Legislature(2025 - 2026)BUTROVICH 205
02/27/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB89 | |
| SB88 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 9 | TELECONFERENCED | |
| += | SB 89 | TELECONFERENCED | |
| *+ | SB 88 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 27, 2025
3:31 p.m.
MEMBERS PRESENT
Senator Forrest Dunbar, Chair
Senator Cathy Giessel, Vice Chair
Senator Matt Claman
Senator Löki Tobin
Senator Shelley Hughes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 89
"An Act relating to physician assistants; relating to
collaborative agreements between physicians and physician
assistants; relating to the practice of medicine; relating to
health care providers; and relating to provisions regarding
physician assistants in contracts between certain health care
providers and health care insurers."
- HEARD & HELD
SENATE BILL NO. 88
"An Act relating to placement of a child in need of aid;
relating to adoption; relating to variances for foster care
licenses; relating to the medical records of children in foster
care; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 89
SHORT TITLE: PHYSICIAN ASSISTANT SCOPE OF PRACTICE
SPONSOR(s): SENATOR(s) TOBIN
02/07/25 (S) READ THE FIRST TIME - REFERRALS
02/07/25 (S) HSS, L&C
02/18/25 (S) HSS AT 3:30 PM BUTROVICH 205
02/18/25 (S) Heard & Held
02/18/25 (S) MINUTE(HSS)
02/27/25 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 88
SHORT TITLE: CHILD PLACEMENT; DILIGENT SEARCH
SPONSOR(s): SENATOR(s) BJORKMAN
02/05/25 (S) READ THE FIRST TIME - REFERRALS
02/05/25 (S) HSS, FIN
02/27/25 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
MARY SWAIN, Chief Executive Officer (CEO)
Camai Community Health Center
Naknek, Alaska
POSITION STATEMENT: Testified by invitation on SB 89.
JENNIFER FAYETTE, PA, Co-Chair
Alaska Academy of Physician Assistants
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 89.
MACKENZIE POPE, Staff
Senator Löki Tobin
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 89.
BARTHOLOMEW GRABMAN, MD, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to SB 89.
DANIEL REYNOLDS, DO, representing self
Naknek, Alaska
POSITION STATEMENT: Testified in support of SB 89.
KATHERINE VAN ATTA, PA, representing self
Naknek, Alaska
POSITION STATEMENT: Testified in support of SB 89.
MICHAEL MICHADU, PA, representing self
Mat-Su, Alaska
POSITION STATEMENT: Testified in support of SB 89.
MOLLY SOUTHWORTH, MD, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to SB 89.
MARGARET CARLSON Consentino, MD, President
Alaska Academy of Family Physicians
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to SB 89.
MEGHAN HALL, PA, President
Alaska Academy of Physician Assistants
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 89.
SENATOR JESSE BJORKMAN, District D
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 88.
LAURA ACHEE, Staff
Senator Jesse Bjorkman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided the sectional analysis for SB 88.
NANCY MEADE, General Counsel
Alaska Court System
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 88.
KIM GUAY, Director
Central Office
Office of Childrens Services
Anchorage, Alaska
POSITION STATEMENT: Answered questions on SB 88.
BRADLEY GALBRAITH, Policy Director
The Center for the Rights of Abused Children
Phoenix, Arizona
POSITION STATEMENT: Testified by invitation on SB 88.
MALAIKA TESSON, Foster Parent
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 88.
KRISTEN A. MOORE, representing self
Wasilla, Alaska
POSITION STATEMENT: Testified by invitation on SB 88.
ACTION NARRATIVE
3:31:05 PM
CHAIR DUNBAR called the Senate Health and Social Services
Standing Committee meeting to order at 3:31 p.m. Present at the
call to order were Senators Tobin, Hughes, Claman, Giessel and
Chair Dunbar.
SB 89-PHYSICIAN ASSISTANT SCOPE OF PRACTICE
3:32:05 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 89
"An Act relating to physician assistants; relating to
collaborative agreements between physicians and physician
assistants; relating to the practice of medicine; relating to
health care providers; and relating to provisions regarding
physician assistants in contracts between certain health care
providers and health care insurers."
3:33:40 PM
MARY SWAIN, Chief Executive Officer (CEO), Camai Community
Health Center, Naknek, Alaska, testified by invitation on SB 89.
She said Camai Community Health Center is a federally qualified
facility serving the Bristol Bay Borough. She stated the center
is critical for delivering primary, urgent, and emergency care,
including receiving all EMS and 911 cases in the region. In the
past year, the center handled over 2,000 patient visits,
including more than 150 emergency cases. She emphasized long-
standing recruitment challenges due to the remote location and
increasing dependence on physician assistants (PAs) and nurse
practitioners. She explained that the current state regulations
requiring physician collaborative practice agreements place
unsustainable financial and administrative burdens on facilities
like Camai. She noted the center pays over $55,000 annually for
physician collaboration, and delays in processing agreements
negatively affect patient care and safety.
MS. SWAIN expressed strong support for SB 89, stating it
modernizes the practice framework for PAs in Alaska by
authorizing a more autonomous model under State Medical Board
oversight. She supported the bill's provision that allows PAs to
practice independently after 4,000 hours of post-graduate
clinical experience, noting that formal training includes
approximately 2,000 hours. She called this a balanced approach
that ensures proper oversight while providing a path to autonomy
for experienced PAs. She cited examples from other states such
as Iowa, Montana, New Hampshire, North Dakota, Utah, and
Wyoming, which have eliminated statutory requirements for direct
physician supervision, creating optimal practice environments.
She added that Arizona also recently updated its laws to grant
greater independence to experienced PAs, improving team-based
healthcare delivery.
3:36:57 PM
MS. SWAIN concluded that SB 89 will reduce wait times and
improve healthcare accessibility without compromising quality.
She underscored that while the legislation supports providers,
it ultimately benefits patients.
3:37:32 PM
JENNIFER FAYETTE, PA, Co-Chair, Alaska Academy of Physician
Assistants, Anchorage, Alaska, testified by invitation on SB 89.
said SB 89 is a crucial measure to modernize Alaska's physician
assistant (PA) statutes and expand access to care. She noted
that PAs have been essential to Alaska's healthcare system since
the 1970s, serving both urban and underserved rural areas, yet
outdated legal requirements continue to create unnecessary
administrative hurdles for hiring and retaining PAs. She stated
that SB 89 directly addresses these issues by updating
collaborative practice language, allowing PAs to practice to the
full extent of their training without compromising patient
safety. She emphasized that the bill does not expand PA scope
into areas like independent surgery or attempt to equate PAs
with physicians but rather aligns regulations with current
clinical practices in Alaska. She described the bill as the
result of extensive discussions with physicians and a thoughtful
response to prior legislative recommendations.
MS. FAYETTE explained that removing outdated restrictions will
enhance flexibility in the healthcare system and improve patient
outcomes across the state. She stressed that modernization is
necessary not just to reduce administrative burden, but also to
sustain and grow Alaska's PA workforce, which faces significant
recruitment and retention challenges. She cited data from the
National Commission on Certification of Physician Assistants
(NCCPA), noting Alaska had the lowest PA workforce growth
nationally. She added that Alaska's healthcare licensing grew
only 14 percent over two years, compared to higher rates for
other provider types. Citing Department of Labor projections of
several thousand unfilled healthcare positions by 2030, she
concluded by urging support for SB 89 to ensure PAs can continue
contributing meaningfully to Alaska's healthcare system and to
meet the state's urgent care needs.
3:40:50 PM
SENATOR HUGHES expressed strong support for SB 89 and shared
that her husband, a retired PA, began his career in Bethel 40
years ago and was a member of the Alaska Academy of Physician
Assistants. She acknowledged the work of the association. She
sought clarification to address concerns and asked whether PAs
still need to complete 100 CME credits biennially to maintain
certification through the NCCPA, essentially doubling the
requirement for physicians.
MS. FAYETTE replied yes
3:42:03 PM
SENATOR CLAMAN referred to Ms. Fayette's statement about the
declining number of physician assistants (PAs) in Alaska and
requested additional context. He asked for a comparison with
trends in other states. He asked for national data to frame
Alaska's situation.
3:42:31 PM
MS. FAYETTE clarified that Alaska has seen a 14 percent increase
in PAs, but this growth is significantly lower than the 35
percent increase among advanced practice registered nurses
(APRNs). She added that nationally, PA numbers have increased by
approximately 11 percent, though many states are experiencing
much higher growth. She noted that the national median growth is
in the 20 percent range, with some states seeing up to a 50
percent increase in PA licenses. She stated she would submit the
relevant data from the NCCPA and emphasized that Alaska ranks at
the bottom in terms of PA workforce growth.
3:43:22 PM
CHAIR DUNBAR acknowledged that SB 89 does not aim to expand the
scope of surgery for PAs and explicitly stated that PAs cannot
perform surgery independently. He pointed out that certain
procedures, such as suturing, can be technically classified as
surgery. He noted that some in the medical community have raised
questions about how SB 89 addresses or defines surgical
activities. He asked for the sponsor or another testifier to
address this concern.
3:43:58 PM
MACKENZIE POPE, Staff, Senator Löki Tobin, Alaska State
Legislature, Juneau, Alaska, answered questions on SB 89. She
explained that the bill's language regarding surgery was
carefully placed under the authority of the State Medical Board,
which is tasked with developing regulations. She stated this
approach allows subject matter experts, such as physicians, PAs,
and other medical professionals, to define "surgery" in a way
that accurately reflects clinical practice. She emphasized that
the regulations and definition of surgery must not restrict
physician assistants from performing routine procedures already
within their established scope, such as suturing and stitching.
She clarified that the bill ensures the State Medical Board
cannot use its regulatory authority to impede PAs from
continuing to perform these common tasks.
SENATOR TOBIN stated the language if found in SB 89, page 2,
lines 6-7.
3:45:32 PM
MS. SWAIN provided a clinical perspective on the definition of
surgery within her facility, noting that in the absence of a
physician, surgical procedures are limited to those performed
with local anesthetic. She stated that procedures like suturing
using localized anesthetic are considered minor surgeries and
are allowed. However, any procedure requiring regional or
blocking anesthesia would fall outside the clinic's capabilities
and would require a physician.
3:46:22 PM
CHAIR DUNBAR opened public testimony on SB 89.
3:47:18 PM
BARTHOLOMEW GRABMAN, MD, representing self, Anchorage, Alaska,
testified in opposition to SB 89 stating that 4,000 hours of
clinical experience is insufficient for safe, independent
medical practice. He compared this to his own training as a
physician, which included roughly 18,000 clinical hours, and
emphasized that even with that background, he still consults a
supervising physician for every patient. He shared the
perspective of a colleague and former physician assistant (PA)
who stated her competence as a PA was significantly lower than
her current competence as a physician in training, highlighting
the difference in education and training. He argued that current
PA regulations under 12 AAC 40.410450 are not burdensome,
citing requirements such as monthly check-ins and quarterly
evaluations. He also stated that SB 89 does not improve rural
healthcare access, suggesting financial incentives would be a
more effective approach. He concluded by urging the committee to
reject SB 89 as written and recommended increasing the clinical
hour requirement to at least 6,000 or 8,000 hours, citing
Arizona as an example.
3:50:49 PM
DANIEL REYNOLDS, DO, representing self, Naknek, Alaska,
testified in support of SB 89 stating he has worked with PAs for
22 years across military, Indian Health Service, and private
practice settings, including in Naknek. He questioned a prior
speaker's claim of working in Naknek, noting he had not
encountered that individual during his eight years there. He
affirmed that PAs receive strong training, especially in family
medicine, and have also performed well in emergency department
settings. He described PA training as extensive and appropriate
for increased autonomy. He emphasized that PAs deliver high-
quality care and, like physicians, consult when needed. He
stated their training supports the level of independence
proposed in SB 89.
3:52:47 PM
SENATOR GIESSEL asked for confirmation that Dr. Reynolds was
amenable to entering into a collaborative agreement with a
physician assistant (PA) to support them during the transition
to independent practice.
DR. REYNOLDS responded, correct.
3:53:34 PM
KATHERINE VAN ATTA, PA, representing self, Naknek, Alaska,
testified in support of SB 89, stating she has been a PA for 20
years and a nurse midwife for seven, holding independent
licensure as an APRN and dependent licensure as a PA. She works
in both Wasilla and Naknek, where the nearest physician is
typically over 100 miles away. She also precepts medical
students in rural rotations. She argued that state-mandated
collaborative plans are unnecessary for experienced providers to
practice safely, citing her ability to consult and transfer care
as an independently licensed APRN. She emphasized that internal
facility-level oversight ensures competence and appropriate
scope of practice without requiring state-imposed collaboration.
She stated that SB 89 would help address healthcare shortages in
rural areas by reducing administrative burdens that limit the
ability of facilities to hire PAs. She concluded that the bill
would give rural clinics more flexibility to hire the most
qualified provider for their needs.
3:56:09 PM
MICHAEL MICHADU, PA, representing self, Mat-Su, Alaska,
testified in support of SB 89, sharing that he practiced as a PA
for three years in emergency departments across Virginia,
ranging from large teaching hospitals to small rural facilities.
He described receiving extensive hands-on training under
physician supervision, which prepared him well for independent
decision-making. He stated that after moving to Alaska to work
with Southcentral Foundation in both the Mat-Su Valley and rural
clinics like McGrath and Iliamna, he immediately experienced the
challenge of providing care without the team-based support he
was accustomed to. He expressed deep respect for the skill and
professionalism of the PAs he has worked with in Alaska. He
urged the legislature to align Alaska's PA practice laws with
the high standards already being demonstrated across the state.
3:58:48 PM
MOLLY SOUTHWORTH, MD, representing self, Anchorage, Alaska,
testified in opposition to SB 89, stating she has been a
physician in Alaska since 1985, with extensive experience in the
tribal system, private sector, and medical education through the
WWAMI program. She emphasized that while PAs strengthen the
healthcare system, SB 89 undermines physician-led teams, which
she believes would reduce care quality and hinder access to
specialists. She warned that passing SB 89 as written could
result in decreased access to quality care for patients. She
urged the legislature to instead focus on strengthening team-
based care and offered to share specific alternative
recommendations.
MS. SOUTHWORTH also shared a written message from Dr. Kamila
Sulak, president-elect of the Alaska College of Emergency
Physicians, who stated, "the physician voice is important, and
the physician groups we represent account for most of the
physicians in the state of Alaska, it is important that we stand
up strong for the highest quality care possible for our patients
and ourselves."
4:01:33 PM
MARGARET CARLSON CONSENTINO, MD, President, Alaska Academy of
Family Physicians, Anchorage, Alaska, testified in opposition to
SB 89. She said the Alaska Academy of Family Physicians,
representing 340 family doctors, and the organization opposes SB
89 in its current form. She noted that while they value their
work with PAs and have collaborated on alternative frameworks,
SB 89 does not reflect a mutually agreed-upon solution. She
acknowledged concerns with current collaborative plan
requirements and confirmed that the State Medical Board is
already working to revise them significantly. She emphasized the
importance of maintaining team-based care models, which she
believes have contributed to successful partnerships between
physicians and PAs. She recommended considering the North Dakota
model, which retains physician-led care teams without granting
full independence to PAs. She urged continued work on SB 89 to
ensure any changes preserve care quality and respect both
physician and PA roles.
4:04:07 PM
MEGHAN HALL, PA, President, Alaska Academy of Physician
Assistants, Anchorage, Alaska, testified in support of SB 89 as
the current president of the Alaska Academy of Physician
Assistants. She explained that the PA profession was originally
created to relieve overburdened physicians and improve access to
care, operating under collaborative agreements for supervision
and liability. She emphasized that the profession has evolved,
with PAs now holding master's degrees, national certifications,
individual licensure, and Drug Enforcement Administration
registration. She stated that while collaboration remains
essential in practice, formal collaborative agreements have
become outdated and now pose barriers to hiring. She noted
Alaska's critical healthcare shortage and warned that outdated
laws are pushing PAs to relocate to states with modernized
practice statutes. She urged support for SB 89 to help retain
the PA workforce and expand access to care across the state.
4:05:59 PM
CHAIR DUNBAR closed public testimony on SB 89.
4:06:38 PM
CHAIR DUNBAR held SB 89 in committee.
4:06:54 PM
At ease.
SB 88-CHILD PLACEMENT; DILIGENT SEARCH
4:08:21 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 88 "An Act relating to
placement of a child in need of aid; relating to adoption;
relating to variances for foster care licenses; relating to the
medical records of children in foster care; and providing for an
effective date."
4:08:43 PM
SENATOR JESSE BJORKMAN, District D, Alaska State Legislature,
Juneau, Alaska, sponsor of SB 88, provided the following
introduction of the bill:
I appreciate you hearing this bill today. It's an
unfortunate, heartbreaking truth that sometimes a
child must be removed from the care of their parents.
It is then incumbent on the state of Alaska to ensure
that these kids receive the best care possible while
they are in the state's custody. This includes
amending Alaska laws necessary to ensure the
Department of Family and Youth Services and the Alaska
court system have guidelines that will allow for the
best possible outcomes for that child.
Studies show that every time a child is moved from one
placement to another, there is an impact on that
child. Kids in the foster care system, on average,
show greater issues of behavior, mental health, and
cognitive abilities than their peers. However, there
can be a direct correlation drawn between the number
of placements a child experiences and the impact that
it has on them. I have invited subject matter experts
that are online to speak about these concerns.
SB 88 seeks to minimize the number of placements a
child may experience in two ways. First, the bill
would place a 30-day timeline and more specific
requirements on the Office of Children's Services for
finding family members and family friends who are able
and willing to take care of a child earlier in the
process, to help minimize the number of placements
that a child may experience, and also help maintain
connections with family and their community. I have
heard stories of relatives that were unaware for
months or even years that a child was in foster care.
Ensuring that more thorough and timely searches are
conducted will help create better outcomes for kids.
Second, this bill provides more latitude to apply the
placement preferences placed on OCS in the court
system. SB 88 will allow the state to consider placing
a child with a foster family instead of a family
member if the child is under six years old and has
been with the family for more than 12 months and it is
determined to be in the best interest of the child for
them to remain there.
Twenty years ago, the Alaska Legislature enacted
policies giving family members ultimate preference
when placing a childpolicies I support through the
provisions that will strengthen family searches.
However, children under six are going through their
most significant phases of brain development, and
placement changes can have a much larger impact than
for older children. It is difficult to craft laws that
will perfectly apply to situations that are guaranteed
to vary widely from one child to the next. This change
in statute wouldn't mandate where a child is placed.
SB 88 provides moral latitude for making the decision
that is in the best interest of the child. Also, by
encouraging timely and diligent family searches, the
number of these difficult situations that occur can be
minimized or avoided entirely.
It's important to note that the statutory change about
placement will not apply to kids that fall under the
federal Indian Child Welfare Act. Placement decisions
will still be made under those federal guidelines.
4:11:53 PM
SENATOR BJORKMAN continued his introduction of SB 88:
In addition, the bill clarifies that foster families
have the right to request a hearing about placement of
a child they have been caring for, in order to ensure
they, as the people most knowledgeable about the child
in their care, have a seat at the table when decisions
are made. They would not be parties to the case and
would not be eligible to have legal representation
under this provision.
It is also important to acknowledge the hard work of
the Office of Children's Services and the heavy
headwinds that they face every day. I am looking
forward to the outcome of the salary survey promised
by the administration, and I hope that we will be able
to find a way to help the division recruit and retain
enough people to keep up with their heavy and
challenging workload. That said, I believe that this
bill directly addresses issues that would be at play
regardless of the circumstances at OCS, and that we
need to act now to improve outcomes for Alaska's
children in foster care.
4:13:25 PM
LAURA ACHEE, Staff, Senator Jesse Bjorkman, Alaska State
Legislature, Juneau, Alaska, paraphrased the sectional analysis
for SB 88:
[Original punctuation provided.]
Senate Bill 88 Child Placement; Diligent Search
Version A Sectional Analysis
February 14, 2025
Section 1: Adds language to AS 47.10.080(s) to clarify
that foster parents may request a hearing regarding
the Department of Family and Community Services'
decision to transfer a child out of the foster home.
Clarifies that while foster parents may request
hearings regarding placement under AS 47.10.080(s),
they are not parties to child in need of aid cases.
Adds language to allow a foster parent to schedule at
their own cost medical or psychological evaluations
for a child for the purpose of providing evidence
during a hearing regarding a proposed transfer.
Section 2: Amends AS 47.10.084(d) to allow foster
parents to request and receive the medical records of
a child under their care.
Section 3: Amends AS 47.10.088(i) to allow for
determination of the best interest of the child when
making decisions regarding permanent placement of a
child. This section also adds language regarding
determination of best interest, including whether a
child is under six years old and has been in the care
of the foster family for at least 12 consecutive
months. Adds direction to follow the new process in AS
47.10.145 when OCS is searching for family when
determining permanent placement of a child.
Section 4: Adds language to AS 47.10.142(i) that
conforms to the changes in Section 4.
Section 5: Adds a new section, AS 47.10.145, that
requires the Department search for adult family
members and family friends suitable for placement of a
child within 30 days of the State removing the child
from the home, describes what constitutes a diligent
statutorily required search, and requires ongoing
searches until excused to do so by the court or the
child is in a permanent placement.
Section 6: Adds language to AS 47.14.100(e) allowing
for consideration of placement with a foster family
when an adult family member has also expressed
interest for children who are under six years old and
have been in the care of that foster family for at
least 12 consecutive months if it is in the best
interest of the child. Also amends language to conform
to the change in Section 4.
Section 7: Amends AS 47.14.100(m) to add that
consideration of the best interest of a child may not
include consideration of poverty of the family member
who has requested placement or inadequate or crowded
housing. Adds language that non-parties requesting
hearings under this and other sections of this statute
are not eligible for publicly appointed legal counsel.
Section 8: Adds a new subsections that would require
the Department to assist adult family member's and
family friend's waivers to licensing requirements
under AS 47.32.032 and defines "department" as the
Department of Family and Community Services.
Section 9: Provides for a January 1, 2026 effective
date.
4:19:33 PM
SENATOR CLAMAN asked the sponsor of SB 88 if the legislation had
changed from a similar proposal introduced last year.
SENATOR BJORKMAN replied there were changes.
MS. ACHEE stated that two main changes had been made to SB 88
since last year. She explained that Section 1, now allows foster
parents to schedule appointments for mental or physical
evaluations. She added that Section 2 permits foster parents to
access the medical records of a child in their care.
4:20:20 PM
SENATOR TOBIN said she was unclear about the language in SB 88,
Section 5 and requested clarification. She noted that Section 5
(d) allows placement with a family friend but expressed concern
that earlier parts of the section do not clearly identify
fictive kin such as a godparent, close family friend, or
community member like a Girl Scout leader. She emphasized the
importance of ensuring this category is explicitly included. She
indicated she might be overlooking how the search and placement
process is defined within the section.
4:21:03 PM
MS. ACHEE responded that she understood the question as a
request to confirm whether the new section ensures that fictive
kin or adult family friends are included in all search and
placement considerations. She pointed to Section 5 (a), line 14,
which references "family member or family friend of the child
suitable for placement" as evidence of their inclusion. She
offered to review the language further if that did not fully
address the concern.
SENATOR TOBIN said she would like to follow up later to ensure
clarity that fictive kin placement is allowed.
MS. ACHEE stated her belief that current law already allows for
the inclusion of fictive kin. SB 88 does not change that
provision. She said SB 88 refers to fictive kin as adult family
friends. She emphasized that SB 88 carefully includes adult
family friends in the search requirements. She added that
conforming changes were made throughout the bill to ensure
consistent terminology.
4:22:12 PM
SENATOR TOBIN asked a follow-up question regarding the
definition of "adult family member." She sought clarification on
whether this includes relatives such as a great-uncle or great-
aunt. She also questioned how "immediate family" is defined and
whether it extends to second- or third-degree relatives. She
asked where this definition is provided or if it remains
undefined.
MS. ACHEE said she would get back to the committee with an
answer.
4:22:46 PM
SENATOR HUGHES stated that she had not participated in a
previous hearing on the bill and framed her comments as an
educational question. She referenced language in SB 88, page 3,
line 15, concerning the department's obligation to consider a
child's physical and psychological well-being in determining
best interest. She noted the weight of that responsibility and
questioned how disagreements between the department and foster
parents are handled. She asked whether there is an appeals
process, what role psychological evaluations play, and how the
department makes such life-impacting decisions.
4:23:54 PM
MS. ACHEE responded that some of the questions regarding
placement decisions are best directed to the Office of
Children's Services (OCS). She noted that there are
opportunities at times for foster families, adult family
members, or parents to appeal decisions. She acknowledged she
was not fully familiar with the timelines or procedures involved
in those appeals. She added that a foster parent would be
included in invited testimony and anticipated that some might
also speak during public testimony, offering further opportunity
to explore their experiences.
4:24:41 PM
SENATOR BJORKMAN explained that this portion of SB 88 gives
judges flexibility to consider a foster family's home as a
viable placement when making decisions about a child's
placement. He stated that under current law, if a relative comes
forward, even years after a child has been placed in a foster
home, the judge must prioritize the relative, regardless of the
time elapsed or the child's bond with the foster family. He
emphasized that SB 88 does not require judges to decide one way
or another but simply allows them to consider the child's
existing placement and emotional stability.
4:26:12 PM
SENATOR HUGHES referred to language in SB 88, page 3, regarding
the department determining the best interest of a child under
six. She sought confirmation that it is accurate to say that the
foster family could appeal to the court if the department
decided to move a three-year-old child to a newly identified
family member. She sought confirmation that the court would then
be able to consider the child's current placement and
potentially reverse the department's decision, confirming that,
under current law, the court does not have that authority.
SENATOR BJORKMAN replied that is his understanding.
4:27:37 PM
CHAIR DUNBAR expressed appreciation to Senator Bjorkman and his
staff for addressing the Indian Child Welfare Act (ICWA) and
clarifying that SB 88 does not impact ICWA-related concerns. He
noted the timing of SB 88 coincides with another adoption-
related bill from Senator Myers, which has prompted outreach
from groups opposed to that approach. He stated that similar
concerns may apply to SB 88, especially in Section 3 and, to
some extent, Section 6, where language removes the presumption
favoring placement with an adult family member unless there is
good cause. He said some groups argue that removing children
from their cultural background can be harmful both to the child
and the broader community. He referenced the underlying
rationale for ICWA and asked whether cultural identity and
connection are considered when determining the best interest of
the child, particularly in cases where placement with a
culturally connected adult family member is at issue.
4:29:50 PM
NANCY MEADE, General Counsel, Alaska Court System, Juneau,
Alaska, answered questions on SB 88. She explained that a
statute exists outlining how to determine the best interest of
the child, found in the Family Law Section, AS 25, which also
governs child custody. She summarized that courts consider
multiple factors, including the child's physical, emotional,
mental, religious, and social needs; the capability and desire
of the individuals seeking custody to meet those needs; the
child's preference if they are of sufficient age and capacity;
the length of time the child has lived in a stable environment;
and the willingness to support relationships with parents.
MS. MEADE stated that while these standards are applied in
custody cases, they also apply to child-in-need-of-aid cases. In
response to the Chair's question, she confirmed that courts
always consider the best interest of the child. She noted that
SB 88 primarily modifies the order of placement preference,
found on page 6, line 6 of the bill. Current law prioritizes
adult family members first, then family friends, followed by
foster homes. She explained that an "adult family member" is
defined under AS 47.10.990 as someone over 18 who is related to
the childsuch as a grandparent, aunt, uncle, sibling, or legal
guardianand that for Indian children, the definition extends
further under ICWA.
4:32:46 PM
MS. MEADE stated that SB 88 allows, in cases involving children
under age six who have lived in a stable foster home for at
least 12 months, the foster family to be considered on equal
footing with adult family members in the placement preference.
She emphasized that this change introduces flexibility for the
court to apply a best interest analysis in situations where a
previously unknown or unavailable family member surfaces later
in the case, and that the change may also affect adoption
decisions, since other statutes refer to this placement order.
4:33:54 PM
CHAIR DUNBAR asked the same question to the Office of Children's
Services.
4:34:35 PM
KIM GUAY, Director, Central Office, Office of Childrens
Services, Anchorage, Alaska, she answered questions on SB 88.
She stated that OCS operates under the Fostering Connections
Act, which includes provisions from the Multiethnic Placement
Act (MEPA). She explained that MEPA prohibits using race, color,
or national origin to discriminate in placement or permanency
decisions. She noted that this may address the question about
considering cultural background,
4:35:10 PM
CHAIR DUNBAR said he understood the federal limitations under
MEPA in the context of a system that prioritizes placement with
an adult family member. He asked whether the federal framework,
which restricts consideration of cultural background in
placement decisions, operates under the assumption that adult
family members are already given first preference, thereby
addressing cultural concerns through that prioritization.
4:35:35 PM
MS. GUAY confirmed that under current statute, an adult family
member is considered a first preference placement. She stated
that OCS prioritizes locating and considering adult family
members when identifying placement options.
4:36:02 PM
SENATOR HUGHES asked whether adding foster families as a
consideration for children under six would affect or conflict
with the Multiethnic Placement Act (MEPA).
4:36:28 PM
MS. GUAY stated her belief that it would not.
4:36:50 PM
SENATOR CLAMAN asked whether, in the case of an Indian child,
the Indian Child Welfare Act (ICWA) takes precedence over state
statute, meaning ICWA guidelines would govern the case.
4:37:13 PM
MS. MEADE stated her understanding that the Indian Child Welfare
Act (ICWA) takes precedence over state statutes in child-in-
need-of-aid cases involving Indian children. She clarified that
she did not want to speak out of turn and suggested that the
Office of Children's Services (OCS) could provide a more
detailed and informed response.
4:37:36 PM
SENATOR CLAMAN requested a response to the question from OCS.
4:38:00 PM
MS. GUAY stated that when OCS is working with a child covered
under ICWA, federal law takes precedence over state law. She
noted that many state statutes are aligned with ICWA
requirements.
4:38:31 PM
SENATOR CLAMAN asked whether, in cases involving a child covered
by the Indian Child Welfare Act (ICWA), the federal law alone
governs decision-making. He questioned if there is any need to
consult current or amended state statutes, given that ICWA would
apply fully and guide all determinations, regardless of state
law alignment.
4:39:06 PM
MS. GUAY responded that the situation is more complex than
simply following federal law alone. She explained that while OCS
is committed to following the law, the best interest
consideration, such as those described by Ms. Mead, also play a
role. She emphasized that child welfare cases involve many
nuances and are not handled solely by OCS. Instead, they include
input from guardians ad litem, public defenders, attorneys,
assistant attorneys general, and ultimately a judge, making it a
collaborative legal process centered on the child's well-being.
4:39:54 PM
CHAIR DUNBAR recalled that the best interest test used by the
court system includes physical, emotional, social, and religious
considerations. He asked whether that test takes into account
the child's ethnic and cultural background, includingbut not
limited toAlaska Native cultures. He noted that, based on the
OCS director's earlier comments, federal law may prohibit
considering those factors and questioned how state and federal
law interact on this issue. He further asked whether "social and
religious needs" are interpreted narrowly, focusing only on the
child's immediate circumstances, or if they also include the
broader cultural group the child comes from.
4:41:08 PM
MS. MEADE responded that the best interest determination is not
a checklist-style test but rather an ongoing discussion among
all parties involved in the case. She explained that, for
example, if someone argues that a child's social needs would be
better met in a particular placement, various subjective and
objective factors would be presented to support that view. She
clarified that it would not be as simple as stating a child must
be placed with a family of the same ethnic background, such as
requiring a child raised in a Hmong household to be placed with
a Hmong foster family. Instead, the process involves broader
discussion and judicial discretion, with cultural background
potentially considered indirectly or contextually. She
acknowledged the complexity and said she could not offer a more
precise answer.
4:42:28 PM
MS. MEADE requested to offer a brief clarification regarding an
earlier question about the best interest finding in SB 88,
Section 3. She explained that while the department (OCS) makes
initial placement decisions, as outlined in Section 1, the court
has the final authority if an objection is raised. She
emphasized that this dynamic, common throughout child-in-need-
of-aid cases, reflects a shared and collaborative decision-
making process between the department and the court.
4:43:16 PM
CHAIR DUNBAR announced invited testimony on SB 88.
4:43:34 PM
BRADLEY GALBRAITH, Policy Director, The Center for the Rights of
Abused Children, Phoenix, Arizona, testified by invitation on SB
88. He stated that children entering foster care have already
endured significant trauma and that the most effective way to
reduce further harm is by quickly placing them in stable, loving
homes, ideally with relatives who can offer familiarity and
continuity. He shared an example from a pro bono law clinic in
Arizona, where a relative expressed interest early in a case but
was ignored, and the child was placed with a foster family.
Years later, on the verge of terminating parental rights, the
state sought to move the child to that relative, despite the
child having developed a strong bond with the foster family. He
described the judge's frustration over the department's delayed
and inadequate response.
4:45:26 PM
MR. GALBRAITH argued that while federal and Alaska law require
relative searches, they lack clarity and accountability. He
explained that this can lead to unnecessary moves, emotional
harm, and prolonged foster care. He said SB 88 introduces
essential reforms by requiring timely and thorough searches,
providing relatives with clear information about their
caregiving options, and enabling courts to review search
efforts. He concluded that SB 88 prioritizes the child's
emotional stability by allowing long-term foster families of
young children to be treated like relatives, helping ensure
permanent and loving placements when relatives are not
identified early in the process.
4:47:04 PM
MALAIKA TESSON, Foster Parent, Anchorage, Alaska, testified by
invitation on SB 88. She testified that she and her husband have
been lifelong Alaskans and licensed foster parents for five
years, with a deep commitment to creating positive change in
their community. She shared the recent experience of having to
surrender two long-term foster children, siblings aged eight and
four, to the Office of Children's Services (OCS), despite having
cared for them for four years. The children had formed deep
bonds with their foster family and had only recently met the 70-
year-old great grandmother they were placed with. She emphasized
that this was not an Indian Child Welfare Act (ICWA) case.
MS. TESSON stated that SB 88 would have allowed them to request
a placement review hearing and provide testimony from medical
providers and others familiar with the children's extensive
physical, cognitive, and emotional needs. She described the
grievance process currently available as inadequate, often
involving biased internal review and long timelines that are
unworkable in urgent situations. She argued that SB 88 would
empower foster families to bring relevant information to the
court and ensure decisions are made based on a comprehensive
understanding of the child's best interest.
4:51:12 PM
MS. TESSON detailed the children's significant medical and
developmental challenges and stressed that disrupting their
established home environment caused severe trauma. She explained
that the relative placement had originally expressed interest
but withdrew due to health concerns, only reappearing years
later. She concluded by urging the passage of SB 88 to prevent
future harm to vulnerable children, stating that while it is too
late for the children that were in her care, the bill is
essential to protect others.
4:54:39 PM
KRISTEN A. MOORE, representing self, Wasilla, Alaska, testified
by invitation on SB 88. She stated she is a nurse and oversight
case manager for adults and youth on Medicaid waivers. She
emphasized that children in foster care experience frequent
movesaveraging eight or more placements which causes emotional
distress and instability. She stated kinship placement is ideal
because it preserves connections to family, school, community,
and cultural identity, which promotes normalcy and healing. She
urged the department to conduct timely and diligent searches for
family members to avoid delayed placements that cause further
trauma. She added that while foster families develop an
understanding of the child's needs over time, uninvolved
relatives may lack awareness of the child's medical and
emotional history, making abrupt placement changes potentially
harmful.
4:57:11 PM
MS. MOORE stated that access to medical records is critical,
especially since one-third of children in foster care have
chronic health conditions and up to 80 percent have significant
mental health needs. She described how lack of consistent
healthcare due to placement changes can cause delays in care and
worsen medical outcomes. She referenced Utah's system, where
child welfare staff gather medical history early and share it
with foster parents to coordinate care. She supported SB 88,
stating it helps ensure timely kinship searches and better
access to medical information to support the child's well-being.
CHAIR DUNBAR thanked the individuals invited to testify on SB
88.
4:59:07 PM
CHAIR DUNBAR held SB 88 in committee.
4:59:33 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Health and Social Services
Standing Committee meeting at 4:59 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 88 Support Document The Effect of Placement Instability 2007.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB 88 Support Document Placement Narratives.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB 88 Support Document Months to Permanent Placement With Kinship.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB 88 Sponsor Statement Version A.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB 88 Sectional Analysis Version A.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB 88 Fiscal Note FCS FLSW 2.21.25.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB 88 Version A.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB 88 Fiscal Note JUD ACS 2.24.25.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |
| SB88 Support Letters as of 02262025.pdf |
SHSS 2/27/2025 3:30:00 PM |
SB 88 |