Legislature(2023 - 2024)ADAMS 519
05/03/2024 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB149 | |
| SB187 | |
| HB307 | |
| SB74 || SB75 | |
| HB232 | |
| SB104 | |
| SB118 | |
| HB122 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 187 | TELECONFERENCED | |
| += | HB 307 | TELECONFERENCED | |
| + | SB 118 | TELECONFERENCED | |
| + | HB 177 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | SB 74 | TELECONFERENCED | |
| + | SB 75 | TELECONFERENCED | |
| += | HB 232 | TELECONFERENCED | |
| + | SB 104 | TELECONFERENCED | |
| += | HB 149 | TELECONFERENCED | |
CS FOR SENATE BILL NO. 74(FIN)
"An Act relating to an interstate physical therapy
licensure compact; relating to the licensure of
physical therapists, physical therapist assistants,
occupational therapists, and occupational therapy
assistants; and providing for an effective date."
CS FOR SENATE BILL NO. 75(FIN)
"An Act relating to an audiology and speech-language
interstate compact; relating to the practice of
audiology and the practice of speech-language
pathology; and providing for an effective date."
6:53:13 PM
SENATOR DAVID WILSON, SPONSOR, introduced himself and
thanked the committee for hearing the two bills. He asked
his staff to start the presentation.
JASMINE MARTIN, STAFF, SENATOR DAVID WILSON, thanked the
committee for hearing the bills. She relayed that SB 75
allowed Alaska to enter the audiologist and speech language
pathologist interstate compact. Senate Bill 74 established
the interstate physical therapy licensure compact. She
would begin with SB 75. She noted that committee members
had received binders that included information relevant to
both bills. She stated that much of the information was
from the Council of State Governments (CSG) where the
National Center for Interstate Compacts was housed. She
detailed that CSG partnered with the Department of Defense
(DOD) to develop interstate licensure compacts. She
explained that the original conversation about the
transition of military families was expanded to a broader
scope of changing licensure structure. She shared that
Alaska was currently part of 28 interstate compacts. She
highlighted the driver's license compact as an example,
which meant that drivers did not have to get a new drivers
license in every state they visited.
6:55:37 PM
Senator Wilson noted that the bill packets also included
letters of support. He provided prepared remarks:
It should be no surprise to anyone here in Alaska that
there is a shortage of healthcare providers. Since
1950, the number of licensed provider occupations have
risen from 5 percent of the workforce to 25 percent.
To address these challenges states and professionals
have turned to occupational and interstate compact
licensures. The interstate compact is a contract
between two or more states that carries the force of
statutory law and allows the states to perform certain
actions to observe certain standards and cooperate in
a certain policy area. These compacts create
reciprocal professional license practices between the
states while ensuring there was quality and safety of
services and safeguarding state sovereignty.
These interstate compacts that are before you today
allow Alaska to still have the autonomy that it would
normally have under a normal licensure agreement. Both
the speech pathologists and audiologists licensure
compacts have a privilege to practice model. A person
obtains their license in their home state (i.e., their
state of residence here in Alaska) and the licensee
can then use their home state license to apply for
privilege of practice in another member state. When
that person is actually practicing here in Alaska they
are subject to our laws including the scope of
practice here in our state as well and they also must
pay for our licensing fees. Alaska must take action to
revoke a person's privilege to practice within our
state. If a person's privilege to practice is
suspended in one or more states, it's suspended in all
member states. Only the home state can take actions
against that home state license.
The compacts provide a greater public protection
through data sharing. Currently, if an Alaska license
is penalized in another state, Alaska will never know.
But under the interstate compact, a license would
receive notification that the licensee broke laws in
another state while practicing under a privilege. A
bad actor license in another state would also not be
able to obtain a privilege to practice in Alaska until
the infraction has been cleared. Knowing when our
licensees are misbehaving is a strong tool that we
currently do not have at our disposal. Under this
compact Alaska can collect fees for those incoming
providers to take action and a privilege to practice
in our state, the providers must work under that scope
of practice and the state will have enhanced access to
report bad actors. Nothing in this bill prevents out
of state persons from going through the regular
licensing process if they choose. They do not have to
go through the compact licensure process.
We've heard from both the audiologists and speech
language pathologists are swamped. We need every
incentive for them to become licensed in our state and
this compact is one of those incentives. Adopting
Senate Bill 75 in its entirety, the audiologists and
speech language pathologists interstate compact will
help us recruit those providers to our state,
strengthen our licensing, sharing of information
between those bad actors in our state, allowing those
patients moving between the state compact to maintain
within their established providers and increase Alaska
access to care all while maintaining our state
sovereignty. Over the next ten years Alaska's
healthcare was expected to have more jobs than any
other sector in our state. Our speech language
pathologists are expected to grow by 11 percent in
that time and we're not growing nearly enough of our
own providers in those fields to meet those demands.
6:59:40 PM
Senator Wilson turned the bill introduction back to Ms.
Martin.
Ms. Martin relayed that audiologists and speech language
pathologists both provide essential care at all stages of
life, but they were especially essential to young children
and older adults. She found it interesting to learn more
about the professions beyond knowing that audiologists help
with hearing issues and speech language pathologists help
with speech issues. She did not know that people always
fully understand the issues that came with difficulties in
those areas. She explained that hearing loss and balance
disorders were among the most commonly diagnosed health
conditions worldwide. She detailed that audiology care was
essential in maintaining quality of life. Timely access to
audiology care was essential in early intervention and
hearing issues for children and in maintenance and
independence for elderly individuals. Speech language
pathologists helped young people with speech development
and helped others recover from stroke or traumatic brain
injuries. She shared that speech language pathologists
helped people with swallowing issues. She elaborated that
if someone did not have the ability to eat independently it
could severely impact their quality of life and ability to
maintain independence. She noted there were invited
testifiers available online.
Co-Chair Foster moved to invited testimony.
7:01:31 PM
NANCY LOVERING, MEMBER, ALASKA SPEECH AND HEARING
ASSOCIATION, ANCHORAGE (via teleconference), testified in
support of SB 75. She shared that she had a private
practice in speech pathology for pediatrics for over 25
years. She relayed there were chronic shortages in speech
language pathologists and patient waiting lists were as
long as two years. The compact would help her as a business
owner to bring employees into the state. She provided care
to military members and their families and received
requests to continue care for children when the family left
the state. She explained she was happy to do so, but the
process of licensing across states was time consuming and
expensive. She was currently licensed in six states outside
of Alaska and frequently it caused a delay or gap in
continuity of care for children. For example, it took her
over a year to get licensed in one state for a family who
had moved out of Alaska.
Ms. Lovering relayed that there was not a speech
pathologist or audiologist licensing board in Alaska;
therefore, the level of consumer protection was a bit
different. She explained that consumer complaints went to
the state level. Due to her work with the Alaska Speech-
Language-Hearing Association and the American Speech and
Hearing Association she had occasionally received phone
calls with questions regarding consumer complaints and how
it fit in with the scope of practice and ethics. She
explained that it was not possible to know what ended up
happening with some of the consumer complaints because
there was no definitive process in Alaska. Much of the
time, she had to refer people to contact the national
association for more assistance. She believed the compact
and its ability to provide consumer protection was
extremely welcomed. She shared that she worked directly
with children with swallowing disorders and there was a
need for more practitioners to work with the population.
She stressed that the list of kids needing care was very
long and it was heartbreaking to hear stories and
professionals did their best to care for everyone possible.
She thanked the committee for its time.
7:06:41 PM
SUSAN ADAMS, DIRECTOR OF STATE AFFAIRS, AMERICAN SPEECH
LANGUAGE HEARING ASSOCIATION, MARYLAND (via
teleconference), explained that she held an ex officio seat
on the Audiology and Speech Language Pathology (ASLP)
Compact Commission. She relayed that the interstate compact
was designed to allow audiologists and speech language
pathologists to practice across state lines and via
telehealth without having to obtain an additional license
in every state. The compact would increase access to care
for individuals with communication disorders, facilitated
continuity of care when clients relocated or traveled, and
increased consumer protection by expanding the
prosecutorial net for bad actors. The compact allowed
greater access to currently underserved and isolated
populations. Additionally, the compact allowed military
spouses to maintain their licensure more easily across
state lines.
Ms. Adams shared that the bill was supported by the Alaska
Speech-Language-Hearing Association. She detailed that the
ASLP commission was currently in the process of developing
a system expected to be operational later in the year. She
explained that passing the legislation would allow Alaska
to appoint two delegates with two votes to the compact
commission, the national joint governmental agency
responsible for administering compacts. The compact
provided guardrails to ensure the commission never exceeded
its authority. There were currently 31 member states in the
compact with several states currently in the legislative
process.
7:09:00 PM
Co-Chair Foster OPENED public testimony on SB 75. He
provided the email address for public testimony.
Co-Chair Foster CLOSED public testimony.
7:09:41 PM
Representative Coulombe thanked Senator Wilson for putting
the bill forward. She relayed that the committee had also
been hearing a nursing compact bill. She had received
numerous emails in support of SB 75, while the nursing
compact seemed to be more contentious. She asked for
comment.
Ms. Martin responded that the nurse licensure compact was
one of the first interstate licensure compacts developed
and used a multi-state license model. She explained there
was no way for the state to know who was coming in and out
or it was much more difficult to track. She explained that
SB 74 and SB 75 operated until a privilege to practice
model. She elaborated that a person would obtain their
license in their home state and could then go online to
register individually for privileges to practice in other
states. The registration was reported in the specific state
and the privilege to practice could be revoked by the
state. She added that the revocation could also be reported
to the practitioner's home state for action against the
underlying license.
Representative Ortiz asked where the audiologist and speech
language pathologist shortages were the most prevalent
(e.g., healthcare facilities, schools).
Ms. Martin responded that the need was everywhere. She
emphasized there were substantial vacancies in many types
of facilities. She underscored that the need for healthcare
providers, including audiologists, speech language
pathologists, and physical therapists, was expected to grow
faster than any other sector in the state over the next ten
years.
7:12:34 PM
Representative Hannan asked how many speech language
pathologists were currently practicing or licensed to
practice in Alaska.
Ms. Martin deferred the question to the Department of
Commerce, Community and Economic Development (DCCED).
SYLVAN ROBB, DIRECTOR, CORPORATIONS, BUSINESS, AND
PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE, COMMUNITY,
AND ECONOMIC DEVELOPMENT, replied that in FY 23 there were
956 audiologists and speech language pathologists in
Alaska. She noted there were far more speech language
pathologists relative to audiologists.
Representative Tomaszewski considered changes under the
bill. He remarked that the first change was a new section
that exempted currently licensed pathologists from a
criminal records check. He asked if it was consistent
through all professional licenses.
Ms. Martin responded it was a change between the original
version of the bill as introduced and the current bill. She
elaborated that Alaska's statutes did not have a criminal
background check. The bill added the background check for
new entrants because it was a requirement of the compact.
She explained that the compact did not require people who
were not interested in entering the compact or current
license holders to go through a background check. As a
result, the bill adjusted the language to ensure DCCED
would not have to go back through and do administrative
work that was not necessary for entering the compact.
Senator Wilson summarized that the legislation was trying
to address the shortage of speech language pathologists and
audiologists in Alaska. He noted there was not an
educational path for speech language pathology or audiology
in Alaska, meaning it was currently necessary to import
professionals. The goal was to help Alaskans and provide
access to healthcare. The ease of access to healthcare was
one of his priorities.
Co-Chair Foster set an amendment deadline for Wednesday,
th
May 8 at 5:00 p.m. for SB 75.
SB 75 was HEARD and HELD in committee for further
consideration.
7:16:40 PM
Co-Chair Foster moved to SB 74. He asked the sponsor to
introduce the bill.
Senator Wilson explained that the physical therapy
licensure compact was an interstate compact that operated
on the privilege to practice model. He relayed there were
individuals online to speak to the profession of physical
therapy as something that anyone could need at any stage in
life. Physical therapy helps individuals maintain strength
and mobility and helped individuals recover from injury and
regain mobility after a stroke or traumatic brain injury.
Physical therapy also helped individuals with conditions
such as multiple sclerosis and cerebral palsy. Access to
physical therapy was important for prevention and recovery
from serious injury and surgery. He highlighted there were
over 100 job postings for the positions. He relayed that
Alaska's schools could only produce 7 to 21 physical
therapists per year.
7:18:22 PM
Co-Chair Foster moved to invited testimony beginning with
Kelly Chick Comstock. He did not see her online.
Ms. Martin did not see Ms. Comstock online. She noted that
Ms. Comstock had been online until midnight the previous
night watching the committee conduct its business. She
appreciated the work and knew it was important to
providers.
Representative Ortiz noted that he heard from Ms. Comstock
at about 11:30 p.m. the previous evening asking if she
would have an opportunity to testify that night. He relayed
that she was a strong supporter of the legislation. He
noted it was a big need in Ketchikan.
7:19:23 PM
JEFF ROSA, COMPACT ADMINISTRATOR, PHYSICAL THERAPY COMPACT
COMMISSION, WASHINGTON, DC (via teleconference),
appreciated the committee's consideration of SB 74. He
relayed that the Physical Therapy (PT) Compact Commission
was an independent governmental entity that currently
consisted of 36 states and D.C. He relayed that each of the
states previously enacted the same legislation the
committee was currently considering. Instead of a multi-
state license model in which an individual license in one
compact state could legally practice in any other compact
state with no notification or requirements to the remote
state, under the PT compact when a licensee wanted to work
in another active compact state (a remote state), the
individual was required to purchase a compact privilege for
the specific remote state. In addition to the fee charged
by the compact commission, each state was also authorized
to charge an additional fee for the purchase of the compact
privilege. He clarified that the compact privilege was the
legal authorization to practice in a remote state.
Mr. Rosa elaborated that although the compact language
authorized the commission to levy on and collect an annual
assessment from each member state, since the formation of
the PT compact in 2016, it had never levied an annual
assessment on member boards. Instead, the sales of compact
privileges had been used to support the operations of the
commission. The PT compact had many benefits for Alaska and
its physical therapy providers. Importantly, as home to
nine military installations, the compact also supported
military families because it greatly improved portability
for military spouses by improving the speed and ease in
obtaining the ability to practice physical therapy when
stationed in Alaska, and for military families from Alaska
stationed in other states. The compact was widely supported
by physical therapists and physical therapy assistants,
including those who live and practice in Alaska. He
appreciated the opportunity to speak.
7:21:37 PM
Co-Chair Foster OPENED public testimony on SB 74. He
provided the public testimony email address.
Co-Chair Foster CLOSED public testimony on SB 74.
Representative Hannan asked how many physical therapists
were currently licensed in Alaska.
Ms. Robb responded that in FY 23 there were 1,559 physical
therapists and 241 physical therapy assistants in Alaska.
Representative Hannan asked if the bill impacted physical
therapy assistants.
Ms. Martin responded in the affirmative.
Senator Wilson expressed appreciation to the committee for
hearing the bill. He relayed that SB 74 was about helping
Alaskans with access to quality healthcare. He stated the
bill could be an option to help with the shortage in
Alaska.
Co-Chair Foster set an amendment deadline of Wednesday, May
th
SB 74 was HEARD and HELD in committee for further
consideration.
th
Co-Chair Foster set an amendment deadline of Monday, May 6
at 5:00 p.m. for HB 149.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 307 Amendments 1 - 8 050324 (2).pdf |
HFIN 5/3/2024 1:30:00 PM |
HB 307 |
| SB 118 Sponsor Statement.pdf |
HFIN 5/3/2024 1:30:00 PM |
SB 118 |
| SB 118 cs Summary of Changes.pdf |
HFIN 5/3/2024 1:30:00 PM |
SB 118 |
| SB118 Sectional.pdf |
HFIN 5/3/2024 1:30:00 PM |
SB 118 |
| SB 187 HCS FIN Amendment Pkt 1-14 050324.pdf |
HFIN 5/3/2024 1:30:00 PM |
SB 187 |
| HB307 Amendment 3 Backup 050324.pdf |
HFIN 5/3/2024 1:30:00 PM |
HB 307 |
| HB 232 Public Testimony Rec'd by 050324.pdf |
HFIN 5/3/2024 1:30:00 PM |
HB 232 |