Legislature(2015 - 2016)BELTZ 105 (TSBldg)

03/17/2015 01:30 PM LABOR & COMMERCE

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Audio Topic
01:30:53 PM Start
01:32:23 PM SB29
01:33:42 PM SB14
02:14:07 PM SB71
02:49:23 PM Confirmation Hearings
03:06:31 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Public Testimony --
*+ SB 14 EMERGENCY MED. SERVICES; DEFIBRILLATORS TELECONFERENCED
Heard & Held
*+ SB 29 STATE MEDICAL BOARD MEMBERSHIP TELECONFERENCED
Heard & Held
*+ SB 71 VACCINE CERTIFICATION FOR PHARMACISTS TELECONFERENCED
Heard & Held
Boards and Commission Appointees:
Workers' Comp. Appeals Commission
Alaska Workers' Comp. Board
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE LABOR AND COMMERCE STANDING COMMITTEE                                                                        
                         March 17, 2015                                                                                         
                           1:30 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Mia Costello, Chair                                                                                                     
Senator Cathy Giessel, Vice Chair                                                                                               
Senator Kevin Meyer                                                                                                             
Senator Gary Stevens                                                                                                            
Senator Johnny Ellis                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARINGS                                                                                                           
                                                                                                                                
     Alaska Workers' Compensation Board                                                                                       
          Pamela Cline - Wasilla                                                                                                
          Chuck Collins Jr. - Juneau                                                                                            
          Jacob Howdeshell - Soldotna                                                                                           
          Linda Hutchings - Soldotna                                                                                            
          Rick Traini - Anchorage                                                                                               
          Patricia Vollendorf - Anchorage                                                                                       
          Lake Williams - Fairbanks                                                                                             
          Robert Weel - Anchorage                                                                                               
                                                                                                                                
     - CONFIRMATIONS ADVANCED on 3/31/2015                                                                                      
                                                                                                                                
     Workers' Compensation Appeals Commission                                                                                 
          Andrew Hemenway - Juneau                                                                                              
                                                                                                                                
     - CONFIRMATION ADVANCED on 3/31/2015                                                                                       
                                                                                                                                
SENATE BILL NO. 29                                                                                                              
"An Act relating to the membership of the State Medical Board."                                                                 
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 14                                                                                                              
"An Act  relating to the  appointment of a mobile  intensive care                                                               
paramedic to the State Medical  Board; relating to medical review                                                               
organizations;  relating  to  immunity  pertaining  to  automated                                                               
external defibrillators; and providing for an effective date."                                                                  
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 71                                                                                                              
"An Act relating to the practice of pharmacy; and relating to                                                                   
the   administration   of    vaccines   and   related   emergency                                                               
medications."                                                                                                                   
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB  29                                                                                                                  
SHORT TITLE: STATE MEDICAL BOARD MEMBERSHIP                                                                                     
SPONSOR(s): SENATOR(s) MEYER                                                                                                    
                                                                                                                                
01/23/15       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/23/15       (S)       L&C, FIN                                                                                               
03/17/15       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
BILL: SB  14                                                                                                                  
SHORT TITLE: EMERGENCY MED. SERVICES; DEFIBRILLATORS                                                                            
SPONSOR(s): SENATOR(s) COGHILL                                                                                                  
                                                                                                                                
01/21/15       (S)       PREFILE RELEASED 1/16/15                                                                               
01/21/15       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/21/15       (S)       L&C, JUD, FIN                                                                                          
03/17/15       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
BILL: SB  71                                                                                                                  
SHORT TITLE: VACCINE CERTIFICATION FOR PHARMACISTS                                                                              
SPONSOR(s): SENATOR(s) GIESSEL BY REQUEST                                                                                       
                                                                                                                                
03/11/15       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/11/15       (S)       L&C                                                                                                    
03/17/15       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
JORDAN SHILLING, Staff                                                                                                          
Senator John Coghill                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented SB 14 on behalf of the sponsor.                                                                
                                                                                                                                
SENATOR JOHN COGHILL                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Sponsor of SB 14.                                                                                        
                                                                                                                                
THOMAS MEYER, President                                                                                                         
Paramedic Association of Alaska                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 14.                                                                           
                                                                                                                                
DON HUDSEN, MD.                                                                                                                 
Anchorage, Alaska,                                                                                                              
POSITION STATEMENT:  Testified in support of SB 14.                                                                         
                                                                                                                                
MITCH FLYNN, Fire Chief                                                                                                         
Steese Volunteer Fire Department                                                                                                
Fairbanks, Alaska,                                                                                                              
POSITION STATEMENT:  Testified in support of SB 14.                                                                           
                                                                                                                                
ROBERT M. VOSTRY, representing himself                                                                                          
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of SB 14.                                                                           
                                                                                                                                
KATHLEEN MCLERON, representing herself                                                                                          
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 14.                                                                           
                                                                                                                                
SARA CHAMBERS, Director                                                                                                         
Division of Corporations, Business, and Professional Licensing                                                                  
Department of Commerce, Community and Economic Development                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Explained that the fiscal notes for SB 14                                                                
and SB 71.                                                                                                                      
                                                                                                                                
JANE CONWAY, Staff                                                                                                              
Senator Cathy Giessel                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Delivered a sectional analysis for SB 71                                                                 
                                                                                                                                
CHAD HOPE, Pharmacy Program Manager                                                                                             
Medicaid Assistance Administration                                                                                              
Division of Health Care Services                                                                                                
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Discussed the fiscal note for SB 71.                                                                     
                                                                                                                                
SCOTT WATTS, representing himself                                                                                               
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as a pharmacist in support of SB                                                               
71.                                                                                                                             
                                                                                                                                
JASON TAPLEY, representing himself                                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as a pharmacist in support of SB                                                               
71.                                                                                                                             
                                                                                                                                
BARRY CHRISTENSEN, Co-Chair                                                                                                     
Alaska Pharmacist Association                                                                                                   
Ketchikan, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 71.                                                                           
                                                                                                                                
RYAN RUGGLES, District Pharmacy Manager                                                                                         
Carrs Safeway Alaska                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 71.                                                                           
                                                                                                                                
AMBER BRIGGS representing herself                                                                                               
Soldotna, Alaska                                                                                                                
POSITION STATEMENT:  Testified as a pharmacist in support of SB                                                               
71.                                                                                                                             
                                                                                                                                
LIS HOUCHEN, Northwest Regional Director                                                                                        
National Association of Chain Drug Stores                                                                                       
Olympia, Washington                                                                                                             
POSITION STATEMENT:  Testified in support of SB 71.                                                                           
                                                                                                                                
ANDREW HEMENWAY, Appointee                                                                                                      
Workers' Compensation Appeals Commission                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as an appointee to the Workers'                                                                
Compensation Appeals Commission.                                                                                                
                                                                                                                                
PAMELA CLINE, Appointee                                                                                                         
Workers' Compensation Board                                                                                                     
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified as an appointee to the Workers'                                                                
Compensation Board.                                                                                                             
                                                                                                                                
CHUCK COLLINS JR., Appointee                                                                                                    
Alaska Workers' Compensation Board                                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:   Testified as  an appointee to  the Workers'                                                             
Compensation Board.                                                                                                             
                                                                                                                                
JACOB HOWDESHELL, Appointee                                                                                                     
Workers' Compensation Board                                                                                                     
Soldotna, Alaska                                                                                                                
POSITION STATEMENT:   Testified as  an appointee to  the Workers'                                                             
Compensation Board.                                                                                                             
                                                                                                                                
LINDA HUTCHINGS, Appointee                                                                                                      
Alaska Workers' Compensation Board                                                                                              
Soldotna, Alaska                                                                                                                
POSITION STATEMENT:   Testified as  an appointee to  the Workers'                                                             
Compensation Board.                                                                                                             
                                                                                                                                
RICK TRAINI, Appointee                                                                                                          
Workers' Compensation Board                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Testified as  an appointee to  the Workers'                                                             
Compensation Board.                                                                                                             
                                                                                                                                
PATRICIA VOLLENDORF, Appointee                                                                                                  
Alaska Workers' Compensation Board                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Testified as  an appointee to  the Workers'                                                             
Compensation Board.                                                                                                             
                                                                                                                                
LAKE WILLIAMS, Appointee                                                                                                        
Alaska Workers' Compensation Board                                                                                              
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:   Testified as  an appointee to  the Workers'                                                             
Compensation Board.                                                                                                             
                                                                                                                                
ROBERT WEEL, Appointee                                                                                                          
Workers' Compensation Board                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Testified as  an appointee to  the Workers'                                                             
Compensation Board.                                                                                                             
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:30:53 PM                                                                                                                    
CHAIR MIA COSTELLO called the  Senate Labor and Commerce Standing                                                             
Committee meeting  to order at 1:30  p.m. Present at the  call to                                                               
order were  Senators Ellis, Meyer,  and Chair  Costello. Senators                                                               
Stevens and Giessel joined the committee soon thereafter.                                                                       
                                                                                                                                
             SB  29-STATE MEDICAL BOARD MEMBERSHIP                                                                          
                                                                                                                                
1:32:23 PM                                                                                                                    
CHAIR  COSTELLO announced  the consideration  of SB  29. "An  Act                                                               
relating to the membership of the State Medical Board."                                                                         
                                                                                                                                
SENATOR  KEVIN MEYER,  speaking as  sponsor, advised  that SB  29                                                               
adds a mobile  intensive care paramedic (MICP) seat  to the State                                                               
Medical  Board.  He introduced  the  bill  at  the request  of  a                                                               
constituent and  afterward became  aware of Senator  Coghill's SB                                                               
14 that  is broader  in scope.  He deferred  his bill  to Senator                                                               
Coghill's more comprehensive legislation.                                                                                       
                                                                                                                                
1:33:19 PM                                                                                                                    
SENATOR STEVENS joined the committee.                                                                                           
                                                                                                                                
CHAIR COSTELLO held SB 29 in committee.                                                                                         
                                                                                                                                
         SB  14-EMERGENCY MED. SERVICES; DEFIBRILLATORS                                                                     
                                                                                                                                
1:33:42 PM                                                                                                                    
CHAIR  COSTELLO announced  the consideration  of  SB 14. "An  Act                                                             
relating to the appointment of  a mobile intensive care paramedic                                                               
to  the   State  Medical  Board;   relating  to   medical  review                                                               
organizations;  relating  to  immunity  pertaining  to  automated                                                               
external defibrillators; and providing for an effective date."                                                                  
                                                                                                                                
SENATOR  JOHN  COGHILL,  sponsor  of  SB  14,  stated  that  this                                                               
legislation  adds a  paramedic  to the  State  Medical Board  and                                                               
gives emergency  medical service  (EMS) agencies  protections for                                                               
peer review  activities. He deferred further  introduction to his                                                               
staff.                                                                                                                          
                                                                                                                                
1:35:23 PM                                                                                                                    
SENATOR GIESSEL joined the committee.                                                                                           
                                                                                                                                
JORDAN SHILLING, Staff,  Senator John Coghill, stated  that SB 14                                                               
does three  things: 1) it adds  a paramedic to the  State Medical                                                               
Board; 2)  it add EMS agencies  and fire departments to  the peer                                                               
review statutes;  and 3)  it repeals  problematic language  in AS                                                               
09.65.087, the automated external defibrillator statutes.                                                                       
                                                                                                                                
He reviewed the bill sections and  the rationale for the bill. He                                                               
explained  that the  State Medical  Board regulates  five medical                                                               
professions   in  Alaska   -  physicians,   osteopathic  doctors,                                                               
physician  assistants  (PA),  podiatrists,  and  paramedics.  The                                                               
board  has five  physician seats,  one  PA seat,  and two  public                                                               
seats. Paramedics have been regulated  by the board for more than                                                               
30  years  and the  sponsor  feels  that giving  this  distinctly                                                               
different profession a seat is  long overdue. Despite the lack of                                                               
representation, the board  plays a significant role  in the lives                                                               
of paramedics  by disciplining, levying  fines, and  making final                                                               
licensing  decisions.  Adding  an   EMS  seat  will  broaden  the                                                               
perspective of  the board  and add  the expertise  of prehospital                                                               
medicine.  He  reported  that  there  are  currently  463  active                                                               
paramedics  in Alaska.  These  professionals,  the State  Medical                                                               
Board, and the five physicians that  sit on the board support the                                                               
legislation.                                                                                                                    
                                                                                                                                
SENATOR COGHILL  asked Mr.  Shilling to  discuss the  peer review                                                               
process.                                                                                                                        
                                                                                                                                
MR. SHILLING explained that peer  review is a rigorous evaluation                                                               
process that healthcare organizations  use to monitor and improve                                                               
patient care.  Hospitals generally  have a peer  review committee                                                               
to  look  at  patient  documentation,  review  reports  and  give                                                               
feedback, all  of which is  statutorily protected  from discovery                                                               
in a civil  trial. This is an important  protection that promotes                                                               
honest, candid  feedback. All 50  states provide  this protection                                                               
and many are  adding it for EMS agencies because  they go through                                                               
the  same  rigorous evaluation  process.  The  sponsor feels  EMS                                                               
agencies should be extended the same protection as hospitals.                                                                   
                                                                                                                                
MR. SHILLING read a statement from a national EMS assessment.                                                                   
                                                                                                                                
     For EMS systems  to be used to  their maximum potential                                                                    
     with  respect to  performance improvement,  peer review                                                                    
     protection is required and should  be the goal of every                                                                    
     state.                                                                                                                     
                                                                                                                                
He highlighted that a group  of EMS experts last year recommended                                                               
that the legislature provide  statutory protection from discovery                                                               
for quality improvement activities related  to EMS care. The bill                                                               
provides this protection in Sections 2-4.                                                                                       
                                                                                                                                
1:41:24 PM                                                                                                                    
SENATOR STEVENS  asked if  paramedics would be  in a  position to                                                               
make a disciplinary licensing decisions about a physician or PA.                                                                
                                                                                                                                
MR. SHILLING answered yes.                                                                                                      
                                                                                                                                
SENATOR STEVENS  asked if paramedics  would be  comfortable being                                                               
in that position.                                                                                                               
                                                                                                                                
MR. SHILLING answered yes.                                                                                                      
                                                                                                                                
SENATOR COGHILL  clarified that the  paramedic member  would have                                                               
one vote, the  physicians would have five votes, the  PA one vote                                                               
and the public member one vote.                                                                                                 
                                                                                                                                
SENATOR GIESSEL  asked if paramedics have  been misrepresented or                                                               
if disciplinary action has been inappropriate.                                                                                  
                                                                                                                                
1:43:55 PM                                                                                                                    
MR. SHILLING replied he has  anecdotal evidence that not having a                                                               
voice has negatively affected the  profession and some paramedics                                                               
personally.                                                                                                                     
                                                                                                                                
SENATOR COGHILL added that the  unique circumstance of paramedics                                                               
isn't addressed to their satisfaction.                                                                                          
                                                                                                                                
1:45:17 PM                                                                                                                    
CHAIR COSTELLO asked  if adding a paramedic to  the State Medical                                                               
Board follows a national trend.                                                                                                 
                                                                                                                                
MR. SHILLING  replied he hasn't  reviewed what other  states have                                                               
done, but  Alaska is somewhat unique  in that EMTs are  under the                                                               
purview of the  Department of Health and  Social Services (DHSS),                                                               
whereas paramedics  and physicians are  under the purview  of the                                                               
State Medical Board.                                                                                                            
                                                                                                                                
CHAIR COSTELLO  asked if the  physicians on the board  have given                                                               
verbal or written support for the legislation.                                                                                  
                                                                                                                                
MR.  SHILLING  advised  that  on   January  13  the  board  voted                                                               
unanimously to  support this concept  and wrote a letter  to that                                                               
effect.                                                                                                                         
                                                                                                                                
CHAIR COSTELLO  asked him  to describe the  value of  making this                                                               
change,  and if  he'd  heard any  arguments  for maintaining  the                                                               
status quo.                                                                                                                     
                                                                                                                                
MR. SHILLING  said the value  is having someone  with prehospital                                                               
expertise  being  involved  in discussions  that  regulate  their                                                               
profession. The  sponsor's office has heard  mild opposition from                                                               
the  Alaska  State  Medical Association,  just  as  they  opposed                                                               
giving  PAs a  seat  a  few years  ago.  Their  suggestion is  to                                                               
designate one of the public seats as public or paramedic.                                                                       
                                                                                                                                
CHAIR COSTELLO  noted the  letter from  the Alaska  State Medical                                                               
Association that was  just distributed. She asked  the sponsor to                                                               
respond to the suggestion Mr. Shilling described.                                                                               
                                                                                                                                
SENATOR COGHILL  said he  sees equal value  in having  people who                                                               
are not  in the industry on  a board and those  who are regulated                                                               
by the board.                                                                                                                   
                                                                                                                                
1:50:38 PM                                                                                                                    
CHAIR COSTELLO opened public testimony on SB 14.                                                                                
                                                                                                                                
1:51:06 PM                                                                                                                    
THOMAS MEYER, President, Paramedic  Association of Alaska, voiced                                                               
support  for  adding  a  paramedic to  the  State  Medical  Board                                                               
because they  currently do not  have representation.  The board's                                                               
terms of  initial licensure requirements, the  terms of renewals,                                                               
and disciplines are among if  not the strictest and most punitive                                                               
in the country. Mobil Intensive  Care Paramedics (MICPs) permeate                                                               
the  system  in   vital  areas  for  emergency   care.  They  are                                                               
firefighters  responding to  medical and  fire emergencies;  they                                                               
provide emergency  services in industrial  and remote  sites; EMT                                                               
teachers are almost  all paramedics; they are  in law enforcement                                                               
special operations;  SWAT and field  officers are often  EMTs and                                                               
paramedics; para rescuers working for  the Air National Guard are                                                               
MICPs; the  U.S. Coast  Guard has MICPs  licensed in  Alaska; and                                                               
air medivac services require an MICP on board.                                                                                  
                                                                                                                                
CHAIR COSTELLO asked  if he could support the  statement that the                                                               
State Medical Board is the most punitive in the country.                                                                        
                                                                                                                                
MR. MEYER  replied the national  registry of state  medical board                                                               
actions and fines  on these licensees shows that  Alaska has been                                                               
in the top five most punitive for many years.                                                                                   
                                                                                                                                
1:55:31 PM                                                                                                                    
DON HUDSEN,  MD., Anchorage, Alaska,  said he's an ER  doctor who                                                               
has worked as  a medivac in remote areas of  Alaska, as a medical                                                               
director, and with  several paramedic schools. When  he served on                                                               
the  State Medical  Board it  was disconcerting  to see  that the                                                               
members really didn't  know what paramedics did for  a living. He                                                               
was pleased  when he saw the  bill come up because  he and others                                                               
have supported having a paramedic on the board since 1981.                                                                      
                                                                                                                                
1:57:25 PM                                                                                                                    
MITCH  FLYNN,  Fire  Chief,  Steese  Volunteer  Fire  Department,                                                               
Fairbanks, Alaska, stated  support for adding a  paramedic to the                                                               
State Medical  Board, but  expressed concern  that SB  14 doesn't                                                               
extend peer review protection to volunteer fire departments.                                                                    
                                                                                                                                
ROBERT  "MEL"  VOSTRY,   representing  himself,  Palmer,  Alaska,                                                               
testified  in support  of SB  14.  He has  been a  state-licensed                                                               
paramedic since 1984  and has been involved with  EMS since 1979.                                                               
He  explained that  the first  paramedics chose  to be  under the                                                               
purview of  the State  Medical Board in  the hopes  of eventually                                                               
attaining  a  professional  status.  The field  of  medicine  has                                                               
evolved in the  last 45 years and being a  paramedic is no longer                                                               
simply  serving on  an  ambulance.  They now  attend  a 1-2  year                                                               
university-level accredited  program. The State Medical  Board is                                                               
made up  of physicians and  most recently a  physician assistant,                                                               
and those professionals  may or may not know  anything about what                                                               
a paramedic does in the field or their level of education.                                                                      
                                                                                                                                
MR.  VOSTRY  said  he  values  the  stringent  requirements  that                                                               
paramedics  are held  to by  the Medical  Board, but  they should                                                               
have a voice.                                                                                                                   
                                                                                                                                
2:04:35 PM                                                                                                                    
KATHLEEN  MCLERON,   representing  herself,   Anchorage,  Alaska,                                                               
testified  in  support of  SB  14.  She  relayed  that she  is  a                                                               
licensed physician  assistant (PA) and a  licensed paramedic. The                                                               
State Medical Board regulates the  practice of PAs and paramedics                                                               
and she  was pleased  when PAs got  representation on  the board.                                                               
She  expressed  strong  support  for  giving  paramedics  similar                                                               
representation,  describing it  as a  logical next  step for  the                                                               
State Medical Board.                                                                                                            
                                                                                                                                
2:05:58 PM                                                                                                                    
CHAIR  COSTELLO found  no further  testifiers  and closed  public                                                               
testimony  on SB  14. She  invited Sara  Chambers to  explain the                                                               
fiscal note.                                                                                                                    
                                                                                                                                
2:06:42 PM                                                                                                                    
At ease from 2:06 p.m. to 2:07 p.m.                                                                                             
                                                                                                                                
2:07:43 PM                                                                                                                    
SARA   CHAMBERS,  Professional   Licensing  Operations   Manager,                                                               
Division of  Corporations, Business, and  Professional Licensing,                                                               
Department  of  Commerce,  Community  and  Economic  Development,                                                               
explained that  the fiscal note  reflects the  estimated addition                                                               
cost  for  travel for  the  State  Medical  Board. The  board  is                                                               
statutorily required to hold quarterly  meetings and has found it                                                               
benefits from face-to-face meetings  so it travels throughout the                                                               
state. Some of  the travel is to remote areas  to ensure that the                                                               
message is  clear that the voice  in rural Alaska is  valued. The                                                               
estimate, based  on past  travel expenses,  is $7,000  per person                                                               
per year.                                                                                                                       
                                                                                                                                
SENATOR  GIESSEL  pointed  out  that  this  falls  under  receipt                                                               
services, which means the board pays for it.                                                                                    
                                                                                                                                
CHAIR  COSTELLO  asked  what  the fees  are  for  paramedics  and                                                               
physicians.                                                                                                                     
                                                                                                                                
MS.  CHAMBERS  explained  that the  biannual  licensing  fee  for                                                               
paramedics  is $50  and physicians  pay $300  biannually. Receipt                                                               
supported  services  and  any  additional   costs  are  borne  by                                                               
licensees of the board.                                                                                                         
                                                                                                                                
CHAIR COSTELLO asked  if the board is operating in  the black and                                                               
if the fees will change.                                                                                                        
                                                                                                                                
MS.  CHAMBERS reported  that  at  the end  of  FY2014, the  State                                                               
Medical Board had a surplus of over $600,000.                                                                                   
                                                                                                                                
CHAIR COSTELLO  asked if  the licensing fees  are expected  to go                                                               
down or remain the same.                                                                                                        
                                                                                                                                
MS. CHAMBERS replied they will remain  the same this year but may                                                               
go up after  the next analysis, depending on whether  or not fees                                                               
from new licensees offset rising costs.                                                                                         
                                                                                                                                
CHAIR COSTELLO asked  if, in addition to  the regularly scheduled                                                               
meetings, the board meets on an as-needed basis.                                                                                
                                                                                                                                
MS. CHAMBERS confirmed  that all the boards in  the division meet                                                               
at the  will of the  board, while  adhering to the  Open Meetings                                                               
Act.  When  the board  deems  it  appropriate, a  mail  balloting                                                               
system can be employed.                                                                                                         
                                                                                                                                
SENATOR GIESSEL asked about the repeal language in Section 5.                                                                   
                                                                                                                                
2:11:54 PM                                                                                                                    
MR. SHILLING explained  that it repeals an  exception to immunity                                                               
related to automatic external defibrillators  (AED) if the use of                                                               
the  device is  not preceded  by employer-provided  training. The                                                               
sponsor believes  that the use  of an AED is  straightforward and                                                               
has  heard that  the  training requirement  tends  to inhibit  an                                                               
employer from having  a device on the premises.  This concern was                                                               
brought forward by the chief of the university fire department                                                                  
in Fairbanks who had noticed a decrease in the use of AEDs in                                                                   
public spaces.                                                                                                                  
                                                                                                                                
CHAIR COSTELLO held SB 14 in committee for further                                                                              
consideration.                                                                                                                  
                                                                                                                                
          SB  71-VACCINE CERTIFICATION FOR PHARMACISTS                                                                      
                                                                                                                                
2:14:07 PM                                                                                                                    
CHAIR COSTELLO announced the consideration of SB 71. "An Act                                                                  
relating to the practice of pharmacy; and relating to the                                                                       
administration of vaccines and related emergency medications."                                                                  
                                                                                                                                
2:14:18 PM                                                                                                                    
SENATOR CATHY GIESSEL, Sponsor of SB 71 introduced the                                                                          
legislation paraphrasing the following sponsor statement:                                                                       
                                                                                                                                
     Currently,  Alaska pharmacists  require oversight  by a                                                                    
     medical doctor  or nurse practitioner to  oversee their                                                                    
     immunization  authority.  SB   71  will  give  already-                                                                    
     trained   and   certified  pharmacists   authority   to                                                                    
     immunize Alaska  adults and children without  having to                                                                    
     contract   with    often   hard-to-find   doctors/nurse                                                                    
     practitioners to oversee their immunization programs.                                                                      
                                                                                                                                
     This  bill  will  particularly  help  rural  pharmacies                                                                    
     increase  their  reach  to populations  who  often  see                                                                    
     their   pharmacist   more    often   than   a   medical                                                                    
     professional.  Consumers would  enjoy more  flexibility                                                                    
     with their schedules and cost  savings by being able to                                                                    
     access    their    local   pharmacist    for    crucial                                                                    
     immunizations.                                                                                                             
                                                                                                                                
     SB  71  expands  authority for  Alaska  pharmacists  to                                                                    
     independently administer all  vaccines and would reduce                                                                    
     burdensome  collaborative practice  agreements. Studies                                                                    
     have  shown  that  states   in  which  pharmacists  are                                                                    
     granted  broad authority  to  administer vaccines  have                                                                    
     higher immunization rates.                                                                                                 
                                                                                                                                
     In  2013 Alaskan  pharmacists administered  over 13,000                                                                    
     flu vaccines  and this legislation  would significantly                                                                    
     improve  access to  additional vaccinations  and public                                                                    
     health as  a result. I  ask for your support  to expand                                                                    
     the   authority   of   pharmacists   to   independently                                                                    
     administer vaccinations.                                                                                                   
                                                                                                                                
2:17:32 PM                                                                                                                    
JANE  CONWAY,   Staff,  Senator   Cathy  Giessel,   provided  the                                                               
following sectional analysis for SB 71:                                                                                         
                                                                                                                                
     Section 1  authorizes the Board of  Pharmacy (board) to                                                                    
     establish standards for  the independent administration                                                                    
     of   vaccines   and  related   emergency   medications,                                                                    
     including the completion of training.                                                                                      
                                                                                                                                
     Section  2   permits  a  pharmacist   to  independently                                                                    
     administer vaccines  and related  emergency medications                                                                    
     if  the pharmacist  is in  compliance with  the board's                                                                    
     standards. Defines "related emergency medication."                                                                         
                                                                                                                                
     Section  3  adds   the  independent  administration  of                                                                    
     vaccines  and  related  emergency  medications  to  the                                                                    
     definition of the practice of pharmacy."                                                                                   
                                                                                                                                
SENATOR  MEYER asked  if other  states extend  this authority  to                                                               
pharmacists.                                                                                                                    
                                                                                                                                
MS. CONWAY answered  yes, but she didn't know  which states grant                                                               
the  authority.   A  study  [copy  in   packets]  that  Walgreens                                                               
conducted  concluded  that  states that  offer  pharmacists  full                                                               
immunization  privileges  have  higher vaccination  uptick  rates                                                               
than states with restricted or no authorization.                                                                                
                                                                                                                                
SENATOR  MEYER asked  how many  states extend  this privilege  to                                                               
pharmacists.                                                                                                                    
                                                                                                                                
MS. CONWAY said she didn't have that information.                                                                               
                                                                                                                                
CHAIR COSTELLO suggested she follow up with the information.                                                                    
                                                                                                                                
2:20:50 PM                                                                                                                    
SENATOR MEYER  asked if  Medicaid would pay  for a  pharmacist to                                                               
administer the vaccine.                                                                                                         
                                                                                                                                
MS. CONWAY replied  the bill received a second  fiscal note today                                                               
that addresses Medicaid. She deferred  further explanation to the                                                               
Medicaid representative who was available on line.                                                                              
                                                                                                                                
SENATOR STEVENS asked what happens  to the patient records when a                                                               
vaccine is administered by a pharmacist.                                                                                        
                                                                                                                                
MS. CONWAY explained  that all immunizations must  be reported to                                                               
VacTrAK, the State of Alaska Immunization Information System.                                                                   
                                                                                                                                
SENATOR GIESSEL confirmed that was correct.                                                                                     
                                                                                                                                
CHAIR  COSTELLO  asked  if  lost  vaccination  records  could  be                                                               
accessed there.                                                                                                                 
                                                                                                                                
MS. CONWAY  answered yes;  each person's  individual vaccinations                                                               
are recorded.                                                                                                                   
                                                                                                                                
CHAIR COSTELLO asked for an explanation of the DHSS fiscal note.                                                                
                                                                                                                                
2:23:03 PM                                                                                                                    
SARA   CHAMBERS,  Professional   Licensing  Operations   Manager,                                                               
Division of  Corporations, Business, and  Professional Licensing,                                                               
Department  of  Commerce,  Community  and  Economic  Development,                                                               
explained  that  the  average  cost  for  a  typical  regulations                                                               
program is $2,500 and the fiscal note speaks to that cost.                                                                      
                                                                                                                                
CHAIR COSTELLO asked  if it's a request  for services application                                                               
(RSA) for the Department of Law.                                                                                                
                                                                                                                                
MS. CHAMBERS explained that the RSA  covers the cost of the legal                                                               
review  as  well  as  postage,   mailing,  and  printing  of  the                                                               
regulations that are sent to the licensees for comment.                                                                         
                                                                                                                                
SENATOR GIESSEL  asked for  confirmation that  there would  be no                                                               
additional  cost if  these regulations  were  coupled with  other                                                               
regulations the board was already doing.                                                                                        
                                                                                                                                
MS. CHAMBERS agreed that the fiscal  note could be lower and have                                                               
a lesser impact to licensees  if there was an ongoing regulations                                                               
project.                                                                                                                        
                                                                                                                                
CHAIR COSTELLO  asked Mr.  Hope to review  the DHSS  fiscal note,                                                               
OMB Component Number: 242.                                                                                                      
                                                                                                                                
2:25:27 PM                                                                                                                    
CHAD   HOPE,  Pharmacy   Program  Manager,   Medicaid  Assistance                                                               
Administration, Division  of Health Care Services,  Department of                                                               
Health  and   Social  Services,   explained  that  rule   42  CFR                                                               
455.410(b) of the Affordable Care  Act requires Medicaid programs                                                               
to  pay  for  covered  services   only  when  they  are  ordered,                                                               
rendered,   or   referred   by   enrolled   Medicaid   providers.                                                               
Pharmacists  currently are  not individually  enrolled by  Alaska                                                               
Medicaid,  just pharmacies.  To satisfy  the federal  requirement                                                               
for paying claims from an  enrolled ordering provider, individual                                                               
pharmacists would need to be enrolled.                                                                                          
                                                                                                                                
DHSS has  not estimated  any additional  costs for  the services,                                                               
but it has  estimated an additional $50,000 to  modify the claims                                                               
processing system to enroll individual pharmacists.                                                                             
                                                                                                                                
SENATOR GIESSEL said she wishes there was a way around the cost.                                                                
                                                                                                                                
CHAIR COSTELLO asked if the effective  date of the bill needed to                                                               
be  amended  if  the  claims processing  system  couldn't  enroll                                                               
pharmacists before 7/1/2016.                                                                                                    
                                                                                                                                
MR.  HOPE   confirmed  that  it   was  extremely   unlikely  that                                                               
pharmacists could be enrolled prior to 7/1/16.                                                                                  
                                                                                                                                
SENATOR MEYER requested additional explanation of the $50,000.                                                                  
                                                                                                                                
MR.  HOPE explained  that the  $50,000 is  the estimated  cost to                                                               
either enroll a new provider type  or add a subtype to the claims                                                               
processing  system.  It  is  not  intended to  be  used  for  any                                                               
activity outside the enrollment of pharmacists.                                                                                 
                                                                                                                                
MR. MEYER asked if this is a one-time expense.                                                                                  
                                                                                                                                
MR. HOPE answered yes.                                                                                                          
                                                                                                                                
2:31:53 PM                                                                                                                    
CHAIR COSTELLO opened public testimony on SB 71.                                                                                
                                                                                                                                
2:32:25 PM                                                                                                                    
SCOTT WATTS, representing  himself, Juneau, Alaska, said  he is a                                                               
practicing  pharmacist  testifying  in  support  of  SB  71.  New                                                               
pharmacists  are coming  out  of school  having  been trained  to                                                               
administer   these   vaccines.   This  will   eventually   reduce                                                               
healthcare costs while  retaining the safety and  tracking of the                                                               
vaccines.                                                                                                                       
                                                                                                                                
JASON TAPLEY, representing himself, Juneau,  Alaska, said he is a                                                               
pharmacist who is  new to Juneau testifying in support  of SB 71.                                                               
He described working in a  retail pharmacy in South Carolina, and                                                               
opined that  it will  be much easier  and more  cost-effective to                                                               
allow pharmacists to independently administer vaccines.                                                                         
                                                                                                                                
2:36:31 PM                                                                                                                    
BARRY  CHRISTENSEN,  Co-Chair   Legislative  Association,  Alaska                                                               
Pharmacist  Association (APA),  said  he is  a second  generation                                                               
community  pharmacist in  Ketchikan testifying  in support  of SB                                                               
71.  He  described  the  bill  as a  win-win-win.  It  will  help                                                               
increase  access   to  immunizations;   it  will   help  decrease                                                               
healthcare  costs  for employers;  and  it  will help  pharmacies                                                               
reduce paperwork. With regard to  the fiscal note, he opined that                                                               
the $50,000 would be returned to the state very quickly.                                                                        
                                                                                                                                
2:39:43 PM                                                                                                                    
RYAN RUGGLES,  District Pharmacy  Manager, Carrs  Safeway Alaska,                                                               
testified  in  support of  SB  71.  Prevention  of disease  is  a                                                               
keystone to  a healthy society and  this one way to  help achieve                                                               
it.   Pharmacy-based   immunizations    are   safe,   convenient,                                                               
economical,  and   effective.  Safeway  has   been  administering                                                               
vaccinations  since 2003  and received  the American  Pharmacists                                                               
Association   Immunization   Champion   Award   in   2014.   Most                                                               
pharmacists  have taken  classes  to get  their degree  regarding                                                               
immunizations  and  most  have taken  post-graduation  continuing                                                               
education  courses. He  discussed the  low incidence  of flu  and                                                               
tetanus inoculations  among Alaskans  and opined that  easier and                                                               
more consistent access will increase participation.                                                                             
                                                                                                                                
MR.   RUGGLES  explained   that   the  current   model  to   give                                                               
vaccinations  requires a  collaborative  practice agreement  with                                                               
the provider, the  pharmacist in charge, and  the location that's                                                               
specified. When  the managing pharmacist changes,  the ability to                                                               
immunize  lapses  until there  is  a  new collaborative  practice                                                               
agreement. That can take from three to six months.                                                                              
                                                                                                                                
Responding to  an earlier question about  tracking immunizations,                                                               
he confirmed  that Safeway participates  in VacTrAK  and provides                                                               
notice  to  whichever physician  the  patient  has specified.  He                                                               
concluded that the ultimate goal  is to keep Alaskans healthy and                                                               
this bill moves in that direction.                                                                                              
                                                                                                                                
2:44:32 PM                                                                                                                    
AMBER  BRIGGS  representing  herself,  said  she  is  a  hospital                                                               
pharmacist  from Soldotna  testifying in  support of  SB 71.  She                                                               
discussed the  rigorous training that pharmacists  receive in the                                                               
administration   of  vaccines,   disease  epidemiology,   vaccine                                                               
characteristics,  and  related   topics.  Responding  to  Senator                                                               
Meyer's question,  she reported that  16 states currently  do not                                                               
require  a  physician  protocol   prescription  to  administer  a                                                               
vaccination.                                                                                                                    
                                                                                                                                
SENATOR  GIESSEL reviewed  Ms. Briggs  credentials and  asked how                                                               
many years of schooling it takes  to receive a doctor of pharmacy                                                               
degree.                                                                                                                         
                                                                                                                                
MS. BRIGGS  replied it  takes four years  of pharmacy  school and                                                               
two to four years of undergraduate work.                                                                                        
                                                                                                                                
SENATOR GIESSEL noted that is similar to a physician.                                                                           
                                                                                                                                
MS. BRIGGS agreed.                                                                                                              
                                                                                                                                
2:47:30 PM                                                                                                                    
LIS  HOUCHEN, Northwest  Regional Director,  National Association                                                               
of Chain  Drug Stores,  testified in  support of  SB 71  to allow                                                               
pharmacists   to    independently   prescribe    and   administer                                                               
immunizations.  In  2012  only   1.2  percent  of  Alaskans  were                                                               
immunized  for influenza,  giving  it  the rank  of  49th in  the                                                               
country.   She  emphasized   that   removing  the   collaborative                                                               
agreement  requirement  will  streamline  the  administration  of                                                               
vaccines.                                                                                                                       
                                                                                                                                
2:49:07 PM                                                                                                                    
CHAIR  COSTELLO  announced  she  would hold  SB  71  for  further                                                               
consideration.                                                                                                                  
                                                                                                                                
^Confirmation Hearings                                                                                                          
                     CONFIRMATION HEARINGS                                                                                  
                                                                                                                              
            Workers' Compensation Appeals Commission                                                                        
                                                                                                                                
2:49:23 PM                                                                                                                    
CHAIR COSTELLO  announced the  final order  of business  would be                                                               
confirmation  hearings.   She  recognized  Mr.  Hemenway   as  an                                                               
appointee to  the Workers'  Compensation Appeals  Commission, and                                                               
reviewed the commission's jurisdiction.                                                                                         
                                                                                                                                
ANDREW   HEMENWAY,  Appointee,   Workers'  Compensation   Appeals                                                               
Commission, stated  that he is  an administrative law  judge with                                                               
the Office  of Administrative Hearings.  He has  prior experience                                                               
with workers'  compensation as  a staff  attorney for  the Alaska                                                               
Supreme Court  and in private  practice. He explained that  he is                                                               
approaching retirement and  decided it was a good  time to submit                                                               
his name  for this position.  He is  doing so with  the knowledge                                                               
that the commission is looking  at making some structural changes                                                               
that  could include  eliminating  it altogether  and sending  the                                                               
appeals to the superior court. He offered to answer questions.                                                                  
                                                                                                                                
CHAIR COSTELLO found no questions and thanked Mr. Hemenway.                                                                     
                                                                                                                                
               Alaska Workers' Compensation Board                                                                           
                                                                                                                                
CHAIR  COSTELLO   reviewed  the   composition  of   the  Workers'                                                               
Compensation  Board and  asked Ms.  Cline to  tell the  committee                                                               
about her interest in serving.                                                                                                  
                                                                                                                                
2:53:26 PM                                                                                                                    
PAMELA CLINE,  Appointee, Workers'  Compensation Board,  said she                                                               
would like to be reappointed to  the board as a representative of                                                               
labor. This is  an important role to ensure  that injured workers                                                               
get treated and  return to work as soon as  possible. In response                                                               
to a question  from the chair, she stated that  she is a business                                                               
representative at the  IBEW Local 1547. Prior to  that she worked                                                               
as a  certified pharmacy technician  and as a  representative for                                                               
the bargaining unit at MatSu Regional [Medical Center].                                                                         
                                                                                                                                
CHAIR  COSTELLO asked  Mr. Collins  to tell  the committee  about                                                               
himself and his interest in continuing to serving.                                                                              
                                                                                                                                
2:54:35 PM                                                                                                                    
CHUCK  COLLINS  JR.,   Appointee,  Alaska  Workers'  Compensation                                                               
Board, said  he was a business  owner for 20 years  and now works                                                               
for the  State of Alaska.  He's been involved in  many committees                                                               
and  organizations   in  Juneau   over  the  years.   A  previous                                                               
administration asked  him to serve as  an industry representative                                                               
and he's found  it to be a very rewarding  experience. He and the                                                               
labor representative in Juneau do the self-insurance overview.                                                                  
                                                                                                                                
CHAIR COSTELLO asked  Mr. Howdeshell to tell  the committee about                                                               
himself and why he is interested in serving.                                                                                    
                                                                                                                                
2:57:53 PM                                                                                                                    
JACOB  HOWDESHELL, Appointee,  Workers' Compensation  Board, said                                                               
he's a union  representative of Laborers Local  942 in Fairbanks.                                                               
He's been in  the industry for about 10 years  and wants to serve                                                               
on the board to bring as much parity as possible.                                                                               
                                                                                                                                
CHAIR COSTELLO  asked Ms. Hutchings  to tell the  committee about                                                               
herself and why she is interested in serving.                                                                                   
                                                                                                                                
2:59:09 PM                                                                                                                    
LINDA HUTCHINGS,  Appointee, Alaska Workers'  Compensation Board,                                                               
said she lives  in Soldotna and was first appointed  to the board                                                               
in 2005.  She's been actively  involved in  worker's compensation                                                               
as a  business owner  for the  last 40 years  and as  an employee                                                               
that might be injured. She believes  that in the last five to six                                                               
years the board  has accomplished a lot and she  looks forward to                                                               
helping continue that trend.                                                                                                    
                                                                                                                                
CHAIR  COSTELLO asked  Mr.  Traini to  tell  the committee  about                                                               
himself and why he is interested in serving.                                                                                    
                                                                                                                                
3:00:26 PM                                                                                                                    
RICK TRAINI, Appointee, Workers'  Compensation Board, said he has                                                               
worked  for  Teamsters  Local  959   since  2007.  He  was  first                                                               
appointed to  the board to  fill a partial  term in 2010  and was                                                               
appointed  to a  second term  in  2012. He  would appreciate  the                                                               
opportunity  to  serve  again.  It's  an  important  adjudicative                                                               
process that  allows injured  workers to  see labor  and industry                                                               
lay  members  from the  community  and  feel that  somebody  will                                                               
listen and they'll get a fair hearing when there's a dispute.                                                                   
                                                                                                                                
CHAIR COSTELLO asked  Ms. Vollendorf to tell  the committee about                                                               
herself and why she is interested in continuing to serve.                                                                       
                                                                                                                                
3:01:46 PM                                                                                                                    
PATRICIA  VOLLENDORF,  Appointee,  Alaska  Workers'  Compensation                                                               
Board, said  she was a teacher  in Anchorage from 1963  until she                                                               
retired in  1993. She served on  the board from 1993  to 1997 and                                                               
from 2004  until the present.  She has seen  a lot of  changes on                                                               
the  board and  most  are for  the better.  She  has enjoyed  the                                                               
service and looks forward to continuing.                                                                                        
                                                                                                                                
CHAIR COSTELLO  asked Mr.  Williams to  tell the  committee about                                                               
himself and why he is interested in continuing to serve.                                                                        
                                                                                                                                
3:02:32 PM                                                                                                                    
LAKE  WILLIAMS, Appointee,  Alaska  Workers' Compensation  Board,                                                               
said this  will be  his second  term on  the board.  He currently                                                               
works  as the  District  7 Representative  for the  International                                                               
Union of  Operating Engineers Local  302 in Fairbanks.  He listed                                                               
his  board  memberships and  relayed  that  he has  a  bachelor's                                                               
degree in business administration. He  has enjoyed serving on the                                                               
board and would like to continue.                                                                                               
                                                                                                                                
CHAIR  COSTELLO  asked  Mr.  Weel to  tell  the  committee  about                                                               
himself and why he is interested in continuing to serve.                                                                        
                                                                                                                                
3:03:57 PM                                                                                                                    
ROBERT WEEL,  Appointee, Workers'  Compensation Board,  said he's                                                               
served as an industry representative  since 2006 and feels he has                                                               
a  good understanding  of  the hearing  process.  He would  enjoy                                                               
serving another term.                                                                                                           
                                                                                                                                
SENATOR  GIESSEL commented  that  she finds  it interesting  that                                                               
there is no a  limit on the number of terms  someone can serve on                                                               
the Workers' Compensation Board.                                                                                                
                                                                                                                                
CHAIR COSTELLO  agreed that  this board has  a lot  of longevity.                                                               
She thanked  the nominees and  announced she would set  the names                                                               
aside and  report all the  nominations from the Senate  Labor and                                                               
Commerce  Standing  Committee  in  one  group.  [The  names  were                                                               
advanced on 3/31/2015.]                                                                                                         
                                                                                                                                
3:06:31 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair Costello  adjourned the Senate Labor  and Commerce Standing                                                               
Committee meeting at 3:06 p.m.                                                                                                  

Document Name Date/Time Subjects
SB 29 - Version A.pdf SL&C 3/17/2015 1:30:00 PM
SB 29
SB 29 - Sponsor Statement.pdf SL&C 3/17/2015 1:30:00 PM
SB 29
SB 29 Request for Hearing SLC.pdf SL&C 3/17/2015 1:30:00 PM
SB 29
SB 29 - Fiscal Note.pdf SL&C 3/17/2015 1:30:00 PM
SB 29
SB 29 - State Med Board Expend. & Rev..pdf SL&C 3/17/2015 1:30:00 PM
SB 29
SB 29 - State Medical Board Minutes 1.17.13.pdf SL&C 3/17/2015 1:30:00 PM
SB 29
SB 29 - Support Resolution Paramedic Assoc.of Alaska.pdf SL&C 3/17/2015 1:30:00 PM
SB 29
SB 14 - Version W.PDF SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - Sponsor Statement.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - Sectional Analysis.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - Hearing Request Memo.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - Fiscal Note.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - Paramedic Association Resolution.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - NHTSA Report Excerpt.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - NAEMT Position Statement.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - Alaska State Medical Board Exp & Rev.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - EMSRDC Letter of Support.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - Dr. Ken Zafren Letter of Support.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - AK Fire Chiefs Resolution.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 14 - ACEMS Letter of Support.pdf SL&C 3/17/2015 1:30:00 PM
SB 14
SB 71 - Version W.PDF SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Sponsor Statement.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Senate L&C Hearing Request.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Sectional Analysis.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Fiscal Note DCCED.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Fiscal Note DHSS.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Briefing Paper - AK Pharmacist Assn.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Letter of Suport NACDS.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Letter of Support - AK Pharmacists Assn.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Letter of Support Brown.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Letter of Support Garrison.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Letter of Support Island Pharmacy.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Letter of Support Ron's Apothecary.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Relevant Article - American Journal of Managed Care.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
SB 71 - Resolution of Support - Board of Pharmacy.pdf SL&C 3/17/2015 1:30:00 PM
SB 71
Williams, Lake - Worker's Comp Board.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Appeals - Hemenway #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Allen.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Cline #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Collins #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Howdeshell #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Hutchings #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Traini #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Vollendorf #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Workers' Comp Board - Weel #3.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission
Worker's Comp Board - Williams #1.pdf SL&C 3/17/2015 1:30:00 PM
Worker's Compensation Board and Worker's Compensation Appeals Commission