Legislature(2025 - 2026)BELTZ 105 (TSBldg)

03/14/2025 01:30 PM Senate LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 89 PHYSICIAN ASSISTANT SCOPE OF PRACTICE TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
*+ SB 96 CHILD CARE: TAX CREDITS TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
Bills Previously Heard/Scheduled
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE LABOR AND COMMERCE STANDING COMMITTEE                                                                        
                         March 14, 2025                                                                                         
                           1:43 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Jesse Bjorkman, Chair                                                                                                   
Senator Kelly Merrick, Vice Chair (via teleconference)                                                                          
Senator Forrest Dunbar                                                                                                          
Senator Robert Yundt                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Elvi Gray-Jackson                                                                                                       
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 89                                                                                                              
"An   Act  relating   to   physician   assistants;  relating   to                                                               
collaborative   agreements  between   physicians  and   physician                                                               
assistants;  relating to  the practice  of medicine;  relating to                                                               
health  care  providers;  and relating  to  provisions  regarding                                                               
physician  assistants in  contracts between  certain health  care                                                               
providers and health care insurers."                                                                                            
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 96                                                                                                              
"An Act  relating to education  tax credits for  certain payments                                                               
and  contributions  for child  care  and  child care  facilities;                                                               
relating to  the insurance tax  education credit, the  income tax                                                               
education credit, the  oil or gas producer  education credit, the                                                               
property  tax education  credit,  the  mining business  education                                                               
credit,  the   fisheries  business  education  credit,   and  the                                                               
fisheries resource  landing tax  education credit;  providing for                                                               
an effective date  by amending the effective date of  secs. 1, 2,                                                               
and 21, ch. 61, SLA 2014; and providing for an effective date."                                                                 
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB  89                                                                                                                  
SHORT TITLE: PHYSICIAN ASSISTANT SCOPE OF PRACTICE                                                                              
SPONSOR(s): SENATOR(s) TOBIN                                                                                                    
                                                                                                                                
02/07/25       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/07/25       (S)       HSS, L&C                                                                                               
02/18/25       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
02/18/25       (S)       Heard & Held                                                                                           
02/18/25       (S)       MINUTE(HSS)                                                                                            
02/27/25       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
02/27/25       (S)       Heard & Held                                                                                           
02/27/25       (S)       MINUTE(HSS)                                                                                            
03/04/25       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
03/04/25       (S)       Moved SB 89 Out of Committee                                                                           
03/04/25       (S)       MINUTE(HSS)                                                                                            
03/05/25       (S)       HSS RPT 5DP                                                                                            
03/05/25       (S)       DP: DUNBAR, CLAMAN, GIESSEL, TOBIN,                                                                    
                         HUGHES                                                                                                 
03/14/25       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
BILL: SB  96                                                                                                                  
SHORT TITLE: CHILD CARE: TAX CREDITS                                                                                            
SPONSOR(s): RULES                                                                                                               
                                                                                                                                
02/12/25       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/12/25       (S)       L&C, FIN                                                                                               
03/14/25       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
SENATOR LOKI TOBIN, District I                                                                                                  
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of SB 89.                                                                                         
                                                                                                                                
MACKENZIE POPE, Staff                                                                                                           
Senator Loki Tobin                                                                                                              
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided the sectional analysis for SB 89.                                                                
                                                                                                                                
MARY SWAIN Chief Executive Officer (CEO)                                                                                        
Camai Community Health Center                                                                                                   
Bristol Bay, Alaska                                                                                                             
POSITION STATEMENT: Testified by invitation on SB 89.                                                                         
                                                                                                                                
MEGHAN HALL, President                                                                                                          
Alaska Academy of Physician Assistants                                                                                          
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified by invitation on SB 89.                                                                         
                                                                                                                                
SONJA KAWASAKI, Professional Assistant                                                                                          
Senate Majority Counsel                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Explained legal counsel on SB 96.                                                                         
                                                                                                                                
REPRESENTATIVE ZACK FIELDS, District 17                                                                                         
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided a history of SB 96.                                                                              
                                                                                                                                
EVAN ANDERSON, Staff                                                                                                            
Representative Zack Fields                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided sectional analysis for SB 96.                                                                    
                                                                                                                                
KATI CAPOZZI, President                                                                                                         
Alaska State Chamber                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified by invitation on SB 96.                                                                         
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:43:43 PM                                                                                                                    
CHAIR  BJORKMAN called  the Senate  Labor  and Commerce  Standing                                                               
Committee meeting  to order at 1:43  p.m. Present at the  call to                                                               
order  were Senators  Dunbar, Yundt  and Chair  Bjorkman. Senator                                                               
Merrick (via teleconference).                                                                                                   
                                                                                                                                
          SB  89-PHYSICIAN ASSISTANT SCOPE OF PRACTICE                                                                      
                                                                                                                                
1:44:44 PM                                                                                                                    
CHAIR BJORKMAN announced the consideration  of SENATE BILL NO. 89                                                               
"An   Act  relating   to   physician   assistants;  relating   to                                                               
collaborative   agreements  between   physicians  and   physician                                                               
assistants;  relating to  the practice  of medicine;  relating to                                                               
health  care  providers;  and relating  to  provisions  regarding                                                               
physician  assistants in  contracts between  certain health  care                                                               
providers and health care insurers."                                                                                            
                                                                                                                                
1:45:03 PM                                                                                                                    
SENATOR  LOKI  TOBIN,  District   I,  Alaska  State  Legislature,                                                               
Juneau, Alaska, sponsor  of SB 89 introduced  the legislation and                                                               
stated that  Alaska is facing  a serious shortage  of physicians,                                                               
and many  communities are struggling  to get the care  they need.                                                               
Though  long-term  efforts  are   underway  to  grow  the  states                                                               
healthcare  workforce, Alaska  needs solutions  that help  people                                                               
now. SB 89 aims to do  just that by allowing physician assistants                                                               
(PAs)  to provide  care to  the maximum  scope of  their training                                                               
without   requiring   a   collaborative  agreement   with   their                                                               
physicians. SB  89 gives  experienced PAs  a path  to independent                                                               
licensure,  similar  to  what nurse  practitioners  have  had  in                                                               
Alaska since the 1980s. She  said her office has provided studies                                                               
showing 40 years of research  from hospitals, medical clinics and                                                               
treatment  programs  showing  PAs  provide care  of  the  highest                                                               
quality.  The  legislation  still  protects  patient  safety  and                                                               
requires physician  assistants (PAs) with fewer  than 4,000 hours                                                               
of clinical experience to have  a collaborating physician. Any PA                                                               
changing medical  specialties would need additional  training, as                                                               
determined by  the state  medical board. SB  89 also  makes clear                                                               
that  PAs  are  not  allowed  to  perform  surgery.  PAs  already                                                               
complete thousands of hours of  hands-on training before entering                                                               
practice, and  their education  includes clinical  rotations with                                                               
medical students. PAs are also  required to complete 100 hours of                                                               
continuing  education  every  two  years,  more  than  any  other                                                               
provider in the  state. SB 89 does not compare  PAs to doctors or                                                               
suggest they  do the same  job. This legislation  gives qualified                                                               
PAs  the   ability  to  care   for  Alaskans   more  efficiently,                                                               
especially in  underserved areas. With 14  percent of supervising                                                               
doctors living out of state,  many PAs are already providing care                                                               
without a  supervising doctor  present. SB  89 helps  ensure that                                                               
PAs can keep  doing their jobs, legally and  effectively and that                                                               
Alaskans continue to get the healthcare they need.                                                                              
                                                                                                                                
1:50:24 PM                                                                                                                    
SENATOR MERRICK joined the meeting via teleconference.                                                                          
                                                                                                                                
1:50:34 PM                                                                                                                    
MACKENZIE  POPE,   Staff,  Senator   Loki  Tobin,   Alaska  State                                                               
Legislature, Juneau, Alaska, provided  the sectional analysis for                                                               
SB 89:                                                                                                                          
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
               Senate Bill 89: Sectional Analysis                                                                             
                                                                                                                                
     Section 1. Removes state medical board (SMB) reference                                                                   
       to AS 08.64.107 Regulation of Physician Assistants                                                                       
     which is repealed and reenacted in a later section.                                                                        
                                                                                                                                
          Section 2. Repeals and reenacts 08.64.107 to                                                                        
    restructure   the   physician   assistant   authorizing                                                                     
     statutes.                                                                                                                  
                                                                                                                                
1:50:51 PM                                                                                                                    
MS. POPE continued with the sectional analysis:                                                                                 
                                                                                                                                
              Subsection  (a)   directs  the  SMB  to  adopt                                                                  
              regulations  related  to the  acts within  the                                                                    
              practice    of    medicine   that    physician                                                                    
              assistants   (PAs)  may  perform,  which  must                                                                    
              allow  for   PA  practice  of  acts  they  are                                                                    
              generally  educated  and  trained to  perform.                                                                    
              This   subsection  specifically  prevents  PAs                                                                    
              from  performing surgery  without supervision.                                                                    
              This  subsection   also  directs  the  SMB  to                                                                    
              promulgate  regulations  for  PAs  who  switch                                                                    
              specialty,   and  the   methods  by   which  a                                                                    
              collaborating physician will assess a PA.                                                                         
                                                                                                                                
              Subsection  (b)  establishes  that a  PA  with                                                                  
              less  than 4,000  postgraduate clinical  hours                                                                    
              may   only  practice  under   a  collaborating                                                                    
              agreement.   These  collaborative   agreements                                                                    
              must be  in writing and describe the specialty                                                                    
              the  hours are  completed within,  as well  as                                                                    
              the oversight methods.                                                                                            
                                                                                                                                
              Subsection  (c) outlines  that assessment  for                                                                  
              PAs  practicing  in rural  areas  can be  done                                                                    
              telephonically or via video.                                                                                      
                                                                                                                                
              Subsection  (d) outlines the process  for a PA                                                                  
              to notify  the SMB if they begin to practice a                                                                    
              new specialty.                                                                                                    
                                                                                                                                
              Subsection   (e)  requires   a  copy   of  the                                                                  
              collaborative  agreement  be  provided to  the                                                                    
              SMB.  At such  a time  as the  PA reaches  the                                                                    
              required   postgraduate   hours,  they   shall                                                                    
              notify  the  SMB and  complete an  attestation                                                                    
              provided by the SMB.                                                                                              
                                                                                                                                
              Subsection  (f)  directs  the  SMB  to  assess                                                                  
              whether    that    specialty   will    require                                                                    
              additional    requirements   or   hours.   For                                                                    
              specialty   change,  or  in  other  regulation                                                                    
              change,  the  requirements are  not to  exceed                                                                    
              the  clinical  hours  required  in  subsection                                                                    
              (b).                                                                                                              
1:52:08 PM                                                                                                                    
MS. POPE continued with the sectional analysis:                                                                                 
                                                                                                                              
     Section 3.  Amends 08.64  to add  a new  section laying                                                                  
     out   the   qualifications  for   physician   assistant                                                                    
     qualifications for licensure.                                                                                              
                                                                                                                                
     Section  4.  Amends  08.64.230  to  add  an  additional                                                                  
     section directing  the SMB or it's  executive secretary                                                                    
     to grant a license to qualified applicants.                                                                                
                                                                                                                                
     Section  5.  Amends  the existing  statute  to  include                                                                  
     physician   assistants   in   the   list   of   medical                                                                    
     practitioners whose  licensure we recognize  from other                                                                    
     states and provinces of Canada.                                                                                            
                                                                                                                                
     Section 6. This amends 08.64.250  to include PAs in the                                                                  
     existing temporary licensure  process and reference the                                                                    
     new applicable section 08.64.206.                                                                                          
                                                                                                                                
     Section 7. This section  amends the existing statute to                                                                  
     include  physician   assistants  alongside   the  other                                                                    
     medical   practitioners  in   the  list   of  temporary                                                                    
     licensure  and substitute  roles  in different  medical                                                                    
     facilities.                                                                                                                
                                                                                                                                
     Section 8: Adds a subsection  to include PAs in the fee                                                                  
     requirement when applying for a license.                                                                                   
                                                                                                                                
     Section 9:  Amends the  section to  include PAs  in the                                                                  
     existing  statute  regarding  the SMBs  parameters  for                                                                    
     evaluating  any  extenuating   circumstances  to  waive                                                                    
     certain    requirements     for    meeting    licensure                                                                    
     qualifications.                                                                                                            
                                                                                                                                
     Section   10.   This   section  amends   AS   08.64.326                                                                  
     subsection (a) to include PAs  in the existing statutes                                                                    
     regarding the  process for being sanctioned  for crime,                                                                    
     misrepresentation, and  failure to pay fees,  to name a                                                                    
     few of the examples given in the statute.                                                                                  
                                                                                                                                
     Section  11.  This  amends   the  existing  statute  to                                                                  
     include  PAs   in  the  existing   voluntary  surrender                                                                    
     provisions in AS 08.64.334.                                                                                                
                                                                                                                                
     Section  12.  This  amends   the  existing  statute  to                                                                  
     include PAs  in the  process for  medical practitioners                                                                    
     who  treat fellow  licensed  medical practitioners  for                                                                    
     alcoholism,   drug   addiction,  and   mental/emotional                                                                    
     disorders  who  might  constitute  a  danger  to  their                                                                    
     patients or themselves, to report to the SMB.                                                                              
                                                                                                                                
1:53:32 PM                                                                                                                    
MS. POPE continued with the sectional analysis:                                                                                 
                                                                                                                                
     Section 13. Grants immunity in  civil liability for PAs                                                                  
     who submit a  report in good faith to  the SMB relating                                                                    
     to addictive substances abuse.                                                                                             
                                                                                                                                
     Section 14.  Amends statute so  that PAs  cannot refuse                                                                  
     to submit a  report to the SMB or  withhold evidence on                                                                    
     the   grounds   that   it   is   under   doctor-patient                                                                    
     confidentiality.                                                                                                           
                                                                                                                                
     Section  15. Updates  the  statute  covering all  state                                                                  
     licensees  under   this  chapter,  including   PAs,  to                                                                    
     specify that if they  practice without a valid license,                                                                    
     they are guilty of a class A misdemeanor.                                                                                  
                                                                                                                                
     Section 16.  Amends the statute  to include PAs  in the                                                                  
     list of  medical providers who  can support  a licensed                                                                    
     physician  in  another state,  in  the  support of  the                                                                    
     regular  medical service  of the  United States  Public                                                                    
     Health Service,  or volunteering services to  the armed                                                                    
     services of  the US among other  unique medical support                                                                    
     situations.                                                                                                                
                                                                                                                                
     Section  17. Amends  the  statute  to allow  physicians                                                                  
     assistants to show their  PA credentials to communicate                                                                    
     their qualifications.                                                                                                      
                                                                                                                                
     Section  18.   Amends  08.64.380  to  include   PAs  as                                                                  
     providers  who  can  accept  concurrent  referrals  for                                                                    
     systemic disease treatment.                                                                                                
                                                                                                                                
     Section 19:  Amends the  definition of  practitioner to                                                                  
     include physician assistant in the statute.                                                                                
                                                                                                                                
     Section  20:   Puts  in   statute  the   definition  of                                                                  
     physician   assistant.     HEALTH  &   SOCIAL  SERVICES                                                                    
     JUDICIARY TRANSPORTATION                                                                                                   
                                                                                                                                
     Section  21: Amends  the statute  referenced  to be  in                                                                  
     line  with the  repealed statutes  removed by  previous                                                                    
     sections.                                                                                                                  
                                                                                                                                
1:54:47 PM                                                                                                                    
MS. POPE continued with the sectional analysis:                                                                                 
                                                                                                                              
     Section  22:  Adds  a section  under  AS  21.07.010  to                                                                  
     prevent   any  requirements   within   a  health   care                                                                    
     insurance policy  from being  more restrictive  than or                                                                    
     inconsistent   with   the   practice,   education,   or                                                                    
     collaboration provisions outlined in AS 08.64.                                                                             
                                                                                                                                
     Section   23:  Updates   the  definition   of  licensed                                                                  
     physician   assistants   to  remove   the   supervision                                                                    
     requirement allowing  for PAs who have  completed their                                                                    
     postgraduate  clinical requirements  and are  no longer                                                                    
     subject  to  a  collaborating  physician  agreement  to                                                                    
     continue their practice.                                                                                                   
                                                                                                                                
     Section  24: Amends  the statute  to include  physician                                                                  
     assistant in the definition of  health care provider in                                                                    
     statute.                                                                                                                   
                                                                                                                                
1:55:24 PM                                                                                                                    
SENATOR  DUNBAR  referred  to  Section   2(a)(1)  of  SB  89  and                                                               
mentioned having  discussions in a prior  committee about whether                                                               
suturing is considered surgery. He  asked if "surgery" is defined                                                               
in statute and  whether physician assistants would  be allowed to                                                               
remove a melanoma.                                                                                                              
                                                                                                                                
1:56:31 PM                                                                                                                    
MS. POPE  answered that their  office consulted  with legislative                                                               
legal regarding the  definition of surgery and  noted that, under                                                               
Section  2(a)(1), the  responsibility for  defining "surgery"  is                                                               
delegated  to   the  state  medical   board  and   their  medical                                                               
expertise.                                                                                                                      
                                                                                                                                
1:57:11 PM                                                                                                                    
SENATOR  TOBIN  stated that  the  regulatory  process allows  for                                                               
public comment and input. Anyone  with concerns about what should                                                               
or shouldn't fall  within a PA's scope of practice  may be shared                                                               
with  the  state  medical  board  during  the  public  rulemaking                                                               
process.                                                                                                                        
                                                                                                                                
1:57:34 PM                                                                                                                    
SENATOR  DUNBAR  asked  if  there are  physicians  on  the  state                                                               
medical  board  that  will  be  determining  what  is  considered                                                               
surgery for this new law.                                                                                                       
                                                                                                                                
1:57:48 PM                                                                                                                    
MS. POPE answered  that there are medical doctors  on the medical                                                               
board.                                                                                                                          
                                                                                                                                
1:57:58 PM                                                                                                                    
SENATOR TOBIN stated  her belief that there  are three physicians                                                               
on  the  medical board  and  a  dedicated  seat for  1  physician                                                               
assistant.                                                                                                                      
                                                                                                                                
1:58:26 PM                                                                                                                    
CHAIR BJORKMAN announced invited testimony on SB 89.                                                                            
                                                                                                                                
1:58:46 PM                                                                                                                    
MARY  SWAIN,  Chief  Executive  Officer  (CEO),  Camai  Community                                                               
Health Center,  Bristol Bay, Alaska,  testified by  invitation on                                                               
SB 89:                                                                                                                          
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
     I  strongly support  Senate Bill  89, which  provides a                                                                    
     pathway  for  independent   licensure  for  experienced                                                                    
     Physician Assistants (PAs)  in Alaska. This legislation                                                                    
     is critical  to addressing healthcare  access barriers,                                                                    
     especially in rural and  underserved areas like Bristol                                                                    
     Bay Borough, where our health center operates.                                                                             
                                                                                                                                
     At Cama'i  Community Health  Center, we  regularly face                                                                    
     significant  provider  shortages,  notably  during  the                                                                    
     busy  summer  months   when  our  community  population                                                                    
     dramatically  increases  due  to the  influx  from  the                                                                    
     world's largest wild sockeye  salmon run. Our Physician                                                                    
     Assistants   play   a   crucial  role   in   delivering                                                                    
     continuous,   high-quality   healthcare  amidst   these                                                                    
     seasonal  fluctuations.  Physician  openings  in  rural                                                                    
     Alaska  often  remain   vacant  for  extended  periods,                                                                    
     frequently averaging  12 months or longer,  as noted by                                                                    
     the  Alaska  Primary  Care Association.  Even  when  we                                                                    
     actively  seek to  recruit physicians,  the reality  is                                                                    
     that   physicians  rarely   apply   for  these   remote                                                                    
     positions. When  they do, the compensation  required to                                                                    
     attract  and   retain  them   often  far   exceeds  the                                                                    
     financial  capabilities   of  rural   clinics,  leaving                                                                    
     critical  roles  unfilled.   Independent  practice  for                                                                    
     experienced  Physician  Assistants will  help  mitigate                                                                    
     these  gaps  by  leveraging  existing,  highly  trained                                                                    
     healthcare  professionals already  embedded within  our                                                                    
     communities.                                                                                                               
                                                                                                                                
2:00:13 PM                                                                                                                    
MS. SWAIN continued her testimony of SB 89:                                                                                     
                                                                                                                                
     The  American Academy  of  Physician Assistants  (AAPA)                                                                    
     notes that  states such as  Arizona, North  Dakota, and                                                                    
     Wyoming,  which   have  implemented   similar  measures                                                                    
     allowing  PAs   independent  practice,   have  observed                                                                    
     enhanced  healthcare  outcomes  and  increased  patient                                                                    
     satisfaction.  Importantly, these  states  did not  see                                                                    
     physicians  replaced;  rather,   PAs  complemented  the                                                                    
     existing   physician  workforce,   allowing  teams   to                                                                    
     operate   more   efficiently,  patient   outcomes   and                                                                    
     expanding  overall  access  to medical  care.  Evidence                                                                    
     consistently   indicates   no  decline   in   physician                                                                    
     employment  or replacement  of physicians  following PA                                                                    
     independence;  instead,  it   enhances  the  healthcare                                                                    
     team's capacity to serve patients more effectively.                                                                        
                                                                                                                                
     PAs  undergo rigorous  training  comparable to  medical                                                                    
     school,   completing   approximately   27   months   of                                                                    
     intensive   education  that   includes  580   hours  of                                                                    
     clinical medicine  coursework and at least  2,000 hours                                                                    
     of   supervised  clinical   rotations  across   various                                                                    
     medical disciplines.  The accreditation  and continuous                                                                    
     professional  development required  of PAs  ensure that                                                                    
     they remain  highly competent  and prepared  to deliver                                                                    
     independent care.                                                                                                          
                                                                                                                                
     By  passing SB  89,  Alaska would  join other  forward-                                                                    
     looking states  in improving  healthcare accessibility,                                                                    
     particularly    in     rural    communities,    without                                                                    
     compromising medical standards  or physician oversight.                                                                    
     The   bill  aligns   with  proven   outcomes,  enhances                                                                    
     healthcare delivery, and  supports community-based care                                                                    
     providers like Cama'i Community Health Center.                                                                             
                                                                                                                                
2:02:21 PM                                                                                                                    
MEGHAN HALL, President, Alaska Academy of Physician Assistants,                                                                 
Anchorage, Alaska, testified by invitation on SB 89:                                                                            
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
     Over 50  years ago, the  PA profession was born  out of                                                                    
     the need for a new  type of healthcare provider to ease                                                                    
     the  burden on  overworked physicians.  Back then,  the                                                                    
     American  Medical  Association  helped  create  the  PA                                                                    
     profession and  actively lobbied for  increased funding                                                                    
     for PA programs.                                                                                                           
                                                                                                                                
2:02:53 PM                                                                                                                    
MS. HALL continued with her testimony of SB 89:                                                                                 
                                                                                                                                
     In order to  rapidly deploy this novel  provider type a                                                                    
     new  credentialing  structure  was  needed.  Enter  the                                                                    
     collaborative plan, supervising  physician, or practice                                                                    
     agreement. These are all forms of the same idea.                                                                           
                                                                                                                                
     In lieu of independent licensing  a PA would work under                                                                    
     the medical license of the  physician they had followed                                                                    
     through  their clinical  year. It  was not  uncommon in                                                                    
     the beginning for a PA  student to spend an entire year                                                                    
     with one  physician learning that practice.  Then after                                                                    
     graduation  the   PAs  worked  under   the  supervising                                                                    
     physician's   license,   ensuring   collaboration   and                                                                    
     liability coverage.                                                                                                        
                                                                                                                                
     This arrangement  made it possible  for PAs  to provide                                                                    
     care to workers  in camps along the pipeline  as it was                                                                    
     being built in the 1970s.                                                                                                  
                                                                                                                                
     Since   then,    the   PA   profession    has   evolved                                                                    
     significantly. We  now graduate with  Master's degrees,                                                                    
     hold national certifications, complete  50 hours of CME                                                                    
     annually, and  are individually state licensed  and DEA                                                                    
     registered. We  are governed by  the medical  board and                                                                    
     held  to the  same  statutes as  all  licensees of  the                                                                    
     board.                                                                                                                     
                                                                                                                                
     The  need for  formal collaborative  agreements between                                                                    
     one or  more physicians  and one  PA has  diminished as                                                                    
     PAs,  even   in  remote   areas,  can   access  several                                                                    
     physicians   or  other   providers  for   consultations                                                                    
     anytime. Collaboration  is integral to the  practice of                                                                    
     medicine,  not  just  a formality  on  paper  and  will                                                                    
     continue even without written plans.                                                                                       
                                                                                                                                
     These collaborative agreements that  once allowed a new                                                                    
     profession  to flourish  have  now  become barriers  to                                                                    
     hiring PAs and are  increasingly viewed as outdated and                                                                    
     unnecessary. They increase the cost  of hiring a PA and                                                                    
     in some  cases completely prevent smaller  clinics from                                                                    
     being able to hire us at all.                                                                                              
                                                                                                                                
2:04:39 PM                                                                                                                    
MS. HALL continued with her testimony of SB 89:                                                                                 
                                                                                                                                
     In  Alaska, we  face the  worst healthcare  shortage in                                                                    
     the  nation, and  many PAs  are considering  leaving to                                                                    
     practice in  states with updated statutes.  Many of the                                                                    
     states  with modernized  PA practice  laws  are in  the                                                                    
     west with  large rural areas,  not unlike  Alaska. This                                                                    
     outmigration of healthcare providers  is the last thing                                                                    
     we need right now.                                                                                                         
                                                                                                                                
     The  heart  of  the   PA  profession  has  always  been                                                                    
     increasing  access   to  care   through  collaboration,                                                                    
     nothing in this bill will change that.                                                                                     
                                                                                                                                
     With your  support of  SB89, PAs  can continue  to grow                                                                    
     and meet the  evolving needs of Alaskans  with safe and                                                                    
     effective   care,   while   ensuring  a   more   robust                                                                    
     healthcare workforce                                                                                                       
                                                                                                                                
2:05:24 PM                                                                                                                    
SENATOR DUNBAR  stated that  he heard  a few  critiques of  SB 89                                                               
from   physicians   claiming   there  are   no   guardrails   for                                                               
independently  practicing PAs;  this will  lessen the  quality of                                                               
patient care and endanger patients.  The hours of training needed                                                               
is  also  a concern.  He  asked  why  PAs  should be  allowed  to                                                               
practice their specialties independently  when PAs have way fewer                                                               
hours of training than a doctor.                                                                                                
                                                                                                                                
2:06:31 PM                                                                                                                    
MS. HALL answered that SB  89 clarifies that all medical statutes                                                               
that apply  to doctors  and podiatrists  also apply  to physician                                                               
assistants. The guardrails remain  in place regardless of whether                                                               
there  is  a collaborative  plan.  She  said PAs  cannot  perform                                                               
procedures  they aren't  trained  or competent  to do,  including                                                               
independent   surgery.  Institutions   can  still   set  stricter                                                               
internal standards,  like chart reviews or  additional oversight.                                                               
A collaborative  plan is just one  layer of safety and  is a low-                                                               
level guardrail. She  said regarding specialty care;  PAs are not                                                               
and  will  not become  physicians  or  specialists. In  specialty                                                               
clinics, PAs  typically handle follow-up  visits or  routine care                                                               
under the  direction of  a specialist.  This helps  clinics serve                                                               
more patients without  lowering the quality of  care and improves                                                               
access to services.                                                                                                             
                                                                                                                                
2:09:10 PM                                                                                                                    
CHAIR BJORKMAN  asked when going  to the "doctor"  what different                                                               
experience would a  common person receive when they see  a PA who                                                               
does family practice, instead of a physician.                                                                                   
                                                                                                                                
2:09:47 PM                                                                                                                    
MS. HALL answered  that in family practice, the  care provided by                                                               
PAs  can often  look very  similar  to that  of physicians.  Many                                                               
patients report that PAs spend  more time with them during visits                                                               
possibly   because  PAs   are  typically   not   paid  based   on                                                               
productivity, so  they aren't  under the  same time  pressures as                                                               
physicians. As a result, appointments  with PAs are often longer.                                                               
She said there isn't much difference  in the content of the visit                                                               
like  reviewing  vaccinations  and recommending  screenings.  She                                                               
said overall family practice is  an area where the care delivered                                                               
by PAs and physicians is quite comparable.                                                                                      
                                                                                                                                
2:11:14 PM                                                                                                                    
CHAIR BJORKMAN  asked if there  is not a  recognizable difference                                                               
of  experience between  a family  practice  doctor and  a PA  how                                                               
would this  legislation assist PAs  in providing primary  care to                                                               
patients.                                                                                                                       
                                                                                                                                
2:11:40 PM                                                                                                                    
MS. HALL  responded that  SB 89  would allow  PAs with  the 4,000                                                               
hours of practice  to work where there are not  two physicians on                                                               
staff to  sign collaborative plans.  If further  benefits smaller                                                               
clinics by reducing paperwork and costs.                                                                                        
                                                                                                                                
2:12:25 PM                                                                                                                    
MS. SWAIN  answered that  the law  already requires  providers to                                                               
introduce  themselves  and  state   their  credentials,  and  the                                                               
providers must  wear identification; this will  continue under SB
89. She  stated that currently,  she has two physicians  who sign                                                               
collaborative  agreements, neither  lives in  the community,  and                                                               
one lives out  of state. The main collaborator  consults by phone                                                               
or  Zoom and  visits the  clinic  quarterly. This  setup costs  a                                                               
small clinic of 12 employees  over $55,000 annually. She said the                                                               
state  takes up  to  three months  to  approve the  collaborative                                                               
plan. SB  89 would let the  clinic bring in a  PA quickly without                                                               
waiting months for approval. She said  PAs would still need to be                                                               
privileged,  with clear  documentation outlining  what procedures                                                               
they're allowed  to perform, like  sutures or x-rays.  That scope                                                               
is  already regulated  by  the  state medical  board,  and SB  89                                                               
doesn't change that.                                                                                                            
                                                                                                                                
2:15:21 PM                                                                                                                    
CHAIR BJORKMAN asked  what guardrails will define  the PA's scope                                                               
of  practice  and outline  the  difference  between  a PA  and  a                                                               
physician once the PA's collaborative agreement ends.                                                                           
                                                                                                                                
2:16:10 PM                                                                                                                    
MS.  SWAIN answered  that currently  collaborative  plans are  in                                                               
place,  but  moving  forward,  clinics   may  choose  whether  to                                                               
maintain the  plans. She said  Federally Qualified  Health Center                                                               
(FQHC), like many  rural clinics in Alaska,  must follow specific                                                               
rules tied  to the clinic's  funding. One requirement  is ongoing                                                               
collaboration  for all  providers,  regardless of  their role  or                                                               
level.  The clinic  must have  a  medical director  who sets  the                                                               
scope of practice for all  staff, including PAs, NPs, and medical                                                               
assistants.  So  even  without  a  mandated  collaborative  plan,                                                               
strong guardrails remain through clinic policy and oversight.                                                                   
                                                                                                                                
2:17:31 PM                                                                                                                    
SENATOR BJORKMAN  asked since the  Camai Community  Health center                                                               
and  other  rural  clinics  are  operating  as  a  FQHC,  do  the                                                               
collaborative  agreements  that  PAs  currently  have  for  those                                                               
clinics  fulfill  the  state   law's  mandate  for  collaborative                                                               
practice agreements.                                                                                                            
                                                                                                                                
2:17:56 PM                                                                                                                    
MS. SWAIN answered that the PAs  at FQHCs aren't required to have                                                               
a collaborative plan, but PAs  are required to have peer reviews.                                                               
A peer  review is  when another provider  reviews the  PA's work.                                                               
She said the  peer reviews and privileging  documents required by                                                               
the state medical  board are the bigger guardrails  that wont  be                                                               
lost in this legislation.                                                                                                       
                                                                                                                                
2:19:01 PM                                                                                                                    
SENATOR  TOBIN   stated  that  the   main  issue   for  physician                                                               
assistants   is   the   unnecessary  administrative   burden   of                                                               
collaborative  agreements. Six  other rural  states have  already                                                               
removed  this step.  These agreements  don't ensure  better care;                                                               
true  oversight comes  from the  state medical  board, continuing                                                               
education, and practicing  within a defined scope.  SB 89 removes                                                               
that outdated paperwork, which often  lacks enforcement. She said                                                               
in some  cases, out-of-state doctors  are paid just to  be listed                                                               
on these plans, turning the  agreements into a costly barrier for                                                               
PAs to do their jobs in Alaska.                                                                                                 
                                                                                                                                
2:20:53 PM                                                                                                                    
SENATOR  DUNBAR stated  that Ms.  Pope confirmed  there are  five                                                               
physicians on the medical board and one physician assistant.                                                                    
                                                                                                                                
2:21:12 PM                                                                                                                    
CHAIR BJORKMAN held 89 in committee.                                                                                            
                                                                                                                                
2:21:23 PM                                                                                                                    
At ease.                                                                                                                        
                                                                                                                                
                  SB  96-CHILD CARE: TAX CREDITS                                                                            
                                                                                                                                
2:23:56 PM                                                                                                                    
CHAIR  BJORKMAN   reconvened  the   meeting  and   announced  the                                                               
consideration  of  SENATE  BILL  NO.   96  "An  Act  relating  to                                                               
education tax credits for certain  payments and contributions for                                                               
child care and  child care facilities; relating  to the insurance                                                               
tax education  credit, the income  tax education credit,  the oil                                                               
or  gas producer  education credit,  the  property tax  education                                                               
credit,  the  mining  business education  credit,  the  fisheries                                                               
business  education credit,  and the  fisheries resource  landing                                                               
tax  education  credit;  providing   for  an  effective  date  by                                                               
amending the  effective date of secs.  1, 2, and 21,  ch. 61, SLA                                                               
2014; and providing for an effective date."                                                                                     
                                                                                                                                
2:24:22 PM                                                                                                                    
SONJA KAWASAKI, Professional  Assistant, Senate Majority Counsel,                                                               
Juneau, Alaska, explained  legal counsel's position on  SB 96 and                                                               
stated that in  November, a lawsuit was  filed challenging Senate                                                               
Bill 189, claiming it violated  art. II, sec. 15, Constitution of                                                               
the  State of  Alaska,  which  requires each  bill  to address  a                                                               
single  subject. This  rule helps  prevent unrelated  issues from                                                               
being  bundled together  in one  bill. Senate  Bill 189  included                                                               
several topics, including a provision  for childcare tax credits.                                                               
She  said to  protect that  childcare program  from being  struck                                                               
down by the lawsuit, lawmakers  are now proposing new legislation                                                               
that  re-enacts  just  the childcare  tax  credit  portion.  This                                                               
ensures  the  program  can  continue, even  if  the  court  rules                                                               
against Senate Bill 189. The  lawsuit is still ongoing. The state                                                               
responded  to  the  complaint  in   January,  and  the  plaintiff                                                               
recently filed  a motion for  summary judgment. A  court decision                                                               
could come  based on  the legal arguments  alone, without  a full                                                               
trial.                                                                                                                          
                                                                                                                                
2:26:36 PM                                                                                                                    
SENATOR  DUNBAR   asked  whether  passing  the   component  bills                                                               
unamended in the same form  as last year strengthens the argument                                                               
for mootness.                                                                                                                   
                                                                                                                                
2:26:57 PM                                                                                                                    
MS.  KAWASAKI   answered  the  strongest  approach   is  for  the                                                               
legislature  to pass  new legislation  that  closely mirrors  the                                                               
original components. This  helps avoid any need for  the court or                                                               
parties  to  evaluate  whether  changes   in  the  new  bill  are                                                               
significant or alter the substance of the original law.                                                                         
                                                                                                                                
2:27:37 PM                                                                                                                    
SENATOR DUNBAR agreed with Ms. Kawasaki's analysis of SB 96.                                                                    
                                                                                                                                
2:28:34 PM                                                                                                                    
REPRESENTATIVE   ZACK   FIELDS,   District   17,   Alaska   State                                                               
Legislature,  Juneau, Alaska,  provided a  history of  SB 96  and                                                               
said  the current  legislation was  part of  Senate Bill  189 and                                                               
part  of House  Bill  89 of  the last  legislature.  He said  the                                                               
childcare tax credit  is a key tool to help  expand and stabilize                                                               
childcare in Alaska. Passing SB  96 now would give businesses the                                                               
financial  and regulatory  certainty  they need  to move  forward                                                               
with plans  to increase  childcare availability.  Some businesses                                                               
are already  exploring how to  use the childcare credit.  He said                                                               
while, the legislature could wait for  the court to decide on the                                                               
lawsuit  involving  the original  bill,  acting  now ensures  the                                                               
program  moves forward,  regardless of  the legal  outcome. These                                                               
childcare  provisions were  developed  over four  years and  were                                                               
thoroughly reviewed. They're based  on best practices from across                                                               
the country and shaped by  input from childcare experts, business                                                               
leaders, and  hundreds of Alaskans through  planning sessions and                                                               
the state's childcare task force.                                                                                               
                                                                                                                                
2:31:18 PM                                                                                                                    
CHAIR BJORKMAN asked for an  explanation on how the childcare tax                                                               
credit works.                                                                                                                   
                                                                                                                                
2:31:23 PM                                                                                                                    
REPRESENTATIVE  FIELDS responded  that  for  businesses that  pay                                                               
state income taxes, SB 96 offers  a 50 percent tax credit if that                                                               
business  provides childcare  support,  like  giving employees  a                                                               
stipend to help  pay for childcare, the business can  get half of                                                               
that amount back as a tax  credit. If a business decides to build                                                               
or expand  a childcare facility  at their workplace,  those costs                                                               
can also  be deducted. He  said the credit is  flexible, allowing                                                               
companies to  support childcare in  different ways. It's  part of                                                               
Alaska's  existing  education  tax  credit  program,  which  many                                                               
businesses already use. He stated that SB 96 doesn't cost the                                                                   
state much, but it can have a big impact by encouraging more                                                                    
childcare options across the state.                                                                                             
                                                                                                                                
2:32:47 PM                                                                                                                    
EVAN ANDERSON, Staff, Representative Zack Fields, Alaska State                                                                  
Legislature, Juneau, Alaska, provided the sectional analysis for                                                                
SB 96:                                                                                                                          
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
                       Sectional Analysis                                                                                     
                        SB 96,Version A                                                                                       
                                                                                                                              
     Sec. 1. AS  21.96.070(a): Adds a child  care tax credit                                                                  
     to the  insurance business  tax statutes,  allowing for                                                                    
     deductions for  contributions of  cash or  equipment to                                                                    
     operate  a child  care facility,  and  payments to  the                                                                    
     employees  of a  taxpayer  for  offsetting their  child                                                                    
     care costs.                                                                                                                
                                                                                                                              
     Sec.  2.   AS  21.96.070(i):  Adds  a   new  subsection                                                                  
     adjusting  the   dollar  limit   on  tax   credits  for                                                                    
     inflation, beginning  on January  1, 2030, and  every 5                                                                    
     years afterwards.                                                                                                          
                                                                                                                                
     Sec. 3. AS  43.20.014(a): Adds a child  care tax credit                                                                  
     to the corporate net income  tax statutes, allowing for                                                                    
     deductions for  contributions of  cash or  equipment to                                                                    
     operate  a child  care facility,  and  payments to  the                                                                    
     employees  of a  taxpayer  for  offsetting their  child                                                                    
     care costs.                                                                                                                
                                                                                                                                
     Sec.  4.   AS  43.20.014(i):  Adds  a   new  subsection                                                                  
     adjusting  the   dollar  limit   on  tax   credits  for                                                                    
     inflation, beginning  on January  1, 2030, and  every 5                                                                    
     years afterwards.                                                                                                          
                                                                                                                                
     Sec. 5. AS  43.55.019(a): Adds a child  care tax credit                                                                  
     to the  oil and  gas production tax  statutes, allowing                                                                    
     for deductions  for contributions of cash  or equipment                                                                    
     to operate a  child care facility, and  payments to the                                                                    
     employees  of a  taxpayer  for  offsetting their  child                                                                    
     care costs.                                                                                                                
                                                                                                                                
     Sec.  6.   AS  43.55.019(j):  Adds  a   new  subsection                                                                  
     adjusting  the   dollar  limit   on  tax   credits  for                                                                    
     inflation, beginning  on January  1, 2030, and  every 5                                                                    
     years afterwards.                                                                                                          
                                                                                                                                
2:33:46 PM                                                                                                                    
MR. ANDERSON continued with the section analysis for SB 96:                                                                     
                                                                                                                                
     Sec. 7. AS  43.56.018(a): Adds a child  care tax credit                                                                  
     to  the  oil  and   gas  exploration,  production,  and                                                                    
     pipeline   transportation    property   tax   statutes,                                                                    
     allowing for  deductions for  contributions of  cash or                                                                    
     equipment  to  operate  a   child  care  facility,  and                                                                    
     payments to the employees  of a taxpayer for offsetting                                                                    
     their child care costs.                                                                                                    
                                                                                                                                
     Sec.  8.   AS  43.56.018(i):  Adds  a   new  subsection                                                                  
     adjusting  the   dollar  limit   on  tax   credits  for                                                                    
     inflation, beginning  on January  1, 2030, and  every 5                                                                    
     years afterwards.                                                                                                          
                                                                                                                                
     Sec. 9. AS  43.65.018(a): Adds a child  care tax credit                                                                  
     to  the  mining  business tax  statutes,  allowing  for                                                                    
     deductions for  contributions of  cash or  equipment to                                                                    
     operate  a child  care facility,  and  payments to  the                                                                    
     employees  of a  taxpayer  for  offsetting their  child                                                                    
     care costs.                                                                                                                
                                                                                                                                
     Sec.  10.  AS  43.65.018(i):   Adds  a  new  subsection                                                                  
     adjusting  the   dollar  limit   on  tax   credits  for                                                                    
     inflation, beginning  on January  1, 2030, and  every 5                                                                    
     years afterwards.                                                                                                          
                                                                                                                                
     Sec. 11. AS 43.75.018(a): Adds  a child care tax credit                                                                  
     to the fisheries tax  statutes, allowing for deductions                                                                    
     for  contributions of  cash or  equipment to  operate a                                                                    
     child care  facility, and payments to  the employees of                                                                    
     a  taxpayer  for  offsetting their  child  care  costs.                                                                    
     Created by Rep. Fields office    relating to child care                                                                    
     tax credits                                                                                                                
                                                                                                                              
     Sec.  12.  AS  43.75.018(i):   Adds  a  new  subsection                                                                  
     adjusting  the   dollar  limit   on  tax   credits  for                                                                    
     inflation, beginning  on January  1, 2030, and  every 5                                                                    
     years afterwards.                                                                                                          
                                                                                                                                
     Sec. 13. AS 43.77.045(a): Adds  a child care tax credit                                                                  
     to  the  floating   fisheries  business  tax  statutes,                                                                    
     allowing for  deductions for  contributions of  cash or                                                                    
     equipment  to  operate  a   child  care  facility,  and                                                                    
     payments to the employees  of a taxpayer for offsetting                                                                    
     their child care costs.                                                                                                    
                                                                                                                              
     Sec.  14.  AS  43.77.045(i):   Adds  a  new  subsection                                                                  
     adjusting  the   dollar  limit   on  tax   credits  for                                                                    
     inflation, beginning  on January  1, 2030, and  every 5                                                                    
     years afterwards.                                                                                                          
                                                                                                                                
2:34:53 PM                                                                                                                    
MR. ANDERSON continued with the section analysis for SB 96:                                                                     
                                                                                                                                
     Sec.  15. Repeals  the provisions  of HB  189 from  the                                                                  
     33rd  Session  that  are identical  to  the  provisions                                                                    
     contained in SB 96.                                                                                                        
                                                                                                                                
     Sec. 16. Adds  new language in uncodified law  to set a                                                                  
     retroactive effective date to July 23, 2024.                                                                               
                                                                                                                                
     Sec.  17. Repeals  the provisions  of HB  189 from  the                                                                  
     33rd  Session  that  are identical  to  the  provisions                                                                    
     contained in SB 96.                                                                                                        
                                                                                                                                
     Sec.  18. This  is a  conforming change  to sunset  the                                                                  
     provisions of this bill on January 1, 2028.                                                                                
                                                                                                                                
     Sec. 19. Sets an immediate effective date.                                                                               
                                                                                                                                
2:35:47 PM                                                                                                                    
CHAIR BJORKMAN announced invited testimony on SB 96.                                                                            
                                                                                                                                
2:35:57 PM                                                                                                                    
KATI CAPOZZI,  President, Alaska Chamber of  Commerce, Anchorage,                                                               
Alaska, testified by invitation on SB  96 and stated that she was                                                               
asked to speak about the  business community's continued need for                                                               
accessible  childcare. People  often ask  why the  Alaska Chamber                                                               
cares  about  this  issue  and the  answer  is  simple:  Alaska's                                                               
economy depends on  a strong, stable workforce. She  said a major                                                               
barrier to that is the  lack of affordable, accessible childcare.                                                               
Around 50,000 working-age  Alaskans rely on childcare  to stay in                                                               
the workforce, yet many providers  have shut down since 2020, and                                                               
staffing shortages  continue. One in five  licensed providers has                                                               
closed. As a  result, businesses across the  state are struggling                                                               
to hire  and keep  workers because parents  can't find  or afford                                                               
childcare. She  stated that when  parents can't  work, businesses                                                               
lose  productivity and  it's costing  Alaska's  economy at  least                                                               
$165 million a year. This  especially affects working women, many                                                               
of whom  have had to cut  back hours or leave  jobs entirely. She                                                               
referenced  a  survey conducted  last  year  by the  chamber,  19                                                               
percent of  parents missed work,  and 12 percent said  they chose                                                               
not to work,  due to childcare challenges. She  said childcare in                                                               
Alaska is also among the most  expensive in the U.S., with infant                                                               
care  averaging  $21,000  a  year.   That's  a  huge  burden  for                                                               
families. SB 96 helps by  giving tax-paying businesses the option                                                               
to support childcare for their  employees or even help create new                                                               
childcare  spaces in  their communities.  She emphasized  this is                                                               
one  step   in  a   broader  solution   to  improve   access  and                                                               
affordability of childcare for all Alaskans.                                                                                    
                                                                                                                                
2:40:10 PM                                                                                                                    
CHAIR BJORKMAN held SB 96 in committee.                                                                                         
                                                                                                                                
2:40:35 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair Bjorkman  adjourned the Senate Labor  and Commerce Standing                                                               
Committee meeting at 2:40 p.m.                                                                                                  

Document Name Date/Time Subjects
SB96 ver A.pdf SL&C 3/14/2025 1:30:00 PM
SB 96
SB96 Sectional Analysis ver A.pdf SFIN 4/25/2025 9:00:00 AM
SL&C 3/14/2025 1:30:00 PM
SB 96
SB96 Supporting Documents-Historic Document Packet.pdf SFIN 4/25/2025 9:00:00 AM
SL&C 3/14/2025 1:30:00 PM
SB 96
SB96 Fiscal Note-DOR-TAX 03.07.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 96
SB96 Fiscal Note-DOLWD-LMI 03.07.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 96
SB96 Fiscal Note-DCCED-DOI 03.10.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 96
SB89 ver A.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Sponsor Statement 03.06.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Sectional Analysis 03.06.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Fiscal Note-DCCED-DOI 02.14.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Fiscal Note-DCCED-CBPL 02.14.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Public Testimony-Email-Aryeh Levenson 03.07.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Public Testimony-Email-Chava Lee .pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Public Testimony-Email-Harmony Billings 03.09.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Public Testimony-Email-Killian Lozach 03.06.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Public Testimony-Email-Marin Granholm 03.03.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Public Testimony-Letter-ANTHC 02.25.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Public Testimony-Letter-Howard Chaitoff 03.05.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Supporting Document-AAPA Issue Brief-PA Education 03.06.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89
SB89 Supporting Documents-Research Summary-Cost PA-Delivered Care 03.06.25.pdf SL&C 3/14/2025 1:30:00 PM
SB 89