ALASKA STATE LEGISLATURE  HOUSE LABOR AND COMMERCE STANDING COMMITTEE  April 1, 2019 3:19 p.m. MEMBERS PRESENT Representative Gabrielle LeDoux, Co-Chair Representative Adam Wool, Co-Chair Representative Zack Fields Representative Sara Hannan Representative Louise Stutes Representative Dave Talerico MEMBERS ABSENT  Representative Josh Revak COMMITTEE CALENDAR  HOUSE BILL NO. 45 "An Act extending the termination date of the Board of Dental Examiners; and providing for an effective date." - MOVED HB 45 OUT OF COMMITTEE HOUSE BILL NO. 79 "An Act relating to participation of certain peace officers and firefighters in the defined benefit and defined contribution plans of the Public Employees' Retirement System of Alaska; relating to eligibility of peace officers and firefighters for medical, disability, and death benefits; relating to liability of the Public Employees' Retirement System of Alaska; and providing for an effective date." - MOVED HB 79 OUT OF COMMITTEE CONFIRMATION HEARING(S): Board of Nursing Danette Schloeder - Anchorage Julie Tisdale - Anchorage - CONFIRMATION(S) ADVANCED Alaska State Board of Public Accountancy Karen Smith - Anchorage Wes Tegeler - Wasilla - CONFIRMATION(S) ADVANCED Board of Barbers and Hairdressers Jessica Steele - Wasilla - CONFIRMATION(S) ADVANCED Board of Dental Examiners Brittany Dschaak - Dillingham Dr. Jesse Hronkin - Palmer Dr. Kelly Lucas - Wasilla Dr. David Nielson - Anchorage Dr. Jonathan P. Woller - Fairbanks - CONFIRMATION(S) ADVANCED Alaska Labor Relations Agency Paula Harrison - Anchorage Dennis Moen - Eagle River - CONFIRMATION(S) ADVANCED Board of Marital and Family Therapy Noah Shields - Kenai - CONFIRMATION(S) ADVANCED PREVIOUS COMMITTEE ACTION  BILL: HB 45 SHORT TITLE: EXTEND BOARD OF DENTAL EXAMINERS SPONSOR(s): REPRESENTATIVE(s) ORTIZ 02/20/19 (H) READ THE FIRST TIME - REFERRALS 02/20/19 (H) L&C, FIN 03/27/19 (H) L&C AT 3:15 PM BARNES 124 03/27/19 (H) Heard & Held 03/27/19 (H) MINUTE(L&C) 03/29/19 (H) L&C AT 3:15 PM BARNES 124 03/29/19 (H) -- MEETING CANCELED -- 04/01/19 (H) L&C AT 3:15 PM BARNES 124 BILL: HB 79 SHORT TITLE: PEACE OFFICER/FIREFIGHTER RETIRE BENEFITS SPONSOR(s): REPRESENTATIVE(s) KOPP 03/06/19 (H) READ THE FIRST TIME - REFERRALS 03/06/19 (H) L&C, FIN 03/20/19 (H) L&C AT 3:15 PM BARNES 124 03/20/19 (H) Heard & Held 03/20/19 (H) MINUTE(L&C) 03/22/19 (H) L&C AT 3:15 PM BARNES 124 03/22/19 (H) Heard & Held 03/22/19 (H) MINUTE(L&C) 03/25/19 (H) L&C AT 3:15 PM BARNES 124 03/25/19 (H) Heard & Held 03/25/19 (H) MINUTE(L&C) 04/01/19 (H) L&C AT 3:15 PM BARNES 124 WITNESS REGISTER KEN TRUITT, Staff Representative Chuck Kopp Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Answered questions during the hearing on HB 79, on behalf of Representative Kopp, prime sponsor. REPRESENTATIVE CHUCK KOPP Alaska State Legislature Juneau, Alaska POSITION STATEMENT: As prime sponsor of HB 79, answered questions from the committee. DANETTE SCHLOEDER, Appointee Board of Nursing Anchorage, Alaska POSITION STATEMENT: Testified as appointee to the Board of Nursing. JULIE TISDALE, Appointee Board of Nursing Anchorage, Alaska POSITION STATEMENT: Testified as appointee to the Board of Nursing. ACTION NARRATIVE 3:19:59 PM CO-CHAIR GABRIELLE LEDOUX called the House Labor and Commerce Standing Committee meeting to order at 3:19 p.m. Representatives Fields, Hannan, Stutes, Talerico, LeDoux, and Wool were present at the call to order. HB 45-EXTEND BOARD OF DENTAL EXAMINERS  3:20:52 PM CO-CHAIR LEDOUX announced that the first order of business would be HOUSE BILL NO. 45, "An Act extending the termination date of the Board of Dental Examiners; and providing for an effective date." 3:21:20 PM CO-CHAIR WOOL moved to report HB 45 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 45 was reported out of the House Labor and Commerce Standing Committee. 3:21:51 PM The committee took a brief at-ease at 3:21 p.m. HB 79-PEACE OFFICER/FIREFIGHTER RETIRE BENEFITS  3:21:59 PM CO-CHAIR LEDOUX announced that the next order of business would be HOUSE BILL NO. 79, "An Act relating to participation of certain peace officers and firefighters in the defined benefit and defined contribution plans of the Public Employees' Retirement System of Alaska; relating to eligibility of peace officers and firefighters for medical, disability, and death benefits; relating to liability of the Public Employees' Retirement System of Alaska; and providing for an effective date." 3:24:40 PM REPRESENTATIVE HANNAN asked when to anticipate receiving the actuarial fiscal note. 3:25:08 PM KEN TRUITT, Staff, Representative Chuck Kopp, Alaska State Legislature, on behalf of Representative Kopp, prime sponsor of HB 79, offered his understanding that with retirement bills, its typical for the actuarial fiscal note to get produced in the finance committee after its evident the bill has a chance at passing. REPRESENTATIVE HANNAN asked if the Department of Administration (DOA) fiscal note is the only one this committee is responsible for. MR. TRUITT answered that's correct. REPRESENTATIVE HANNAN asked why it would take more employees to administer the program, as the employees are already currently covered by Tier 4. 3:27:08 PM REPRESENTATIVE CHUCK KOPP, Alaska State Legislature, prime sponsor of HB 79, said it's an excellent question that will most likely be answered in the House Finance committee. CO-CHAIR WOOL, in response to Rep Hannan, offered his understanding that it may be set up costs or software for the system's reorganization. CO-CHAIR WOOL addressed the importance of HB 79 and expressed his support for passing it out of committee. CO-CHAIR LEDOUX noted that the current bill "has been a long, long time coming" and expressed her support for passing it out of committee. 3:30:13 PM CO-CHAIR WOOL moved to report HB 79 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 45 was reported out of the House Labor and Commerce Standing Committee. 3:30:43 PM The committee took an at-ease from 3:30 p.m. to 3:32 p.m. ^CONFIRMATION HEARING(S): ^Board of Nursing CONFIRMATION HEARING(S):  Board of Nursing    3:32:33 PM CO-CHAIR LEDOUX announced that the next order of business would be confirmation hearings for the various boards and commissions. 3:33:04 PM DANETTE SCHLOEDER, Appointee, Board of Nursing, informed the committee she is a second generation Alaskan and has been a registered nurse licensed in the state of Alaska for the last 24 years, adding she is current a perinatal clinical specialist at Providence Alaska Medical center as well as part-time faculty member in an RN to BSN program for the University of Providence. She gave a short description of her educational background and her experience working in the healthcare industry. She stated her most significant contributions to the health and safety of Alaskans has been her work on improving the outcomes for women with morbidly adherent placenta, obstetrical mass transfusion, and hemolytic disorder of pregnancy. She said her current work is in the development of a care pathway for pregnant woman with opiate use disorder. 3:36:13 PM REPRESENTATIVE HANNAN thanked Ms. Schloeder for her longtime work with women and children. She referenced an audit on the Board of Nursing from 2018, asking how the delivery of care could be improved via nursing education using telemedicine in rural Alaska. 3:37:04 PM MS. SCHLOEDER said she has been fortunate to have been involved in all aspects of telemedicine through the Providence ICU, which has allowed her to watch how closely physicians and nurses can remotely manage very complex situations in areas of which patients would have been afforded no other option. She noted that in a state like Alaska telemedicine is a necessity, adding that it needs to be managed and regulated so that its safe REPRESENTATIVE HANNAN stated that the Board of Nursing audit found that the board did not have appropriate regulatory notification when a nurse's ability to do prescription oversight had been pulled. She asked if Ms. Schloeder could see that as an area where her insight and career could help guide the development of regulations that would be practical and timely to insure that the Board of Nursing is adequately prepared to address the fact there may be an extended pharmaceutical responsibility on Nurses that, when denied, notifications must be made in a practical matter so that they do not continue to prescribe opiates. MS. SCHLOEDER offered her belief that boards need to work together to protect Alaskans, adding that if there is an individual operating outside their scope of practices or who has had their privileges withdrawn there needs to be an absolute way in which everyone is informed of that. She offered her belief that she could offer expertise and assistance in making sure that is never an issue again. 3:41:00 PM REPRESENTATIVE FIELDS questioned whether the Board of Nursing could impact the delivery of reproductive healthcare services. MS. SCHLOEDER offered that nurse practitioners and certified nurse midwives are highly involved in women's reproductive health. REPRESENTATIVE FIELDS asked what role the Board of Nursing should play in reproductive healthcare and whether there are opportunities for the board to influence the delivery of reproductive healthcare. MS. SHLOEDER replied that any issue brought in front of the board should be looked at as how it affects the scope of practice of nursing, adding that it is very important to keep the practice of nursing separate from the practice of medicine. REPRESENTATIVE FIELDS, in attempt to clarify Ms. Schloeder's response, asked if she believes the boards role is limited to issues of scope and practice more than regulating or restricting the delivery of reproductive healthcare. He asked if that was an accurate understanding. MS. SCHLOEDER answered yes and opined that the board does do regulations that are related to the practice of nursing. 3:43:54 PM CO-CHAIR LEDOUX opened public testimony. After ascertaining that no one wished to testify, she closed public testimony. 3:44:31 PM The committee took a brief at-ease at 3:44 p.m. 3:44:46 PM JULIE TISDALE, Appointee, Board of Nursing, informed the committee she was born and raised in Alaska and gave a short description of her educational background and volunteer experience. Her interest in serving on the board as a public member stems from the "wonderful" experiences she's had with nurses in Anchorage. She offered her understanding that her role on the board would be to listen to nurses' concerns, adding that she looks forward to serving. 3:46:26 PM REPRESENTATIVE FIELDS asked if Ms. Tisdale had any professional experience in nursing or women's health. MS. TISDALE answered no. REPRESENTATIVE FIELDS observed that Ms. Tisdale sought appointments on two boards and commissions, the Alaska Bar Association and the Board of Nursing. He asked why the Bar Association was her first choice. MS. TISDALE replied she has friends that are attorneys and is interested in law. She further noted that she has no legal experience. REPRESENTATIVE FIELDS asked for Ms. Tisdale's view on abortion rights. MS. TISDALE answered "pro-life." REPRESENTATIVE FIELDS asked for further clarification on what that means and how it aligns with or against the Alaska Constitution. MS. TISDALE stated she respects that abortion is legal. She voiced that her personal view is "pro-life;" however, women have the right to have an abortion because it is a legal procedure. REPRESENTATIVE FIELDS asked if Ms. Tisdale has any concerns with the health risks of abortion on women, either physical or psychological. MS. TISDALE answered yes. 3:48:52 PM REPRESENTATIVE FIELDS asked whether the Board of Nursing could play a role in informing women about what she sees as those risks. MS. TISDALE shared her belief that abortion is beyond the scope of the Board of Nursing. REPRESENTATIVE FIELDS questioned whether Ms. Tisdale would anticipate in her role on the board having any influence on the delivery of reproductive health services. MS. TISDALE answered no. 3:49:56 PM CO-CHAIR LEDOUX opened public testimony. After ascertaining that no one wished to testify, she closed public testimony. 3:50:20 PM REPRESENTATIVE HANNAN, referencing the 2018 legislative audit on the Board of Nursing and their recommendations, stated that there was found to be an inadequate timeframe for responding to investigations about potential licensures being pulled from both CNAs and LPNs. She asked what Ms. Tisdale could bring to the board to facilitate a quicker response and corrective action. MS. TISDALE offered her understanding that in those instances the board is notified and given a list of licenses that are being pulled and should "deal with it" at the next board meeting. She was surprised that, according to the audit, it took more than a year to resolve those issues. REPRESENTATIVE HANNAN, referencing another recommendation from the audit, stated that there are 22 CNA training programs in the state of Alaska and that the Board of Nursing had not adequately conducted their onsite reviews. She asked how, in a time of budget constraints, Ms. Tisdale would make sure that adequate on-site overviews of the training programs are met without the opportunity to visit them in person. MS. TISDALE offered her understanding that the board would not be responsible for traveling to training facilities in remote locations, instead a state employee would be responsible. 3:54:51 PM CO-CHAIR WOOL asked if the board is currently composed of mostly new members. MS. TISDALE answered yes. CO-CHAIR WOOL asked if Ms. Tisdale is concerned with the lack of experience on the board. MS. TISDALE explained that the current chair has previous experience, having served on the board for a year. She stated that, despite being mostly new, the members work well together, adding that the nurses who serve on the board are well-educated. CO-CHAIR WOOL asked why all the members are new. MS. TISDALE answered no. 3:56:42 PM CO-CHAIR WOOL established a scenario in which a nurse got a Driving Under the Influence (DUI) and asked if that should be grounds for revocation of his or her license. MS. TISDALE answered possibly. CO-CHAIR WOOL asked if there is a nursing shortage in Alaska and whether things are being done to counter it. MS. TISDALE offered her understanding that there is a small nursing shortage in Alaska. 3:58:17 PM REPRESENTATIVE FIELDS asked for Ms. Tisdale's view on the new UA/APU partnership with respect to the training of nurses. MS. TISDALE said she is not familiar with that partnership. 3:59:01 PM CO-CHAIR WOOL asked if any of the nurses on the board have experience in psychiatric nursing. MS. TISDALE replied she doesn't know. CO-CHAIR WOOL asked if having at least one nurse with psychiatric nursing experience should be a requirement of the board, seeing as there are problems in the state with behavioral health and the difficulty API has had with hiring any psychiatric nurses. MS. TISDALE offered her belief that it would be helpful but not necessary. CO-CHAIR WOOL offered that psychiatric nursing is a sub- discipline and although many nurses have experience with patients who have mental issues it's not the same thing. He suggested that the board give it further consideration. 4:00:55 PM REPRESENTATIVE FIELDS asked if would be valuable to have a board member who has experience with workforce development in the field of nursing or closely related occupations. MS. TISDALE said it would be helpful. 4:02:21 PM CO-CHAIR LEDOUX instructed the committee to keep the conversation focused on Ms. Tisdale's qualifications to be a member of the Board of Nursing. 4:02:51 PM REPRESENTATIVE STUTES emphasized the importance of having a diverse group of board members to widen the scope and think outside the box. She expressed her appreciation that Ms. Tisdale took the time to apply for the public seat on the Board of Nursing. 4:03:41 PM REPRESENTATIVE HANNAN pointed out that there is a bill to extend the Board of Nursing as it is currently set to sunset in June. She asked if Ms. Tisdale if, as a public member, she had thought about advocating for its continuation and whether the board had discussed the potential for it to sunset. MS. TISDALE noted that there was some small discussion on it, adding that she absolutely thinks it's an important board that should continue. REPRESENTATIVE HANNAN questioned whether advocating for the passage of the bill that continues the Board of Nursing is within Ms. Tisdale's ability in her role as a public member. MS. TISDALE said she would be willing to advocate for the board's continuation; however, she was unsure if it would be appropriate as a board member. 4:05:27 PM CO-CHAIR LEDOUX thanked Ms. Tisdale for applying to be a member of the Board of Nursing.   4:05:58 PM CO-CHAIR WOOL made a motion to advance the confirmations of Danette Schloeder and Julie Tisdale, appointees to the Board of Nursing, to the joint session for consideration. He reminded members that signing the reports regarding appointments to boards and commissions in no way reflects individual members' approval or disapproval of the appointees, and the nominations are merely forwarded to the full legislature for confirmation or rejection. ^Alaska State Board of Public Accountancy ^Board of Barbers and Hairdressers ^Board of Dental Examiners ^Alaska Labor Relations Agency ^Board of Marital and Family Therapy Alaska State Board of Public Accountancy  Board of Barbers and Hairdressers  Board of Dental Examiners  Alaska Labor Relations Agency  Board of Marital and Family Therapy  4:06:31 PM CO-CHAIR LEDOUX turned the committee's attention to the remaining boards and commissions. She stated that she has not had any requests from members to have anyone appear before the committee. 4:07:19 PM CO-CHAIR WOOL moved to advance the confirmations for appointees referred to the House Labor and Commerce Standing Committee for consideration to the joint session of the House and Senate for consideration. He reminded members that signing the reports regarding appointments to boards and commissions in no way reflects individual members' approval or disapproval of the appointees, and the nominations are merely forwarded to the full legislature for confirmation or rejection. The committee took a brief at-ease. 4:08:27 PM ADJOURNMENT  There being no further business before the committee, the House Labor and Commerce Standing Committee meeting was adjourned at [4:08] p.m.