23:
• Replaces 2,000 hours with 4,000 hours for physician
assistants who may only practice under a collaborative
agreement.
Page 5, line 22:
• Remove "Under the supervision, control, and
responsibility of either a physician licensed under
this chapter or a physician exempted from licensing
under AS 08.64.370" and replace it with "as authorized
in AS 08.64.107
Page 6, line 2:
• Insert "physician assistant" into the definition of
practitioner
Page 6, line 25:
• Regarding what a health insurance policy may not
contain, this inserts "(4) imposes a practice,
education, or collaboration requirement on physician
assistants that is inconsistent with or more
restrictive than the requirements imposed under AS
08.64.107 or a regulation adopted by the State Medical
Board"
Page 7, line 18 inserts Section 12
• Removes advanced practice registered nurses from those
eligible to provide group supervision, which the board
states is due to the limited amount of psychology
education in their program
• Eliminates temporary licenses for marital and family
therapists. The board states temporary licenses were
created to fill a gap in those individuals who had
completed the supervision and practice hours of
licensure but were waiting for a licensing exam date.
Now there are multiple licensing exam dates throughout
the year and Marriage and Family Therapist Associates
can take the licensing exam at any time they are
accruing hours, making the need for temporary licenses
outdated.
• Eliminates the definition of "courses" so requirements
are defined by the number of semester or quarter hours
needed. The current statute appears that meeting the
number of courses is sufficient, even if semester or
quarter hours are not. Leaving this term in statute
may confuse applicants who may want to use courses
that are under 3 credits, but have enough of those
courses to meet the requirements under each category.
3:41:01 PM
MACKENZIE POPE, Staff, Senator Löki Tobin, Alaska State
Legislature, Juneau, Alaska, provided a statement on behalf of
Senator Tobin, sponsor of SB 115. She stated Senator Tobin does
not agree with the repeal of AS 08.63.120(b)(2)(D) that relates
to nurse practitioners and therefore would not support the
committee substitute. She asked why the Board of Marital and
Family Therapy sought its repeal.
3:42:22 PM
NOAH SHIELDS, Chair, Board of Marital and Family Therapy, Kenai,
Alaska, replied that advanced nurse practitioners (ANPs), though
highly qualified in their profession, lack the educational
course work to oversee marriage and family therapists (MFTs)when
compared to other professions that meet or exceed the
requirements. He provided examples of standards of practice that
are different between the two professions. He stated the repeal
does not keep Marital and Family therapists from working under
or with ANPs. It ensures Martial and Family Therapy associates
are working towards licensure and receive appropriate
supervision to uphold clinical practice standards while
integrating with other professions.
3:44:21 PM
SENATOR DUNBAR said SB 115 would essentially become another bill
through the changes in the committee substitute. He stated that
although a summary of changes was provided, a practical
presentation regarding what the changes accomplish hasn't been
offered. He asked for a description of what the bill does and
what it means to the medical providers that it involves.
3:45:20 PM
MR. SHIELDS replied that a lot of the provisions that are
recommended update language, for example replacing "face-to-
face" with "synchronous." Other changes would make understanding
requirements easier, for example "courses" can be worth
different credit hours. He opined that clarifying language
would reduce the amount of time the board and staff must spend
helping people understand the requirements.
3:46:50 PM
SENATOR DUNBAR said the changes to improve and modernize
language seem relatively uncontroversial and perhaps popular,
except for the provision that restricts the work of ANPs. He
asked whether the Board of Marital and Family Therapist would
support the committee substitute if Section 12 were removed to
avoid controversy.
3:47:40 PM
MR. SHIELDS replied absolutely. Any of the changes would be
positive for those licensed under AS 08. He reiterated that ANP
are not being limited, rather it is about where MFT associates
will obtain their group supervision hours. He noted that the
required 200 hours can be acquired through group or individual
supervision. It is imperative that supervisors have the training
necessary to ensure that the professionals under the chapter are
practicing ethically and at MTF standards that may be different
from other professions.
3:49:18 PM
CHAIR WILSON stated the Department of Commerce provided a
comparison of requirements by licensure types. He stated ANP
requirements aligned more with the requirements of a social
worker than a Licensed Professional Counselor (LPC).
3:50:50 PM
SENATOR GIESSEL questioned why the changes were inserted into a
clean bill instead of creating a separate bill.
3:51:02 PM
MR. SHIELDS stated it was his first time going through the
process. After reaching out to legislators, who connected him to
Senator Wilson's office, where they informed him that a solution
was to include the changes in SB 115.
3:51:45 PM
CHAIR WILSON stated the changes were made in consultation with
the sponsor of SB 115. He stated his office worked with the
Department of Commerce to make sure the changes were benign and
aligned with other licensure types.
3:52:29 PM
At ease
3:54:33 PM
CHAIR WILSON reconvened the meeting and asked if there were
further questions.
3:54:50 PM
CHAIR WILSON withdrew his motion to adopt CSSB 115. There being
no objection, the motion was withdrawn. SB 115 was before the
committee.
CHAIR WILSON said that further discussion with the bill sponsor
is needed prior to making changes to the bill.
3:55:09 PM
CHAIR WILSON [held SB 115 in committee.]
3:55:39 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 3:55 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 115- Hall - Opposition.pdf |
SHSS 2/6/2024 3:30:00 PM |
SB 115 |
| SB 115 - Hug - LOS.pdf |
SHSS 2/6/2024 3:30:00 PM |
SB 115 |
| MFT Proposed Changes Compared to CSW and PCO Statutes (1.31.24).xlsb |
SHSS 2/6/2024 3:30:00 PM |
SB 115MFT Proposed Changes Compared to CSW and PCO Statutes (1.31.24) |
| MFT Proposed Changes Compared to CSW and PCO Statutes (1.31.24) - one page.pdf |
SHSS 2/6/2024 3:30:00 PM |
SB 115 MFT Proposed Changes Compared to CSW and PCO Statutes (1.31.25) (one page) |
| SB 115 Draft CS Work Order No. 33-LS0542 v S.pdf |
SHSS 2/6/2024 3:30:00 PM |
SB 115 |
| SB 115 Grabman Opposition_Redacted.pdf |
SHSS 2/6/2024 3:30:00 PM |
SB 115 |
| SB 115 Amer Society of Plastic Surgeons - Opposition 2.6.24.pdf |
SHSS 2/6/2024 3:30:00 PM |
SB 115 |