02/12/2024 01:30 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SSCR4|| EO 127 | |
| SSCR6|| EO 129 | |
| SSCR7|| EO 130 | |
| SB197 | |
| SB183 | |
| HB57 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SSCR 4 | TELECONFERENCED | |
| *+ | SSCR 6 | TELECONFERENCED | |
| *+ | SSCR 7 | TELECONFERENCED | |
| *+ | SB 197 | TELECONFERENCED | |
| *+ | SB 183 | TELECONFERENCED | |
| *+ | HB 57 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
February 12, 2024
1:35 p.m.
MEMBERS PRESENT
Senator Jesse Bjorkman, Chair
Senator Click Bishop, Vice Chair
Senator Elvi Gray-Jackson
Senator Kelly Merrick
Senator Forrest Dunbar
COMMITTEE CALENDAR
EO 127 ELIMINATING THE BOARD OF MASSAGE THERAPISTS
- HEARD
SENATE SPECIAL CONCURRENT RESOLUTION NO. 4
Disapproving Executive Order No. 127.
- MOVED SSCR 4 OUT OF COMMITTEE
EO 129 ELIMINATING THE BOARD OF BARBERS AND HAIRDRESSERS
- HEARD
SENATE SPECIAL CONCURRENT RESOLUTION NO. 6
Disapproving Executive Order No. 129.
- MOVED SSCR 6 OUT OF COMMITTEE
EO 130 ELIMINATING THE BOARD OF CERTIFIED DIRECT-ENTRY MIDWIVES
- HEARD
SENATE SPECIAL CONCURRENT RESOLUTION NO. 7
Disapproving Executive Order No. 130.
- MOVED SSCR 7 OUT OF COMMITTEE
SENATE BILL NO. 197
"An Act relating to residential building codes; relating to
construction contractors and residential contractor
endorsements; establishing the Alaska State Building Code
Council; and providing for an effective date."
- HEARD & HELD
SENATE BILL NO. 183
"An Act relating to the workers' compensation benefits guaranty
fund; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 57
"An Act relating to review organizations and permitting an
emergency medical services provider to establish a review
organization; and relating to patient records."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SSCR 4
SHORT TITLE: DISAPPROVE EO 127
SPONSOR(s): RULES
02/12/24 (S) READ THE FIRST TIME - REFERRALS
02/12/24 (S) L&C
02/12/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: SSCR 6
SHORT TITLE: DISAPPROVE EO 129
SPONSOR(s): RULES
02/12/24 (S) READ THE FIRST TIME - REFERRALS
02/12/24 (S) L&C
02/12/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: SSCR 7
SHORT TITLE: DISAPPROVE EO 130
SPONSOR(s): RULES
02/12/24 (S) READ THE FIRST TIME - REFERRALS
02/12/24 (S) L&C
02/12/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: SB 197
SHORT TITLE: RESIDENTIAL BUILDING CODE
SPONSOR(s): SENATOR(s) BJORKMAN
01/22/24 (S) READ THE FIRST TIME - REFERRALS
01/22/24 (S) L&C, FIN
02/12/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: SB 183
SHORT TITLE: WORKERS' COMP BENEFITS GUARANTY FUND
SPONSOR(s): LABOR & COMMERCE
01/16/24 (S) READ THE FIRST TIME - REFERRALS
01/16/24 (S) L&C, FIN
02/12/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: HB 57
SHORT TITLE: EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
SPONSOR(s): REPRESENTATIVE(s) WRIGHT
02/03/23 (H) READ THE FIRST TIME - REFERRALS
02/03/23 (H) L&C, HSS
02/17/23 (H) L&C AT 3:15 PM BARNES 124
02/17/23 (H) Heard & Held
02/17/23 (H) MINUTE(L&C)
03/03/23 (H) L&C AT 3:15 PM BARNES 124
03/03/23 (H) Moved HB 57 Out of Committee
03/03/23 (H) MINUTE(L&C)
03/06/23 (H) L&C RPT 4DP 1NR
03/06/23 (H) DP: SADDLER, PRAX, RUFFRIDGE, SUMNER
03/06/23 (H) NR: CARRICK
03/21/23 (H) HSS AT 3:00 PM DAVIS 106
03/21/23 (H) Heard & Held
03/21/23 (H) MINUTE(HSS)
03/28/23 (H) HSS AT 3:00 PM DAVIS 106
03/28/23 (H) Moved HB 57 Out of Committee
03/28/23 (H) MINUTE(HSS)
03/29/23 (H) HSS RPT 5DP
03/29/23 (H) DP: RUFFRIDGE, SUMNER, FIELDS, MINA,
PRAX
05/09/23 (H) TRANSMITTED TO (S)
05/09/23 (H) VERSION: HB 57
05/10/23 (S) READ THE FIRST TIME - REFERRALS
05/10/23 (S) L&C, HSS
02/12/24 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
WITNESS REGISTER
LAURA ACHEE, Staff
Senator Jesse Bjorkman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SB 197 on behalf of the sponsor.
JEFF TWAIT, Owner
Cornerstone Custom Homes and Designs
Soldotna, Alaska
POSITION STATEMENT: Testified by invitation on SB 197.
ERIC VISSER, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 197.
DAVID OWENS, representing self
Wasilla, Alaska
POSITION STATEMENT: Testified in support of SB 197.
AARON WELTERLEN, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of SB 197.
LAURA ACHEE, Staff
Senator Jesse Bjorkman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SB 183 on behalf of the Senate
Labor and Commerce Standing Committee, Senator Bjorkman, Chair.
CHUCK COLLINS, Director
Division of Workers' Compensation
Juneau, Alaska
POSITION STATEMENT: Testified by invitation on SB 183.
REPRESENTATIVE STANLEY WRIGHT, District 22
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Spoke as the sponsor of HB 57.
RACHEL GUNN, Staff
Representative Stanley Wright
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Gave a presentation on HB 57.
BRIAN WEBB, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on HB 57.
DR. TIM PETERSON, Capital City Fire Rescue (CCFR)
Juneau, Alaska
POSITION STATEMENT: Testified by invitation on HB 57.
DR. MICHAEL LEVY, representing self
Eagle-River, Alaska
POSITION STATEMENT: Testified by invitation on HB 57.
ACTION NARRATIVE
1:35:24 PM
CHAIR JESSE BJORKMAN called the Senate Labor and Commerce
Standing Committee meeting to order at 1:35 p.m. Present at the
call to order were Senators Gray-Jackson, Dunbar, Merrick,
Bishop, and Chair Bjorkman.
^EO 127
SSCR 4-DISAPPROVE EO 127
EO 127 ELIMINATING THE BOARD OF MASSAGE THERAPISTS
1:38:01 PM
CHAIR BJORKMAN announced the consideration of [Executive Order
(EO) 127 and SENATE SPECIAL CONCURRENT RESOLUTION NO. 4
Disapproving Executive Order No. 127].
1:38:11 PM
CHAIR BJORKMAN found no discussion and solicited the will of the
committee.
1:38:28 PM
SENATOR BISHOP moved EO 127 with individual recommendations be
reported from committee, and SSCR 4 with individual
recommendations and attached fiscal note(s) be reported from
committee for further consideration in the Senate.
1:38:58 PM
CHAIR BJORKMAN reminded members that this does not reflect any
intent by any of the members to vote for or against a special
concurrent resolution disapproving this executive order in joint
session.
1:39:16 PM
CHAIR BJORKMAN found no objection and EO 127 and SSCR 4 were
reported from the Senate Labor and Commerce Standing Committee.
1:39:29 PM
At ease
^EO 129
SSCR 6-DISAPPROVE EO 129
EO 129 ELIMINATING THE BOARD OF BARBERS AND HAIRDRESSERS
1:42:23 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of [Executive Order (EO) 129 and SENATE SPECIAL
CONCURRENT RESOLUTION NO. 6 Disapproving Executive Order No.
129].
1:42:48 PM
CHAIR BJORKMAN found no discussion and solicited the will of the
committee.
1:42:54 PM
SENATOR BISHOP moved EO 129 with individual recommendations be
reported from committee, and SSCR 6 with individual
recommendations and attached fiscal note(s) be reported from
committee for further consideration in the Senate.
1:43:23 PM
CHAIR BJORKMAN reminded members that this does not reflect any
intent by any of the members to vote for or against a special
concurrent resolution disapproving this executive order in joint
session.
1:43:35 PM
CHAIR BJORKMAN found no objection and EO 129 and SSCR 6 were
reported from the Senate Labor and Commerce Standing Committee.
1:43:46 PM
At ease
^EO 130
SSCR 7-DISAPPROVE EO 130
EO 130 ELIMINATING THE BOARD OF CERTIFIED DIRECT-ENTRY MIDWIVES
1:45:03 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of [Executive Order (EO) 130 and SENATE SPECIAL
CONCURRENT RESOLUTION NO. 7 Disapproving Executive Order No.
130].
1:45:16 PM
CHAIR BJORKMAN found no discussion and solicited the will of the
committee.
1:45:29 PM
SENATOR BISHOP moved EO 130 with individual recommendations be
reported from committee, and SSCR 7 with individual
recommendations and attached fiscal note(s) be reported from
committee for further consideration in the Senate.
1:45:48 PM
CHAIR BJORKMAN reminded members that this does not reflect any
intent by any of the members to vote for or against a special
concurrent resolution disapproving this executive order in joint
session.
1:46:03 PM
CHAIR BJORKMAN found no objection and EO 130 and SSCR 7 were
reported from the Senate Labor and Commerce Standing Committee.
1:46:16 PM
At ease
SB 197-RESIDENTIAL BUILDING CODE
1:47:41 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of SENATE BILL NO. 197, "An Act relating to
residential building codes; relating to construction contractors
and residential contractor endorsements; establishing the Alaska
State Building Code Council; and providing for an effective
date."
1:48:14 PM
LAURA ACHEE, Staff, Senator Jesse Bjorkman, Alaska State
Legislature, Juneau, Alaska, presented SB 197 on behalf of the
sponsor. She read from the following statement:
[Original punctuation provided.]
When an Alaskan buys a new home or has a custom home
built, they should have confidence that the home that
they and their family are living in is safe.
There are municipalities in Alaska that have municipal
residential building codes, but for homes that are
built outside of those communities, Senate Bill 197
would establish a statewide residential building code.
The bill directs the Alaska Housing Finance
Corporation to adopt by regulation the 2018
International Residential Building Code published by
the International Code Council, with allowances for
Alaska-specific amendments and adopting updated
versions of the Code.
The residential building code would not supersede
municipal codes where they currently exist or are
adopted in the future, and it would not interfere with
any other state building codes or the statutory
requirements for other contractors such as plumbers
and electricians.
1:49:59 PM
JEFF TWAIT, Owner, Cornerstone Custom Homes and Designs,
Soldotna, Alaska, testified by invitation on SB 197. He said he
is a member of the Kenai Peninsula Builders Association (KPBA)
and the Alaska State Home Building Association (ASHBA). He has
been working over the last decade with ASHBA to place a
statewide residential building code. He explained that the
backbone of SB 197 is to provide a minimum building standard in
areas without building code jurisdiction. This will help level
the playing field for licensed builders and provide protection
for purchasers who may not be aware of potential building
deficiencies. He compared a home to a human body - a set of
systems that need to work together and make the house
affordable, healthy, comfortable, and sustainable over time. He
shared an example of the way various systems within a home need
to work together to ensure safety and proper functioning.
1:53:00 PM
MR. TWAIT explained that, currently, a contract between the
builder and the purchaser is meant to ensure that minimum
building standards are met; however, there is little to no
recourse in the event that the builder does not hold to this
agreement. He compared a declaration that a builder is "building
to the code" to attaining a D- in school and added that this is
not a high bar to attain. Therefore, creating a statewide
building code should not be considered something that will add
extra costs to building a house. Additionally, he shared his
belief that codifying statewide building standards would
lengthen the housing life cycle and create healthier markets and
more efficient homes. He stated that housing affordability is a
big concern and explained that while this might appear to raise
housing costs, it will reduce total costs of the home over time
by lowering the costs of utilities and maintenance, and an
increased appreciation in value. He said that federal funds
require the adoption of the energy code and building code. He
opined that ASHBA experts are the right people to help create a
statewide building code and suggested that AHFC oversight
combined with recommendations made by volunteer industry experts
would mean a minimal fiscal burden and large benefit.
1:54:55 PM
SENATOR GRAY-JACKSON expressed concern that recreational cabins
and owner-built homes are exempt.
1:55:33 PM
MR. TWAIT expressed his agreement. He explained that
recreational cabins are exempt primarily because some energy
codes included in the updated building codes can be difficult to
obtain in remote locations. He shared his personal agreement
that owner-built homes should be included and expressed hope
that they will be included at a later date. He offered his
understanding that several legislators have districts with a low
number of contract builders and a high number of owner-builders
and suggested that this may be why this group was left out of SB
197.
1:56:54 PM
SENATOR DUNBAR asked if the building code would only apply to
structures of 1-4 units.
1:57:17 PM
MR. TWAIT replied yes. He explained that when a building is a
fourplex or larger, the international building code kicks in,
which is under the jurisdiction of the State Fire Marshal.
1:57:41 PM
SENATOR DUNBAR commented that there is interest in increasing
housing construction and housing density in Alaskan cities. He
expressed his understanding that the international building code
restricts the construction of certain types of buildings with
single stairwells. He asked for clarification that this does not
apply to SB 197.
1:58:13 PM
MR. TWAIT said that he is not familiar with this issue.
1:58:30 PM
SENATOR DUNBAR shared his understanding that the US is one of
the only countries in the world that forbids single stairwells
in buildings with more than four units due to fire code
concerns. He said that this has limited multi-family
construction in certain places. He reiterated his understanding
that SB 197 does not apply to this issue, because buildings with
more than four units are under the purview of the Fire Marshal.
He asked if this is correct.
1:58:55 PM
MR. TWAIT replied yes.
1:59:35 PM
CHAIR BJORKMAN provided his rationale for sponsoring SB 197. He
explained his hope that, when Alaskans hire someone to build a
home for them, they hire a contractor who is qualified and
builds a home to a standard that is safe for them to live in. He
stated that professionals are expected to have a certain level
of training and expertise and to perform a certain level of care
to a standard set by government licensing requirements. He
explained that there have been several instances in his home
community where builders have built unsafe homes. He added that,
without a statewide building code to refer to as the minimum
standard to which homes should be built, Alaskans have little
recourse in these situations. He stated that SB 197 is a
consumer protection bill and pointed out that it only applies to
contractors who are licensed by the state as builders - it does
not apply to someone who is building their own house. He shared
his belief that someone who is building their own house can take
their own risks; however, when a contractor advertises
themselves as a professional who can build a safe house - and
receives money in exchange for this service - a minimum standard
should be in place.
2:01:50 PM
CHAIR BJORKMAN opened public testimony on SB 197.
2:02:23 PM
ERIC VISSER, representing self, Anchorage, Alaska, testified in
support of SB 197. He said he is a past president for both the
Alaska State Home Building Association (ASHBA) and Anchorage
Home Builders Association (AHBA). He said that ASHBA has been
working to create a statewide building code for the past 10-15
years. He stated that ASHBA has learned from previous
legislation that was introduced and opined that SB 197 "strikes
the right balance," adopting a building code that is already in
place. He estimated that 99 percent of ASHBA members already
build to the code requirements in SB 197. He stated that the
Alaska Housing Finance Corporation adopts this code regularly -
and most builders are familiar with this standard. He explained
that adopting a statewide building code protects the consumer
from outliers who do not build to this standard.
2:03:50 PM
SENATOR DUNBAR inquired about the standard of Anchorage's
building code.
2:04:17 PM
MR. VISSER replied that the housing code has a lot of grey area,
which is left up to the authority with jurisdiction. He
explained that Anchorage does not have a good building official
to make these determinations, and shared his belief that this
drives up the cost of housing in Anchorage.
2:04:55 PM
SENATOR DUNBAR asked if the current structure of Anchorage's
building code would meet the standard set by SB 197.
2:05:09 PM
MR. VISSER replied yes.
2:05:14 PM
SENATOR GRAY-JACKSON thanked Mr. Visser for his testimony.
2:05:28 PM
DAVID OWENS, representing self, Wasilla, Alaska, testified in
support of SB 197. He said that he owns Owen's Inspection
Services in Palmer, Alaska and has been a building inspector for
almost 40 years. He shared his belief that SB 197 is well
thought out and addresses concerns that need to be addressed. He
shared his understanding that it applies to contractors with a
residential endorsement, giving them a minimum standard to
inspect to. He said that it gives inspectors a minimum level to
inspect to and builders a minimum level to build to. In answer
to an earlier question from Senator Dunbar, he explained that
the amount of stairwells in a building depends on the amount of
occupants in the building. The occupancy must be very low to
have a single exit or stairwell. He said that this is why
nationwide fire and building codes have this standard in place.
2:07:26 PM
AARON WELTERLEN, representing self, Fairbanks, Alaska, testified
in support of SB 197. He said he is a past president of the
Interior Alaska Building Association (IABA) and the Alaska State
Home Builders Association (ASHBA). He said that ASHBA has been
working on a statewide building code for a long time as a form
of consumer protection. He explained that Fairbanks has a small
city building department and most structures are built outside
of the city. He acknowledged that certain home financing
organizations will require that homes pass inspection standards.
However, SB 197 provides long-term protection for consumers. A
statewide building code would provide a standardized building
system so that consumers know they are protected.
2:09:47 PM
CHAIR BJORKMAN closed public testimony and held SB 197 in
committee.
2:10:04 PM
At ease
SB 183-WORKERS' COMP BENEFITS GUARANTY FUND
2:13:45 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of SENATE BILL NO. 183, "An Act relating to the
workers' compensation benefits guaranty fund; and providing for
an effective date."
2:14:24 PM
LAURA ACHEE, Staff, Senator Jesse Bjorkman, Alaska State
Legislature, Juneau, Alaska, presented SB 183 on behalf of the
Senate Labor and Commerce Standing Committee, Senator Bjorkman,
Chair. She read from the following statement:
[Original punctuation provided.]
In recent years the Workers' Compensation Benefits
Guaranty Fund has had difficulties making timely
payments to injured workers because the Fund has been
subject to Constitutional Budget Reserve sweeps.
Sweeping the Fund balance to zero each year has
created a hurdle to paying claims until its regular
revenues or supplemental budget appropriations become
available. Senate Bill 183 would rectify this problem
by moving the Fund from the General Fund to the State
Treasury, leaving its balance intact at the end of the
fiscal year as it would no longer be subject to the
CBR sweep.
2:15:54 PM
CHUCK COLLINS, Director, Division of Workers' Compensation,
Juneau, Alaska, testified by invitation on SB 183. He said that
the Workers' Compensation Benefits Guaranty Fund was established
in 2005 so that employees whose employers had neglected to
insure for on the job injuries would have a way to be covered in
the event of injury. He stated that over the years the fund has
paid out several million dollars in benefits. These funds
support injured workers and their families. He said that
currently there are over 20 ongoing cases, several cases are
children of injured workers who were not able to return to work
due to the severity of their injury. He explained that the fund
is made up of settlements and penalties paid by employers who
were fined for not being properly insured. In the past, the fund
was held aside and only accessed when it was needed. However, he
stated that several years ago the fund was swept. He explained
that it was a non-reverse sweep and to date, just over $4
million has been taken from the fund. He said that there are
several pending claims in addition to ongoing claims. He
explained that the division has anywhere from 6-12 claims
yearly. The division works to bring in revenue from
stipulations. Referring to AS 23.30.082, he stated that the
division would like to see protections for the fund so that the
money would not lapse - thus ensuring that the funds are
available to those who need them. He referred to a member of
Chair Bjorkman's community who was badly burned while working -
and who continues to receive support from the guaranty fund.
2:20:25 PM
SENATOR BISHOP asked what the current fund balance is.
2:20:30 PM
MR. COLLINS replied that the fund balance varies daily and is
currently around $300 thousand.
2:20:42 PM
SENATOR BISHOP asked if the fund is owed $4.4.
2:20:46 PM
MR. COLLINS replied that this is correct.
2:20:48 PM
SENATOR DUNBAR asked why the guaranty fund was changed from a
non-swept fund to a swept fund. He shared his understanding that
there are constitutional prohibitions on dedicated funds and
asked how SB 183 can avoid the constitutional prohibition.
2:21:28 PM
MR. COLLINS replied that he cannot speak to the legal terms;
however, he explained that all funds are subject to the sweep
action, as there are no dedicated funds. He stated that
oftentimes, the legislature will protect funds from the sweep by
voting for a reverse sweep - which did not happen in this case.
he explained that the division approached the attorney general's
office and SB 183 is the best solution.
2:22:30 PM
SENATOR GRAY-JACKSON asked if there is a plan to make the fund
whole.
2:22:46 PM
MR. COLLINS replied that there is no plan to make the fund
whole. He explained that it is the will of the Alaska Worker's
Compensation Board is to have the money returned to the fund. He
clarified that the division and the department do not have an
opinion.
2:23:21 PM
SENATOR GRAY-JACKSON shared her belief that there should be a
plan in place to make this fund whole.
2:23:35 PM
SENATOR BISHOP said that he has a plan to make the fund whole.
He shared his belief that sweeping the fund was a travesty and
that Alaskan workers need to know that the state cares about
them - one way to do this is to make the fund whole.
2:24:28 PM
CHAIR BJORKMAN held SB 183 in committee.
2:24:34 PM
At ease
HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
2:26:43 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of HOUSE BILL NO. 57, "An Act relating to review
organizations and permitting an emergency medical services
provider to establish a review organization; and relating to
patient records."
2:27:19 PM
REPRESENTATIVE STANLEY WRIGHT, District 22, Alaska State
Legislature, Juneau, Alaska, sponsor of HB 57, read the
following statement:
[Original punctuation provided.]
This legislation corrects an inequity that has long
affected our emergency medical services (EMS) in
Alaska. This bill seeks to extend the same quality
assurance program protections to EMS workers that
fixed healthcare facilities have benefitted from for
years.
This is not an unprecedented request, several other
states have already recognized and acted upon the need
to provide these protections to their EMS systems.
Alaska's EMS system, particularly in our rural and
super rural areas, operates largely on the strength of
volunteerism.
It's important to understand that these volunteers are
not just our emergency technicians and paramedics, but
include volunteer medical directors as well. These
selfless individuals, many of whom are physicians,
play a crucial role in ensuring their communities have
access to state-certified Emergency Services.
However, a glaring discrepancy exists: while these
physicians enjoy quality assurance protections in
their primary roles within clinics and hospitals, they
are stripped of these protections when serving as EMS
medical directors in the same communities. This
discrepancy not only poses a risk to the health and
safety of Alaskans but also threatens the very
existence of our rural EMS systems.
This amendment is critical for maintaining the
viability of our EMS programs, and the health and
safety of our communities across Alaska.
2:29:41 PM
RACHEL GUNN, Staff, Representative Stanley Wright, Alaska State
Legislature, Juneau, Alaska, gave a presentation on HB 57. She
read the following statement:
[Original punctuation provided.]
Emergency Medical Services in Alaska stands as a
hybrid organization, intersecting transportation,
safety, medical, and public health disciplines, with
an unwavering commitment to saving lives outside the
walls of primary care facilities.
Many emergency physicians are involved with the direct
care provided in the field by EMTs and Paramedics, and
these Emergency medicine specialists are pivotal,
extending their expertise beyond hospital walls to
guide EMT and Paramedics in the field. Through
"medical control," they issue treatment orders,
ensuring immediate and appropriate care. Furthermore,
pre-hospital protocols, or standing orders, empower
EMS teams with clear guidelines for patient care
before hospital arrival.
In emergency care, every second counts, and decisions
are made in the blink of an eye. These decisions,
often made under extreme conditions, can have profound
effects on patient outcomes. After the dust settles,
our EMS professionals, including ETTs EMTs,
paramedics, and their medical directors, engage in
critical self-reflection through Peer Review Boards
and Quality Assurance programs.
The Peer Review Process is comprised of providers with
similar competencies evaluating the care provided to
the patient and encourages EMS providers to evaluate
and refine their patient care systems continually. A
successful Quality Assurance committee is essential,
usually comprised an auditor, a medical director, and
a feedback provider. This team focuses on patient
outcomes, leveraging data to pinpoint and implement
process improvements. Here they dissect each decision
and action, asking, "Could we have handled that
better? What can we learn from this?" This reflective
practice is crucial for continual learning and
improvement, ensuring better patient care in future
emergencies.
Under the current framework, any admission by EMS
personnel, any acknowledgment of potential improvement
areas, could be misconstrued as liability in a
lawsuit. Protections that are inherent for medical
directors administering care as a doctor or surgeon
within the walls of the hospital do not extend to the
review process for the EMS cases they oversee. A
considerable portion of EMS providers and the
physicians and medical directors guiding them in
Alaska serve voluntarily, and the absence of
protective measures for them is a glaring neglect of
our frontline workforce.
This fear stifles open, honest review and discussiona
cornerstone of medical improvement and patient safety.
Our proposed legislation seeks to shield these frank
discussions from being weaponized in legal battles.
It does not prevent an EMS provider a Medical Director
from being sued, it simply limits the information
gleaned from Peer Review Programs and Quality
Assurance meetings allowable for discovery. It's not
about evading responsibility; it's about creating a
safe space for EMS professionals to learn, grow, and
enhance the quality of care they provide without the
constant fear of legal repercussions. This proactive
approach to continuous learning and improvement is
vital for the evolution of emergency medical services
and protecting our Medical Directors and EMS providers
the way we protect our healthcare.
CHAIR BJORKMAN announced invited testimony on HB 57.
2:33:16 PM
BRIAN WEBB, representing self, Anchorage, Alaska, testified by
invitation on HB 57. He said he has been an Alaska Emergency
Medical Services (EMS) clinician since 1978 and currently
volunteers for Alaska EMS improvement and advocacy efforts. He
stated that Alaska EMS services should be afforded the same
program protections that fixed facilities enjoy and requested
that the legislature correct this inequity. Referring to Alaska
Statute definitions, he explained that this wording does not
include pre-hospital personnel or activities. Therefore, HB 57
seeks to change this definition. He said that EMS does not
experience a two-way flow of information. He explained the lack
of protections has had a chilling effect for many, as what is
discussed or presented by EMS is discoverable outside of the EMS
process. As a result, EMS providers are often concerned about
privacy issues. He said that this effects both the educational
growth and patient care improvement systems. He added that
protecting this process allows EMS providers to safely grow in
their craft and become better patient care advocates. He
compared EMS to a three-legged stool and explained that it is
able to survive due to its volunteerism of services,
volunteerism of EMS clinicians, and EMS medical directors. He
said that all three of these must be balanced to ensure the
safety of citizens.
2:35:15 PM
MR. WEBB explained that HB 57 seeks to fix a crack in one leg of
the stool that is impacting volunteer EMS clinicians and EMS
medical directors. He stated that, nationwide, EMS recruitment
has faced challenges. He stated that losing valuable volunteer
EMS clinicians and EMS medical directors would result in a lack
of protection. He pointed out that most of these individuals are
no longer willing to risk their financial or professional
futures because of this disclosure. He said that during the day,
EMS medical directors have protection, yet when they switch
gears after daytime working hours and volunteer for EMS
services, they no longer have protection. This has resulted in
the loss of many volunteers. He emphasized that a lack of
volunteers means no EMS to respond - and no EMS services. He
listed states that have enacted these protections.
2:37:03 PM
SENATOR BISHOP asked if this definition change would result in a
lower insurance premium.
2:37:50 PM
MR. WEBB said that this issue was discussed during committee
hearings in the House. He explained that HB 57 precludes many
things that can be discovered through lawsuits. He stated that
indemnity for medical directors is a separate issue and noted
that many regional offices are working to build insurance-based
solutions for volunteer EMS medical directors, but added that
this is a very long process.
2:39:00 PM
DR. TIM PETERSON, Capital City Fire Rescue (CCFR), Juneau,
Alaska, testified by invitation on HB 57. He said he has been an
emergency physician at Bartlett Regional Hospital since 1989 and
has dealt with EMS volunteers from around the state when
patients have required medivac. He said he is co-chair of Alaska
Council for Emergency Medical Services (ACEMS), which recently
finished a four-year project relating to scope of medical
practices. He stated that information regarding updated scope of
medical practices must be provided to those in the industry via
training and education. He said he is also the medical director
for Southeast Regional EMS Council (SEREMS), which covers remote
areas that are volunteer-dependent. He explained that the
volunteer EMS system was strained during the Covid-19 pandemic.
He added that many older volunteers simply quit, and they are in
the process of rebuilding. The job, he said, is to ensure that
Alaska EMS services are operating to a standard of care that is
equivalent to the standard of care across the country. He stated
that "quality assurance" refers to the quality of the services
offered. He explained that for many small communities, "run
reviews" are done. In rural communities, few doctors have
malpractice insurance because they don't know where or how to
get it, or the associated costs. He emphasized the importance of
open and honest dialogue around what is working and what is not
- and expressed a desire to have bullet points of what is
discussed at meetings (with all personal identifying information
removed).
2:42:53 PM
SENATOR BISHOP commented that HB 57 would allow EMS
professionals to discuss issues and keep records that they can
then share with their peers around the state and hopefully avoid
repeating problematic behaviors.
2:43:37 PM
DR. PETERSON replied that he would like to be able to attend
conferences and discuss cases with others in the profession in
order to learn from other people's mistakes, which is not
possible currently.
2:44:11 PM
DR. MICHAEL LEVY, representing self, Eagle-River, Alaska,
testified by invitation on HB 57. He said he is the immediate
past president of the National Association of EMS Physicians
(NAEMSP) and State of Alaska EMS Medical Director. He is the EMS
Medical Director for various state EMS agencies and has
practiced in Alaska since 1989. He said he is board certified
with an EMS medicine specialty and explained that EMS medicine
is a sub-specialty that offers board certification by the
American Board of Medical Specialties since 2013. He added that
this is an acknowledgement that EMS medicine is a distinct
practice of medicine - and that EMS is part of the healthcare
system. He said that many states have established laws providing
peer-review protection for EMS agencies, which ensures that
information gathered for the purposes of improving quality of
health remains non-discoverable in legal proceedings. He
provided a list of examples of this information. He stated that
EMS is evolving as a versatile community health resource that is
integral to local and regional systems of care. He added that
EMS is clearly a public health entity and must be people
centered. He stated that EMS treatments should include
processes, protocols, and practices that are designed to have
the best practices for individuals. EMS clinicians should
deliver care by evidence-based practices. He pointed out that
peer review and quality of care have long been accepted as
fundamental tools for improved care; however, protection from
discovery has not explicitly included EMS. He commented that
many EMS providers question whether they did the right thing -
yet they are not able to receive feedback on their decisions. He
emphasized the value of feedback for improvement and added that
HB 57 is a step toward supporting EMS practitioners by adding
protections already provided by other states.
2:48:10 PM
SENATOR DUNBAR commented that Dr. Levy and others with the
Anchorage Fire Department did tremendous work leading to nation
leading results in cardiac arrest survival rates. He pointed out
that in the United States military, certain investigations can
lead to punitive actions; however, they also have safety
investigations that are for improved safety going forward. He
explained that information provided during a safety
investigation cannot lead to punishment.
2:49:18 PM
SENATOR GRAY-JACKSON echoed Senator Dunbar's comments.
2:49:37 PM
DR. LEVY expressed appreciation.
2:49:49 PM
CHAIR BJORKMAN expressed gratitude for the work Dr. Levy has
done in his district.
2:50:01 PM
CHAIR BJORKMAN opened public testimony on HB 57; finding none,
he closed public testimony.
2:50:40 PM
CHAIR BJORKMAN held HB 57 in committee.
2:51:02 PM
There being no further business to come before the committee,
Chair Bjorkman adjourned the Senate Labor and Commerce Standing
Committee meeting at 2:51 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB183 ver A.pdf |
SL&C 2/12/2024 1:30:00 PM |
SB 183 |
| SB183 Sponsor Statement verA.pdf |
SFIN 3/6/2024 9:00:00 AM SL&C 2/12/2024 1:30:00 PM |
SB 183 |
| SB183 Sectional Analysis ver A.pdf |
SFIN 3/6/2024 9:00:00 AM SL&C 2/12/2024 1:30:00 PM |
SB 183 |
| SB183 Fiscal Note-DOLWD-WC-02.09.24.pdf |
SL&C 2/12/2024 1:30:00 PM |
SB 183 |
| SB183 Supporting Documents-AWCB_Resolution 23-01.pdf |
SFIN 3/6/2024 9:00:00 AM SL&C 2/12/2024 1:30:00 PM |
SB 183 |
| SB183 Supporting Documents-Overview and History of WCBG Fund.pdf |
SFIN 3/6/2024 9:00:00 AM SL&C 2/12/2024 1:30:00 PM |
SB 183 |
| SB183 Supporting Documents-AWCB Letter to Claimant.pdf |
SFIN 3/6/2024 9:00:00 AM SL&C 2/12/2024 1:30:00 PM |
SB 183 |
| SB197 ver S.pdf |
SL&C 2/12/2024 1:30:00 PM |
SB 197 |
| SB197 Sponsor Statement Ver S.pdf |
SFIN 3/6/2024 9:00:00 AM SL&C 2/12/2024 1:30:00 PM |
SB 197 |
| SB197 Sectional Analysis Ver S.pdf |
SFIN 3/6/2024 9:00:00 AM SL&C 2/12/2024 1:30:00 PM |
SB 197 |
| SB197 Fiscal Note-DCCED-CBPL-02.09.24.pdf |
SL&C 2/12/2024 1:30:00 PM |
SB 197 |
| SB197 Supporting Documents-ADN Opinion 05.14.23.pdf |
SL&C 2/12/2024 1:30:00 PM |
SB 197 |
| HB57 ver A.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Sponsor Statement 1.25.2024.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Sectional Analysis 1.25.2024.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Fiscal Note-DOH-Em Programs-01.16.24.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Supporting Documents-Dr. John Hall Email 02.06.23.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Supporting Documents-Washington Statewide Registry-1.25.2024.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Supporting Documents-Support Letters-Mio Rhein-Brian Webb-1.25.2024.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Testimony-Received as of 03.03.2023.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Testimony-Recieved as of 02.17.2023.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Supporting Documents-ACEMS 02.24.23.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Supporting Documents-California Evidence Code 1157.7 1.25.2024.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| HB57 Supporting Documents-Contra Costa EMS QIPP 12.19.19.pdf |
SL&C 2/12/2024 1:30:00 PM |
HB 57 |
| SSCR4 ver A.pdf |
SL&C 2/12/2024 1:30:00 PM |
SSCR 4 |
| SSCR4 Fiscal Note.pdf |
SL&C 2/12/2024 1:30:00 PM |
SSCR 4 |
| SSCR6 ver A.pdf |
SL&C 2/12/2024 1:30:00 PM |
SSCR 6 |
| SSCR6 Fiscal Note.pdf |
SL&C 2/12/2024 1:30:00 PM |
SSCR 6 |
| SSCR7 ver A.pdf |
SL&C 2/12/2024 1:30:00 PM |
SSCR 7 |
| SSCR7 Fiscal Note.pdf |
SL&C 2/12/2024 1:30:00 PM |
SSCR 7 |
| EO127 Public Testimony-Letter from Board Chair 01.31.24.pdf |
SL&C 2/12/2024 1:30:00 PM |
EO 127 |