Legislature(2019 - 2020)BELTZ 105 (TSBldg)

03/07/2019 01:30 PM LABOR & COMMERCE

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Audio Topic
01:33:08 PM Start
01:35:08 PM Confirmation Hearing(s):
01:57:37 PM Overview: Licensure in Alaska
02:42:39 PM Overview: Department of Defense-state Liaison Office
02:56:24 PM SB11
03:00:49 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: TELECONFERENCED
-- Public Testimony on All Appointees --
- Board of Certified Direct Entry Midwives -
Dr. Dana Espindola
- Board of Nursing - Wendy Monrad, Danette
Schloeder, Julie Tisdale
+ Overview: TELECONFERENCED
Licensure in Alaska by:
- Sara Chambers, Director Division of
Corporations, Business & Professional Licensure
- Tammie Perreault, Northwest Regional Liaison,
Department of Defense Military Community &
Family Policy
- Commissioner-Designee General Torrence Saxe
*+ SB 11 MILITARY SPOUSE COURTESY LICENSE TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE LABOR AND COMMERCE STANDING COMMITTEE                                                                        
                         March 7, 2019                                                                                          
                           1:33 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Lora Reinbold, Chair                                                                                                    
Senator Mia Costello, Vice Chair                                                                                                
Senator Chris Birch                                                                                                             
Senator Elvi Gray-Jackson                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Click Bishop                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARING(S):                                                                                                        
                                                                                                                                
Direct Entry Midwives                                                                                                         
Dana Espindola - Eagle River                                                                                                    
                                                                                                                                
     CONFIRMATION ADVANCED                                                                                                      
                                                                                                                                
Board of Nursing                                                                                                              
Wendy Monrad - Anchorage                                                                                                        
Danette Schloeder - Anchorage                                                                                                   
Julie Tisdale - Anchorage                                                                                                       
                                                                                                                                
     CONFIRMATIONS ADVANCED                                                                                                     
                                                                                                                                
OVERVIEW: LICENSURE IN ALASKA                                                                                                   
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
OVERVIEW: DEPARTMENT OF DEFENSE-STATE LIAISON OFFICE                                                                            
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
SENATE BILL NO. 11                                                                                                              
"An Act relating to temporary courtesy licenses for certain                                                                     
nonresident professionals; and relating to the Department of                                                                    
Commerce, Community, and Economic Development."                                                                                 
                                                                                                                                
     -HEARD AND HELD                                                                                                            
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 11                                                                                                                   
SHORT TITLE: MILITARY SPOUSE COURTESY LICENSE                                                                                   
SPONSOR(s): SENATOR(s) KAWASAKI                                                                                                 
                                                                                                                                
01/16/19       (S)       PREFILE RELEASED 1/7/19                                                                                

01/16/19 (S) READ THE FIRST TIME - REFERRALS

01/16/19 (S) L&C, FIN 03/07/19 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) WITNESS REGISTER DANA ESPINDOLA, M.D., Appointee Board of Certified Direct Entry Midwives Division of Corporations, Business, and Professional Licensing Department of Commerce, Community and Economic Development Eagle River, Alaska POSITION STATEMENT: Testified as appointee to the Board of Certified Direct Entry Midwives. WENDY MONRAD, Appointee Board of Nursing Division of Corporations, Business, and Professional Licensing Department of Commerce, Community and Economic Development Anchorage, Alaska POSITION STATEMENT: Testified as appointee to the Board of Nursing. DANETTE SCHLOEDER Appointee Board of Nursing Division of Corporations, Business, and Professional Licensing Department of Commerce, Community and Economic Development Anchorage, Alaska POSITION STATEMENT: Testified as appointee to the Board of Nursing. JULIE TISDALE Appointee Board of Nursing Division of Corporations, Business, and Professional Licensing Department of Commerce, Community and Economic Development Anchorage, Alaska POSITION STATEMENT: Testified as appointee to the Board of Nursing. SARA CHAMBERS, Deputy Director Juneau Office Division of Corporations, Business, and Professional Licensing Department of Commerce, Community and Economic Development Juneau, Alaska POSITION STATEMENT: Presented a PowerPoint on Licensure in Alaska. TAMMIE PERREAULT, Regional Liaison Department of Defense, Military & Family Policy Washington, D.C. POSITION STATEMENT: Presented an overview on the Department of Defense, State Liaison Office. SENATOR SCOTT KAWASAKI Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Testified as sponsor of SB 11. DEBORAH STOVERN, Administrator State Medical Board Division of Corporations, Business, and Professional Licensing Department of Commerce, Community and Economic Development Juneau, Alaska ACTION NARRATIVE 1:33:08 PM CHAIR LORA REINBOLD called the Senate Labor and Commerce Standing Committee meeting to order at 1:33 p.m. Present at the call to order were Senators Costello, Gray-Jackson, Birch and Chair Reinbold. ^CONFIRMATION HEARING(S): CONFIRMATION HEARING(S): Board of Certified Direct Entry Midwives Board of Nursing 1:35:08 PM DANA ESPINDOLA, M.D., Appointee, Board of Certified Direct Entry Midwives, Eagle River, stated that she is a practicing, board certified, full skills OBGYN. She received her undergraduate degree in biology and completed medical school and residency training at the University of New Mexico. She and her family relocated to Eagle River four years ago and she is one of four owners of a longstanding medical clinic. Their provider group includes seven OBGYNs, four certified nurse midwives, and two advanced nurse practitioners. She said she has worked in collaboration with midwives throughout her career and is passionate about women's healthcare. She feels well suited and qualified to serve on the Board of Certified Direct Entry Midwives and help to bring about positive change where it is needed. 1:37:20 PM CHAIR REINBOLD asked whether she was comfortable with the midwifery profession and if she had been well-received in this community. DR. ESPINDOLA said she has always worked cooperatively with midwives, so when she moved to Alaska, she sought a group that included midwives. Her experience also includes hospital-based obstetrics care and work with direct entry midwives in Anchorage. She said her experiences have been positive. 1:38:49 PM CHAIR REINBOLD opened public testimony and after first determining no one wished to testify, closed public testimony on the confirmation hearing for Dr. Espindola. 1:38:58 PM CHAIR REINBOLD asked her if she had any closing comments. DR. ESPINDOLA remarked that she was happy to serve. CHAIR REINBOLD asked Danette Schloeder to tell the committee why she was interested in serving on the Board of Nursing. 1:40:11 PM DANETTE SCHLOEDER, Appointee, Board of Nursing, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community and Economic Development, Anchorage, said she has worked as a registered nurse licensed in Alaska for the past 24 years. She currently works as a perinatal clinical specialist at Providence Alaska Medical Center and as part-time faculty for the University of Providence. She has two undergraduate degrees in healthcare administration and nursing plus two graduate degrees in nursing. Her nursing career has been devoted to caring for women and children. Currently, her primary role is to plan the care of high-risk obstetric patients and improve patient care by translating evidence-based practice into bedside care. She also works to improve safety of nursing care in complex medical systems. Her teaching experience includes prehospital and basic obstetrical care and electronic fetal monitoring in many locations in Alaska. Her current work is in the development of a care pathway for pregnant women with opiate use disorder. She speaks about these issues nationally. She has been involved in the review of nursing licensing exams and validation requirements for entry-level nurses with the National Council of State Boards of Nursing. MS. SCHLOEDER said she would like to serve on the Board of Nursing because she is passionate about the art and science of nursing and the safety of Alaska residents. She is drawn to public service and believes it is an honor to contribute in this way. 1:43:02 PM SENATOR BIRCH said her resume is phenomenal and she is eminently qualified for this position. He noted her previous involvement with the WWAMI [Washington, Wyoming, Alaska, Montana, Idaho, and the University of Washington School of Medicine] program. He asked her to comment on the value it has brought to Alaska. MS. SCHLOEDER explained that she was in charge of the third-year medical students doing their obstetrical rotation through the WAAMI program. She said it was an amazing experience and she was privileged to work with the many physicians who graduated from the program and returned to work in Alaska. She offered her belief that many of these competent physicians probably would not have returned to Alaska if not for the WWAMI program. SENATOR BIRCH thanked her for her willingness to serve. 1:45:05 PM CHAIR REINBOLD said the board would be blessed to have her as part of the team. 1:46:03 PM WENDY MONRAD, Appointee, Board of Nursing, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community and Economic Development, Anchorage, said she is currently employed at the Alaska Native Medical Center as a certified registered nurse anesthetist (CRNA). She has served as a CRNA for about 19 years and as a registered nurse for about 28 years. In 2002, after serving in the military and traveling the world, she became an Alaska resident. She will retire from active duty with the U.S. Public Health Service in September and stay on as a regular direct-hire employee. In addition to her nursing experience, she said she developed leadership skills from her affiliation with governmental agencies and by serving in the state and national professional associations. She has served for the last nine years as the co-chief nurse anesthetist at the Alaska Native Medical Hospital. She said she is honored to be considered for the position on the Board of Nursing and, if confirmed, will be committed to act in the best interests of the people of Alaska. She said her contributions will include preserving and advancing the practice of nursing into the future, addressing access to care, and protecting public safety and health. 1:48:13 PM SENATOR GRAY-JACKSON thanked her for her willingness to serve and expressed appreciation for her views. She asked whether her personal views will enter into any decisions she would make if she is confirmed to serve on this board. MS. MONRAD, in response to Senator Gray-Jackson's clarification on whether she would bring her personal views on reproductive health and abortion, she said she would approach these topics from the board's position on how it relates to the practice of nursing. 1:49:13 PM SENATOR GRAY-JACKSON said she respects that everyone has a right to their personal views. She further clarified her question was, if confirmed, whether her personal views on any matter will have any effect on the decisions she makes as a member of the board. MS. MONRAD answered that she would look at an issue from a legal perspective and a nursing practice perspective and set aside her personal views. CHAIR REINBOLD disclosed that she has known the next appointee for a long time. She asked Julie Tisdale to tell the committee about her interest in serving on the Board of Nursing. 1:50:55 PM JULIE TISDALE, Appointee, Board of Nursing, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community and Economic Development, Anchorage, clarified that her appointment is as a public member of the board. She said she was born and raised in Alaska and graduated from the University of Alaska with a bachelor's degree in business with an accounting major. For the last 15 years she has owned her own accounting practice and has been active in the volunteer community. She said her interest in serving on the Board of Nursing centers on her high regard for the profession and her interest in listening to the board's concerns and any concerns Alaska residents might bring forward. CHAIR REINBOLD voiced support for Ms. Tisdale and described her as hardworking, thoughtful, and empathetic. 1:52:46 PM CHAIR REINBOLD opened public testimony and after determining no one wished to testify, closed public testimony on the confirmation hearings for Wendy Monrad, Danette Schloeder, and Julie Tisdale, appointees to the Board of Nursing. CHAIR REINBOLD asked for any closing comments from the appointees. 1:53:22 PM MS. SCHLOEDER responded that it was her lifetime dream to serve the nursing profession in Alaska. MS. MONRAD thanked the committee for its consideration and said she looked forward to serving the state. MS. TISDALE thanked the committee for its consideration and said she looked forward to serving the state. 1:54:28 PM CHAIR REINBOLD stated that in accordance with AS 39.05.080, the Senate Labor and Commerce Standing Committee reviewed the following and recommends the appointments be forwarded to a joint session for consideration: Direct Entry Midwives Dr. Dana Espindola, M.D. - Eagle River Board of Nursing Wendy Monrad - Anchorage Danette Schloeder - Anchorage Julie Tisdale - Anchorage [Signing the reports regarding appointments to boards and commissions in no way reflects individual members' approval or disapproval of the appointees; the nominations are merely forwarded to the full legislature for confirmation or rejection.] 1:55:01 PM At-ease. 1:57:33 PM CHAIR REINBOLD reconvened the meeting. ^OVERVIEW: Licensure in Alaska OVERVIEW: LICENSURE IN ALASKA 1:57:37 PM CHAIR REINBOLD announced that the next order of business would be an overview of Licensure in Alaska by Sara Chambers. She made opening remarks. 1:58:15 PM SARA CHAMBERS, Deputy Director, Juneau Office, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community and Economic Development (DCCED), began a PowerPoint on licensure in Alaska, titled "The Professional Licensing Process." She reviewed the division's "revamped" mission statement on slide 2. Inspiring public confidence through balanced regulation of competent professional & business services She explained that this mission statement guides and directs the agency to assist professionals in the licensure process, but also through its disciplinary actions. 2:00:24 PM MS. CHAMBERS reviewed slide 3, titled, Self-Funded Services to Support Businesses & Protect Consumers. The division also issues business licenses and accept corporate filings on behalf of the state. The division has 19 staff in its enforcement section, to enforce professional licensing and endorsements to business licenses. MS. CHAMBERS reviewed slide 4, titled Volume by the Numbers - 2018." In 2018, the division spent about one-third of its time in three areas: business licensing, corporations, and professional licenses. The division issued approximately 75,000 business licenses, 73,000 corporate filings, and 90,000 professional licenses. 2:01:15 PM SENATOR BIRCH disclosed that he has held a civil engineering license issued by the Board of Architects, Engineers, and Land Surveyors since 1978. 2:01:34 PM MS. CHAMBERS reviewed slide 5, titled, Professions Regulated by the Division. She said the division regulates 43 different programs, and 150 professions. This slide lists the 22 professions that are not governed by a board: Acupuncturists Athletic Trainers Audiologists Behavior Analysts Collection Agencies Guardians & Conservators Construction Contractors Concert Promoters Dietitians & Nutritionists Dispensing Opticians Electrical Administrators Animal Euthanasia Permits Professional Geologists Hearing Aid Dealers Home Inspectors Mechanical Administrators Morticians Naturopaths Nursing Home Administrators Pawnbrokers Speech-Language Pathologists Underground Storage Tank Workers 2:02:44 PM SENATOR BIRCH asked how the number of Alaska's regulated professions compares with those regulated in the Lower 48. MS. CHAMBERS offered to cover this in more depth later in the presentation. She said some people want more regulation for some professions while others want less. Alaska is considered the 45th of 50 jurisdictions for the least regulation. 2:04:22 PM SENATOR GRAY-JACKSON asked for clarification on tobacco endorsements. MS. CHAMBERS explained that if someone wants to sell tobacco, the business would obtain an endorsement on its business license, so the division can monitor compliance with tobacco laws. 2:04:55 PM SENATOR COSTELLO said the legislature has been interested in the DCBPL for some time. She asked her to provide information that identifies licensing fees and identifies which boards are solvent and the ones that struggle. MS. CHAMBERS offered to provide it to the committee. 2:05:55 PM CHAIR REINBOLD expressed interest in the number of professions that were unregulated. MS. CHAMBERS clarified that the professions she mentioned on [slides 5-6] were the regulated professions, with 22 professions regulated by the division and 21 board-regulated professions. CHAIR REINBOLD asked whether she could provide a list of unregulated professions and industries. MS. CHAMBERS explained that any profession that does not require a license or one that was not required to meet certain government standards would be considered unregulated. She suggested that it would be an exhaustive list. 2:06:40 PM MS. CHAMBERS reviewed slide 6, Boards or Commissions Regulating Professions- 21 [boards]. Board of Registration for Architects, Engineers and Land Surveyors Board of Barbers and Hairdressers Big Game Commercial Services Board Board of Chiropractic Examiners Board of Dental Examiners Board of Marine Pilots State Medical Board Board of Marital and Family Therapy Board of Massage Therapists Board of Certified Direct-Entry Midwives Board of Nursing Board of Examiners in Optometry Board of Professional Counselors Board of Pharmacy Board of Physical Therapy and Occupational Therapy Board of Psychologist and Psychological Associate Examiners Board of Public Accountancy Board of Certified Real Estate Appraisers Real Estate Commission Board of Social Work Examiners Board of Veterinary Examiners 2:07:00 PM MS. CHAMBERS reviewed slide 7, Funding and Fees FY 2018. She explained that the division was completely funded by receipts outside the general fund. The division does not receive any appropriation from the legislature. She said that 98 percent of the division's activities were fee supported. She explained the division has some third party travel reimbursement since some national associations will cover travel for board members and lead staff to learn more about national trends. The Board of Nursing and a prescription-drug monitoring program receive some federal grants. MS. CHAMBERS reviewed slide 8, Funding and Fees. She said that the division is mandated to ensure that fees are set equal the cost of regulation. When program costs are reduced, the division reduces the licensing fees for licensees and if program costs increase, the licensing fees increase, she said. The division reviews fees and must consult with the boards and commissions about fee changes. In the last few years, the division has streamlined its process. Typically, just prior to the biennial license renewal cycle, the division will provide analysis to the board, obtain its input and feedback, and calculate the fee adjustments. The division must estimate projected expenses, and expenses typically fluctuate depending on investigation costs. For example, when a license is suspended, the licensee has due process rights to appeal the board decision. The division's enforcement system is complaint driven, she said. 2:09:55 PM MS. CHAMBERS turned to slide 9, Streamlining and Reducing Expenses. She said that the division balances in-person meetings with videoconferences that allow public participation. The division augments its training to help improve decision making. The division focuses on individual skill sets and employs cross training and sharing staff to assist programs with vacancies. The division seeks to find efficiencies and may introduce legislation to accomplish some of those goals. The division also seeks to challenge assumptions and not rely on "we've always done it this way." 2:13:01 PM MS. CHAMBERS reviewed slide 10, Total Professional Licenses. She reported that in the last 10 years, the number of licensees has dramatically increased, in part, due to an aging population and the greater need for health care. In addition, the state has had an expansion of construction contractor licensure. 2:13:49 PM CHAIR REINBOLD asked if she could elaborate on potential statute changes the division seeks this year. Ms. Chambers said that the division seeks to find efficiencies. Perhaps Alaska might be the only state that continues to regulate a particular program and if so, the division would want to eliminate it, if possible. 2:14:38 PM MS. CHAMBERS turned to slide 11, Temporary Licenses. She said this slide is intentionally blank slide, since the figures fluctuate. She said that temporary licenses might provide a pathway to speed up full licensure, a courtesy that would allow a veterinarian to practice in Alaska during the Iditarod, or for dentists to practice in rural Alaska to address dental needs. She said that generally the focus of temporary licenses is to allow people to get to work until the licensure process is completed. She offered to provide data. In FY 2018, the division issued 462 temporary physician licenses. 2:16:17 PM CHAIR REINBOLD asked for further clarification on temporary physician licenses. She recalled at one time the division did not issue temporary licenses for physicians. MS. CHAMBERS deferred to Deborah Stovern, the administrator for the State Medical Board. 2:17:06 PM DEBORAH STOVERN, Administrator, State Medical Board, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community and Economic Development, Juneau, answered that the State Medical Board has been issuing temporary permits at least since she became administrator in 2010. The function of temporary permits is to get the physician prior to the board approval since the board meets quarterly, she said. CHAIR REINBOLD said that several physicians have expressed frustration at the time it takes to obtain their temporary licenses. 2:18:20 PM SENATOR BIRCH asked for the status on expediting temporary licenses for military spouses. MS. CHAMBERS acknowledged that was a point of key interest. She said that Senator Kawasaki worked on expedited licensure for military spouses for several years, including introducing SB 11 this year. The need for expedited licensure accelerated last year, when the Fairbanks and North Pole communities expressed concern about the division's ability to meet the demand for temporary professional licenses due to the Eielson Air Force Base expansion. The division has a process to expedite these licenses, so long as the spouses indicate their status on license applications. This statute allows the division to process the military spouse's applications ahead of others, she said. The statutes provide authority for boards to issue temporary licenses to military spouses who await the board or division approval of their professional licenses. The department has seen some friction and delay from boards. While some boards have instituted processes to consider military experience for active duty members or for veterans, many boards have not addressed the need to address military spouses. The department anticipates that would change with passage of SB 11. She highlighted two areas would turn the "may" into a "shall," which would require the department to issue a temporary courtesy license to the spouse of an active duty member who meets certain requirements. These licensees could begin work until the appropriate board took action on their professional license, she said. 2:22:22 PM MS. CHAMBERS reviewed slide 13, Division Personnel. She said three programs were added based on passage of legislation in 2014, which were implemented in 2015. She said the diagrams on this slide show the number of staff needed to maintain its 21 boards, 43 licensing programs, and 250,000 licensees. 2:22:29 PM MS. CHAMBERS reviewed the flowchart on slide 14 that illustrated the process. The slide had a dotted line to show the applicant's responsibilities depicted on the left and the division's responsibilities shown on the right. She said that licensees would need to research Alaska's requirements for licensure, file a completed application, and provide all of the documents to support the application, including transcripts, hospital privileges, or work experience required by the board or the division. Some applications, such as physicians, nurses, and other health care positions have national clearinghouses a licensee can opt into, but often do not do so. However, some licensees are not eligible to use a clearinghouse because of "blemishes" on their record. Alaska would want to investigate any disciplinary action taken or anything in the record that would warrant it. For example, a surgeon licensed in another jurisdiction may have cut off the wrong arm and this information would surface in the licensure process. Applicants would also be required to provide any letters of reference, court documents for any criminal history, and credentialing service, she said. MS. CHAMBERS stated that the division has emphasized the importance of expediting applications by creating timeframes. The division requires staff to screen an application within 10 days to let the applicant know what documents or requirements are still needed. Next, the division would investigate any criminal or disciplinary history and might need additional information. She reported that the division staff turnaround on investigations is about two weeks. When applicable, the investigator requests board expertise. MS. CHAMBERS reviewed slide 15, Licensing Timeframes, which illustrates the division standards, current timeframes, and causes for delays in the licensure process. 2:27:17 PM MS. CHAMBERS explained that board members are volunteers. She pointed out that the board might be required to vote on an application, which can add more time. Most boards engage in the online process, which may take up to two weeks to complete. Some boards prefer to meet as a group, but the division is working towards the online process. Once the board takes its action, a licensee is either qualified or denied. Applicants are entitled to due process, which allows them to appeal the board or division's decisions. 2:28:40 PM SENATOR BIRCH asked for further clarification on reciprocity in Alaska, since many professionals, such as engineers practice in multiple states. MS. CHAMBERS said most professions allow application by credential, endorsement, or reciprocity. The process is generally quicker, but the division still must review the applicant for disciplinary action and to ensure that the education and experience is substantially equivalent to Alaska's requirements. Some programs do not have reciprocity, such as marine pilots. The division would accept U.S. Coast Guard qualifications. However, Alaska has specific navigation hazards, such as the Wrangell Narrows. In terms of engineering, applicants must take an Arctic Engineering course, she said. 2:31:20 PM MS. CHAMBERS reviewed slide 15, Licensing Timeframes. She explained that staff processing time is minimal, and most programs finish their application review process within 20 days. She offered her belief that temporary licenses are issued within 10 days. Medical facilities can request expedited processing, she said. 2:32:34 PM MS. CHAMBERS reviewed slide 17, Streamlining the Experience: Physicians. She said the processing time is relatively fast. She said FCVS relates to Federal Credentials Verification Service, an online credentials verification clearinghouse, previously mentioned. 2:33:27 PM MS. CHAMBERS reviewed slide 18, MY LICENSE, online portal - Fall 2018. She said the division has offered online renewal of licensure for all programs since 2015. Registration is possible through myAlaska and allows the applicant to upload documentation and check on the status of their application. The applications sections are color coded so applicants can easily see what has been received by the agency and what is missing, she said. 2:34:51 PM CHAIR REINBOLD thanked her for her efforts. 2:35:06 PM Ms. Chambers reviewed slide 20, Military Licensing. She said needed legislation will streamline the process and accommodate "Universal Temporary Licensure" for all professions. This will hopefully address the concern that Senator Birch mentioned and force the department to deliver the service that military spouses and health care providers deserve. MS. CHAMBERS reviewed slide 22, Universal Temporary Licensure. She explained that universal temporary licensure is one area addressed in SB 11, which will give the department more control over temporary licensure for all professions. 2:36:25 PM CHAIR REINBOLD said this will be helpful. MS. CHAMBERS said the division has an administrative responsibility to keep the process moving quickly. Delays sometimes occur, due to investigations or board member availability. 2:37:19 PM MS. CHAMBERS reviewed slide 23 titled, Investigative Process. She said that the investigator has implemented processes to ensure efficiencies and timeliness. Last year, the division began implementing a 30-day review. The division added two senior level investigators by converting two vacant positions. The division has added additional items to ensure public safety and to ensure the "paper trail" is adequate, she said. 2:38:52 PM MS. CHAMBERS reviewed slides 25 and 26. She said "right-touch regulation" is an international buzzword in licensing. It seeks to be transparent, balanced, reasonable, responsive, and within allocated resources. As Senator Birch mentioned earlier, it's important to ask if we're getting it right. She referenced the inverted pyramid superimposed on the slide. She explained that it ranges from market competition and whether the market can take care of it to licensure, which is the most restrictive. The list on the left indicates the least restrictive professions to the most restrictive ones, she said. Some professions such as automotive service technician don't need a license but their Better Business Bureau rating can be checked to assess quality. Some professions such as phlebotomists, radiologic technicians, and ministers are regulated in other states, but not in Alaska. Government hasn't seen a need to get involved, but legislation has been proposed. In closing, she stated that the legislature makes policy calls on which professions to regulate. 2:41:16 PM CHAIR REINBOLD expressed concern about nail and offered her belief that it is a concern in the community. She further expressed concern that investigators were compiled in a different department. She thanked Ms. Chambers for addressing the temporary medical licenses and expedited licensure for military spouses. ^OVERVIEW: DEPARTMENT OF DEFENSE-STATE LIAISON OFFICE OVERVIEW: DEPARTMENT OF DEFENSE-STATE LIAISON OFFICE 2:42:39 PM CHAIR REINBOLD announced that the next order of business would be an Overview of the Defense-State Liaison Office. 2:43:57 PM TAMMIE PERREAULT, Regional Liaison, Department of Defense, Military & Family Policy, Washington, D.C., began a PowerPoint on the Defense-State Liaison Office. She reviewed slide 1, What We Do. The Defense-State Liaison Office, or DSLO, works with state policymakers to change laws and policies to improve military family well-being. Since 2010, we've worked with state policymakers to enact over 600 bills that make life better for the military community. If is a priority for military families, it's a priority for us. She commended Alaska's support for military families to make life easier for military families. 2:45:22 PM MS. PERREAULT turned to slide 3, Military Matters: 10 Key Issues for 2019. She offered to focus on the three key issue related to licensure for military spouses: Occupational Licensing Compacts, military spouse teacher licensure, and licensure law and implementation. She said this is important because: 68% of married Service Members report their spouse's ability to maintain a career impacts their decision to remain in the military? 77% of military spouses report they want or need to work? 15.2% of military spouses move from State to State annually? As many as 34% of military spouses are required to maintain occupational licensure for employment. MS. PERREAULT directed attention to a memorandum in members' packets that the Secretary of the Navy sent in February that indicated the U.S. Navy would make its basing decisions, in part, on the quality of the schools and reciprocity of licensure. She stated that this issue became important a few years ago when the department began hearing from military members who indicated their decision to leave the service was due to their spouse's inability to work. MS. PERREAULT directed attention to slide 9, Why this Matters to Alaska. She referred to a table on the slide that showed the total number of service members at 20,738 with 10,281 spouses for the nine bases in Alaska, including the U.S. Coast Guard. She said that other than Hawaii, Alaska has the largest number of military spouses per capita in the nation. MS. PERREAULT turned to slide 6, Distribution of [Licensed] Occupations. She reviewed the pie chart on the slide that showed 49 percent of the spouses were in health related fields and 32 percent were education related licensed positions. The demand for health care professionals continues to grow and military spouses could fill that gap. 2:49:51 PM SENATOR BIRCH said his dad was stationed in the Aleutians during WWII. His dad obtained an engineering degree through the GI bill, he said. He asked whether the military provides any educational benefits to military spouses. MS. PERREAULT, after clarifying the question, answered that a number of programs were available through the DOD's OneSource, which provides partnership with organizations such as Microsoft. The U.S. Chamber of Commerce has set up specific hiring zones for military spouses, she said. She offered to provide more information to the committee. 2:51:43 PM MS. PERREAULT noted that Senator Reinbold mention earlier the feedback she'd received on the licensure process at JBER. She referenced slide 9 that that lists where DoD has looked at occupations and licensure if various states. They participated in the University of Minnesota study and found that often times state boards did not implement their state law. They found that one way to alleviate this issue is for states to have a data collection and reporting process it could alleviate the issue. 2:52:48 PM MS. PERREAULT reviewed slide 10, What is happening in 2019? She listed compacts and Occupational Licensing Learning Policy Consortium. She noted what is happening in other states and Exemption. She highlighted four compacts DoD is currently tracking. These are the Physical Therapy License Compact, the Enhanced Nurse Licensure Compact (eNLC) that has been approved in 31 states and is the gold standard for military spouses, REPLICA Emergency Medical Services Compact, and PSYPACT Psychological Interjurisdictional Compact. 2:53:52 PM MS. PERREAULT explained that the Occupational Licensing Policy Learning Consortium is some best practices sources that are available. She noted that Senator Costello mentioned recently developed crosswalk resources. The National Council of State Legislatures, the National Governors' Association, and the Council of State Governments are good sources of information. 2:54:05 PM MS. PERREAULT referenced slides 13, 14, and 15 that address legislation in other states. Montana has a best practice of changing "may" to "shall" to force boards to recognize licenses from other states. Idaho recently issued an executive order and introduced a house bill that highlights four ways the state can move forward on licensure for military spouses, ensuring public safety and cost effectiveness. Oregon proposed an amendment that is much like what Alaska is doing in SB 11. It is a review of MS. PERREAULT reported that three states allow military spouses to work in the state, based upon having a valid out-of-state license, without evaluating "substantial equivalency." She directed attention to the quote on slide 17 from Colorado Second Lady, Karen Pence, Fort Carson, September 2018: But I can say without a doubt that the strength of our nation does not just come from the people in uniform who fight to protect our freedoms. The spouses and the families, who serve alongside them, also make tremendous sacrifices to the greater benefit of our country. CHAIR REINBOLD thanked Ms. Perreault for the presentation. SB 11-MILITARY SPOUSE COURTESY LICENSE 2:56:24 PM CHAIR REINBOLD announced that the final order of business would be SENATE BILL NO. 11, "An Act relating to temporary courtesy licenses for certain nonresident professionals; and relating to the Department of Commerce, Community, and Economic Development." 2:56:48 PM SENATOR BIRCH clarified that the committee would be hearing the original version of SB 11, labeled 31-LS0262\A. Senator Gray- Jackson objected for purpose of discussion. 2:57:18 PM SENATOR SCOTT KAWASAKI, Alaska State Legislature, Juneau, speaking as sponsor of SB 11, said he would provide a high-level overview of SB 11. He said that a similar bill [House Bill 262] passed the House last year with a 40-0 vote and gained bipartisan support in the Senate before it failed to reach the floor for a vote. The concept of this bill is listed as a priority for the U.S. Department of Defense by the state liaison serving Alaska. SENATOR KAWASAKI said that Alaska supports its armed service members, its veterans, its military and its families. He said that volunteer groups transition soldiers and their families as they come to Alaska. The school districts help integrate children into their local schools quickly and without any issues. Even small businesses participate. He described Fairbanks as welcoming to military members, that its small businesses offer discounts to military families. He reported that Fairbanks has 9,000 servicemen and women, with 4,000 spouses. The community anticipates an additional 1,000 armed service members in Fairbanks with the F-35s anticipated to come to Alaska. Joint Base Elmendorf-Richardson (JBER), located in Anchorage has 10,000 servicemen and women, he said. 2:59:03 PM SENATOR KAWASAKI explained that SB 11 would build off the original bill that Representative Thomas introduced in 2011 to expedite temporary and courtesy licenses. He described SB 11 as one way the legislature could show support for its military families and allow spouses and dependents to transition into their jobs quickly. He said he hoped to advance the bill quickly since it is pro-military pro-jobs, and pro-economy at a time when Alaska needs it more than ever. He thanked the Department of Defense and the Department of Commerce, Community, and Economic Development for their assistance. [SB 11 was held in committee.] 3:00:25 PM CHAIR REINBOLD reviewed upcoming committee announcements. 3:00:49 PM There being no further business to come before the committee, Chair Reinbold adjourned the Senate Labor and Commerce Standing Committee meeting at 3:00 p.m.

Document Name Date/Time Subjects
L&C Direct Entry Midwives Resume - Espindola.pdf SL&C 3/7/2019 1:30:00 PM
Governor's Appointees to Boards and Commissions
L&C Nursing Resume - Monrad.pdf SL&C 3/7/2019 1:30:00 PM
Governor's Appointees to Boards and Commissions
APRN letter of support Monrad.pdf SL&C 3/7/2019 1:30:00 PM
Monrad Letter to Senate Labor and Commerce Committee.pdf SL&C 3/7/2019 1:30:00 PM
AKANA Letter of Support Monrad.pdf SL&C 3/7/2019 1:30:00 PM
ANMC Chief Nurse Executive letter of support Monrad.pdf SL&C 3/7/2019 1:30:00 PM
L&C Nursing Resume - Schloeder.pdf SL&C 3/7/2019 1:30:00 PM
Governor's Appointees to Boards and Commissions
L&C Nursing Resume - Tisdale.pdf SL&C 3/7/2019 1:30:00 PM
Governor's Appointees to Boards and Commissions
03.17.2019 Senate Labor and Commerce Committe - CBPL Licensing Hearing.pdf SL&C 3/7/2019 1:30:00 PM
03.07.2019 Senate Labor and Commerce Committee - Department of Defense Alaska Occupational Licensure -.pdf SL&C 3/7/2019 1:30:00 PM
Professional Licensure
02.23.18 Tri-Service to NGA - Consideration of schools and reciprocity of professional licensure for military familites.pdf SL&C 3/7/2019 1:30:00 PM
Professional Licensure
REACH Military Spouse Licensure Portability Examination State Report.pdf SL&C 3/7/2019 1:30:00 PM
Professional Liensure
SB 11 Version A.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Sponsor Statement.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB011-DCCED-CBPL-03-01-19.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Letter of Support - DOD State Liaison.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Supporting Document- Military Licensing in Alaska DCCED CBPL April 2018 FINAL.PDF SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Supporting Document- Military Licensure Update CBPL 2-1-18.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Supporting Document- Top Spouse Professions DoD 2012.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Supporting Document- Millitary Courtesy License Statute.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Supporting Document- DoD Licensure Implementation Eval. 2.2.17.pdf SL&C 3/7/2019 1:30:00 PM
SB 11
SB 11 Supporting Document- Military Licensing Flyer DCCED CBPL April 2018 FINAL.PDF SL&C 3/7/2019 1:30:00 PM
SB 11