Legislature(2023 - 2024)BELTZ 105 (TSBldg)
03/08/2023 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB74|| SB75 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 74 | TELECONFERENCED | |
| *+ | SB 75 | TELECONFERENCED | |
SB 74-PHYSICAL THERAPY LICENSURE COMPACT
and
SB 75-AUD. & SPEECH-LANG INTERSTATE COMPACT
1:34:28 PM
CHAIR BJORKMAN announced the consideration of:
SENATE BILL NO. 74 "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."
and
SENATE BILL NO. 75 "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."
1:35:09 PM
SENATOR DAVID WILSON, District N, Alaska State Legislature,
Juneau, Alaska, sponsor of SB 74. He expressed his intention to
present SB 74, the Physical Therapy (PT) Compact, and SB 75
simultaneously because one bill is based on the other. They are
slightly different in language, and both bills pertain to
interstate compacts.
SENATOR WILSON said the presentation will follow this order:
- overview of information relevant to both pieces of
legislation,
- testimony from Daniel Logdson, Director, National Center of
Interstate Compacts, The Council of State Governments (CSG)
- presentation and sectional analysis on SB 74, and
- presentation on SB 75.
SENATOR WILSON said both bills allow Alaska to join their
interstate licensure compacts. He reiterated that both bills
have a similar structure. He intends to present the bills
jointly to avoid repetition and use committee time best. He
explained that an interstate compact is a compact between two or
more states and carries the force of statutory law. It allows
participating states to perform certain actions, observe certain
standards, and cooperate in a critical policy area. Interstate
compacts increase access to quality and care by promoting
cooperation and actions among states. Interstate compacts
maintain rigorous licensure standards and state sovereignty
while decreasing the burdens on the licensure requirements. He
said these two state compacts differ from the other ones before
the legislature. He introduced SB 74 and SB 75 for the following
reasons:
- to address the workforce shortages,
- to streamline licensing issues,
- to advance telehealth options which would increase access to
more nationwide providers that may not be able to practice in
Alaska, and
- to address shortages in speech-language pathology and
audiology services in school districts.
1:40:16 PM
SENATOR WILSON said both compacts use a privilege to practice
model, which is different from the other compact before the
legislature. Persons who obtained a license in their home state
of residence can use it to apply for a [privilege to practice]
in other compact member states. Persons practicing in a remote
state are subject to that state's laws, which include scope of
practice. A remote state can take action to revoke a person's
privilege to practice in that state and notify all compact
member states. The Physical Therapy Licensure Compact (PT
Compact) became official in 2017, and 34 states have adopted it.
The [Audiology and Speech-Language Pathology Interstate Compact
(ASLP-IC)] became official in 2019, and 23 states have adopted
it. In the bill's supporting documents on BASIS, he referenced
various documents that contain a great deal of data on
interstate compacts.
SENATOR WILSON drew attention to the National Center for
Interstate Compacts housed within CSG. He said the Department of
Defense (DOD) partnered with CSG to help fund and support the
development of new interstate compacts for occupational
licensure. CSG generates a lot of interstate compact material,
facilitates state cooperation on complex policy issues,
strengthens economies, protects public health and safety, and
champions state sovereignty.
1:45:01 PM
CHAIR BJORKMAN invited Mr. Logsdon to put himself on the record
and begin his testimony.
1:45:10 PM
DAN LOGSDON, Manager, National Center for Interstate Compacts,
The Council of State Governments, Lexington, Kentucky, gave a
brief overview of interstate compacts. Interstate compacts are
agreements between and among states. They are legislatively
enacted and are essentially contracts that states enter into
with each other. Interstate compacts are proven simple,
versatile tools between states. The best example of an
interstate compact is the driver's license compact. States
joined together and worked the details out, so licensed drivers
could drive between states without stopping at the border for
permission. Compacts are a proven method for states to address
common problems cooperatively. It allows states to respond to
national priorities with one voice and retain their collective
state sovereignty over issues. There are 265 active interstate
compacts; on average, states belong to about two dozen.
Interstate compacts provide states with the benefit of flexible,
state-driven solutions. He said that most of the time, the
federal government and Congress give states "one-size fits all"
solutions that cannot possibly account for vagaries among the
states. However, states can account for their different
situations when they gather at the table, leading to a win-win
situation when they retain sovereignty over issues in the
federalist system. He said he has examples of states doing this.
Interstate compacts have been around since the founding of the
republic. Compacts were mainly used to resolve boundary issues,
establish boundaries, and provide access to natural resources
like rivers up until the 20th century.
MR. LOGSDON said states began using interstate compacts for
administrative functions in the 20th century and to put a check
on the federal government to ensure states retain control of
issues left explicitly to them. Some of the issues compacts
address include:
- Crime control and correction
Interstate Compact for Adult Offender Supervision
- Interstate Compact on Juveniles
- Child welfare
Interstate Compact on the Placement of Children
- Education
Military Children's Compact Commission ensures school
districts award students proper credit when moving from
station to station and state to state.
- Emergency Management Assistance Compact
- Insurance Product Regulation
Insurance Compact
MR. LOGSDON said there are a number of occupational licensure
compacts, including one for nurses, physicians, physical
therapists, psychologists, emergency medical service personnel,
audiology and speech-language pathologists, occupational
therapists, counselors, and advanced practitioner nurses. He
said that compacts for cosmetology, dentists, dental hygienists,
massage therapists, social workers, and teachers were just
finished under the DOD cooperative agreement. They are working
on a compact for school psychologists and dieticians.
MR. LOGSDON explained interstate compacts differ from a number
of other agreements that states have with each other. He
emphasized that interstate compacts are binding, legislatively
enacted, signed into law, or allowed to become law by the
governor and are embedded in statutes. This differs from a
memorandum of understanding between the states or uniform law.
Uniform laws become less uniform as states enact them, using the
parts they like and disregarding the elements they do not like.
1:50:40 PM
SENATOR DUNBAR suggested he add the Electronic Registration
Information Center (ERIC) to his list of compacts. Alaska is a
member, and it prevents voter fraud. It is how Alaska knows
whether a person is registered in one state and not another. It
is another successful example of a compact used in the U.S.A.
1:51:34 PM
JASMINE MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, Juneau, Alaska, presented the sectional analysis
available on BASIS under the bill. She highlighted the following
sections of the sectional analysis for Senate Bill 74, version
S:
Section 1: Amends AS 08.84.010.
Adds implementation of the Interstate Physical Therapy
Licensure Compact to the list of duties of the State
Physical Therapy and Occupational Therapy Board.
Section 2: Amends AS 08.84.030.
Adds section (a)(4) which requires an applicant for a
physical therapist and a physical therapist assistant
license, who is not a graduate of a school located
outside of the United States, to be fingerprinted and
pay fees for a criminal background check.
Adds section (b)(4) which requires an applicant for an
occupational therapist or occupational therapist
assistant license, who is not a graduate of a school
located outside of the United States, to be
fingerprinted and pay fees for a criminal background
check.
1:52:58 PM
MS. MARTIN noted that SB 74 does not pertain to Occupational
Therapy Compact legislation. However, subsection (b)(4)
maintains continuity between the two statutes should
occupational therapists decide to work on the Occupational
Therapy Compact; language is already in place and the pieces of
law would match.
Section 3: Amends AS 08.84.032.
Adds section (a)(4) which requires an applicant for a
physical therapist and a physical therapist assistant
license, who is a graduate of a school located outside
of the United States, to be fingerprinted and pay fees
for a criminal background check.
Section 4: Amends AS 08.84.050.
Adds fees for compact privileges to the list of fees
the Department of Commerce, Community, and Economic
Development may charge.
Section 5: Amends AS 08.84.150.
Adds a privilege to practice to the list of exceptions
under which someone not licensed in the state may
practice physical therapy.
1:53:11 PM
MS. MARTIN explained that the privilege to practice under this
model is not a full license in Alaska. If someone were
practicing under the privilege to practice in Alaska, they would
[be licensed and have been] practicing in another state.
Section 6: Amends AS 08.84 to add Article 3.A
Interstate Physical Therapy Licensure Compact.
This section contains the uniform compact language
adopted by all states entering the compact.
MS. MARTIN said Section 6 is the compact piece of the bill, the
bulk of the legislation, and the contract the state would adopt.
Compact Section 1. Purpose.
Defines the purpose of the Interstate Physical Therapy
Licensure Compact.
Compact Section 2. Definitions:
Definition Section.
Compact Section 3. State Participation in the Compact:
Explains requirements the state must meet to
participate in the agreement.
Compact Section 4. Compact Privilege:
Explains the requirements for obtaining a privilege to
practice.
Compact Section 5. Active Duty Military Personnel or
their Spouses:
Explains what counts as a home state for active duty
military members and their spouses.
1:54:18 PM
MS. MARTIN said these compacts were originally designed in
coordination with DOD with a focus on making transitions for
military families easier, and it has been expanded. If it is a
good idea and works well, it works well for everyone in the
profession.
Compact Section 6. Adverse Actions:
This section explains how the compact, home, and
remote states will conduct and report adverse actions.
As well as the consequences for a physical therapist
or physical therapist assistant who receives adverse
actions.
Compact Section 7. Establishment of the Physical
Therapy Compact Commission:
This section lays out parameters for the Physical
Therapy Compact Commission.
Compact Section 8. Data System
This section denotes the requirement of sharing
licensee information for all compact states.
Notwithstanding any other provision of state law to
the contrary, a compact state shall submit a uniform
dataset to the Coordinated Database on all PTC
physical therapist and physical therapist assistants
to whom this compact is applicable as required by
rules of the Commission. This database will allow for
the expedited sharing of adverse actions against
compact physical therapist and physical therapy
assistants. The coordinated database information will
be expunged by the law of the reporting compact state.
1:55:52 PM
MS. MARTIN noted that this is the same language used in SB 75,
Compact Section 9 of the Audiologist and Speech-Language
Pathologist Interstate Compact.
Compact Section 9. Rulemaking:
This section describes the process for creating rules
that will govern compact operations once the compact
is accepted by the first ten states.
Compact Section 10. Oversight, Dispute Resolution, and
Enforcement:
This section details the oversight and enforcement of
the compact by member states.
[Compact] Section 11. Date of Implementation of the
Interstate Commission for Physical Therapy Practice
and Associated Rules, Withdrawal, and Amendment:
This section details when the Compact and rules become
effective.
MS. MARTIN noted that this is the same language used in SB 75,
Compact Section 12 of the Audiologist and Speech-Language
Pathologist Interstate Compact.
1:56:40 PM
MS. MARTIN continued with Compact Section 12 of the sectional
analysis.
[Compact] Section 12. Construction and Severability:
This section states that the compact shall be
liberally construed to effectuate the purpose thereof.
If this Compact is contrary to the constitution of any
state member, the compact shall remain in full force
and effect as to the remaining compact states.
MS. MARTIN said this section concludes the compact language in
the bill. She noted that this is the same language used in SB
75, Section 13 of the Audiologist and Speech-Language
Pathologist Interstate Compact.
Section 7: Amends AS 12.62.400.
Adds section (a)(23), adding physical therapists,
physical therapist assistants, occupational
therapists, and occupational therapy assistants to the
list of fingerprints that may be submitted to the FBI
for a national criminal history check.
Section 8: Amends uncodified law.
Sets transition language for physical therapists,
physical therapist assistants, occupational
therapists, and occupational therapy assistants who
are currently licensed who have not been
fingerprinted. Allows them to continue to practice.
Section 9: Effective date.
Sets an effective date for this legislation of July 1,
2024.
1:57:53 PM
SENATOR DUNBAR directed attention to Section 7 about
fingerprints and the national background check. He asked whether
fingerprinting is a new requirement for physical therapist
licensure in Alaska or whether this is a requirement for
communicating with the national compact organization.
MS. MARTIN answered that it is not a requirement right now.
SENATOR DUNBAR asked whether physical therapy organizations know
the compact will impose this requirement on them and their
thoughts on the subject.
MS. MARTIN answered that Senator Wilson's Office has worked
closely with them. Those who want licensure under the compact
are subject to fingerprint requirements. The legislation does
not intend to require every physical therapist in the state to
go through a criminal background check. The same goes for
audiologists and that legislation's language. It is not the
intention for all of them to go through the criminal background
check; only people who want eligibility for the compact
privilege.
2:00:17 PM
SENATOR WILSON said he would like the invited testifiers for SB
74 to begin if it is the will of the committee.
2:00:28 PM
CHAIR BJORKMAN invited Jeff Rosa to put himself on the record.
2:00:43 PM
JEFF ROSA, Compact Administrator, Physical Therapy Compact
Commission, and The Federation of State Boards of Physical
Therapy, Alexandria, Virginia, gave invited testimony on SB 74.
He said the purpose of the compact is to facilitate the
interstate practice of physical therapy to improve access to
physical therapy services while enhancing public protections.
The compact is an alternate way for physical therapy providers
to meet eligibility requirements to obtain the privilege to
practice in other states within minutes through the compact
commission website. Benefits of the PT Compact include:
- Member states can charge a fee for people who purchase a
compact privilege in their state. State revenues lost from no
longer needing endorsement applications are offset by the
ability of states to generate revenue through compact
privilege purchases.
- The process is much faster and more efficient than the
traditional licensure process for physical therapists and
physical therapist assistants.
- Improved access to a choice of physical therapy providers for
all Alaskans, especially those living in underserved areas.
- The process also preserves the state-based licensure system
while providing an alternate mechanism for physical therapists
and physical therapy assistants to obtain the legal authority
to practice in Alaska.
- Improved public protections by requiring the full
participation of member states in the essential licensure and
disciplinary database, including a regular reporting
requirement of disciplinary actions through the centralized
data system, and
- The compact supports the military since it greatly improves
the speed and ease for military spouses to obtain the ability
to practice physical therapy while stationed in Alaska. The
same applies to military families that call Alaska home but
are stationed in other states.
MR. ROSA said physical therapists and physical therapist
assistants widely supported the compact, including those who
live and practice in Alaska.
2:03:53 PM
CHAIR BJORKMAN asked Alec Kay and LeeAnne Carothers, invited
testifiers, to put themselves on the record.
2:04:08 PM
ALEC KAY, President, Alaska Chapter of the American Physical
Therapy Association, Anchorage, Alaska, gave invited testimony
and spoke in support of SB 74. The association has been
educating and consulting members on this concept for three
years. He said the association has the support of the
membership. He said there are no concerns regarding the
additional security clearance and Federal Bureau of
Investigation (FBI) background check. The PT Compact is
important for Alaska at this time. There is a significant
workforce shortage across the state, and physical therapy is no
exception. There is a shortage nationally as well. The PT
Compact would decrease the administrative burden for applicants.
He spoke as a private practice owner, reflecting on the
challenges and delays of getting therapists licensed. It affects
the economy and the industry's ability to care for the
community. He said about 450 association members in the state
support SB 74.
2:06:37 PM
SENATOR DUNBAR asked what factors influenced the association to
believe the PT Compact would be a net importer of physical
therapists rather than a net exporter.
2:07:23 PM
MR. KAY answered that is a good question; it has come up. There
is no way to measure outcomes. He said he could only speak to
the frustration of licensure in Alaska. He has received
unsolicited letters from potential licensees who said it is
easier to work in states that are part of compacts. Alaska's
licensure system and process are antiquated and burdensome. He
said that in his experience recruiting employees and, as chapter
president, receiving unsolicited complaints, therapists are not
considering employment in Alaska. Many people are interested in
making it easier to work in Alaska. He expressed that the state
has much to offer and is a good place economically to practice
physical therapy. He said that though he had no data, he
believed the PT Compact would benefit Alaska. Nothing prevents
physical therapists from leaving Alaska; he suggested a subject
expert with data speak to this piece.
2:09:16 PM
LEEANNE CAROTHERS, Government Affairs Liaison and Immediate Past
President, Alaska Physical Therapy Association, Anchorage,
Alaska, gave invited testimony on SB 74. She said that her day
job is Assistant Dean in the School of Allied Health at the
University of Alaska Anchorage (UAA), which represents about 21
different health care providers in the state. The primary
function of her job is to decrease workforce shortages
throughout Alaska. She has a bird's eye view of obstacles
graduates face getting licensed in Alaska. She is aware of at
least a several-month wait from graduation to the time the board
processes the license. Licensing boards are relatively short-
staffed, so getting the job done takes time. She expressed her
belief that decreasing the administrative burden of licensure
would:
- help the people that live here,
- help the people that apply for the privilege to practice,
- help health care providers get from the point of application
to seeing patients more rapidly.
MS CAROTHERS advised that therapists must maintain their home
state license to participate in the PT Compact. This means the
privilege to practice requires an additional license; Alaskan
therapists would not lose their license to practice in Alaska by
participating in the PT Compact. It is not either or, but both.
2:11:56 PM
CHAIR BJORKMAN invited Rebecca Byerly to put herself on the
record and begin her testimony.
2:12:06 PM
REBECCA BYERLY, Physical Therapist, Soldotna, Alaska, gave
invited testimony on SB 74. She stated that she had been a
physical therapist in Alaska for 27 years as a department
director on the Kenai Peninsula and in private practice. There
have been challenges in recruiting therapists. The healthcare
industry has recruiting challenges statewide. The state needs
additional therapists. Time considerations, application
processes, and the expense to employers limit individuals who
may opt out of coming to Alaska to work. She said the PT Compact
would provide the industry with reduced licensure wait times and
decreased employer costs.
MS. BYERLY said currently, licensure is a complicated process.
She explained the patient population has increased, and there
are vulnerable populations with multiple co-morbidities. When
the industry lacks the staffing to fulfill the patient
population's care needs, it creates additional medical
compromises. The PT Compact will make it easier for therapists
to come to Alaska and provide care.
MS. BYERLY advised that the privilege to practice and security
are huge pluses. The background check provides stronger
security. She supports SB 74.
2:15:22 PM
CHAIR BJORKMAN asked how many physical therapist positions are
vacant on the Central Kenai Peninsula.
MS. BYERLY replied almost every facility has at least one
position open. There are probably 10 to 15 vacancies from Seward
down to Homer.
CHAIR BJORKMAN asked what the turnover rate is on the Kenai
Peninsula.
MS. BYERLY answered that once a physical therapist comes to
Alaska, they do not leave. She said applicants are employment
opportunities, education, and professional and career
development. She said the benefits of the Alaska outdoors are
tremendous and many therapists remain in the state.
2:17:14 PM
CHAIR BJORKMAN opened public testimony on SB 74.
2:17:56 PM
KELLY MICHELLE CHICK, representing self, Ketchikan, Alaska,
testified in support of SB 74. She came to Alaska as a traveling
physical therapist in the 1990s and decided to stay. She has
been in private practice for 20 years, operates her own
business, and has employed up to seven physical therapists at
one time. The industry took a big hit during COVID. She agreed
with previous testimony regarding recruitment, licensure issues,
and the state of the industry. Administrative burdens and delays
peaked during the last two years.
MS. MICHELLE CHICK said there is a Physical Therapist Assistant
School of Allied Health at UAA, but not one for physical
therapy. Physical therapists practicing in Alaska obtained their
education elsewhere. They go elsewhere for continuing education
credits. Physical therapists can now train in advanced
certifications. She enrolled in an electromyography (EMG)
residency program. Nobody in Ketchikan provides this training,
so she travels out of state for mentorship. She explained that
as a physical therapist, compact licensure offers her an amazing
option. It opens up the ability to get mentoring in other
states, return with skills, and provide that service in
Ketchikan.
2:21:50 PM
SENATOR DUNBAR asked her to elaborate on the lack of education
opportunities for physical therapists in Alaska.
MS. MICHELLE CHICK answered mentors are unavailable in Alaska
for the EMG residency program. Many continuing education and
certifications can be done online, but in-person training is
primarily done in the Lower 48 because that is where the
expertise resides.
2:23:44 PM
At ease.
2:24:39 PM
CHAIR BJORKMAN reconvened the meeting and invited Melissa
Bunselmeier to put herself on the record.
2:24:50 PM
MELISSA BUNSELMEIER, representing self, North Pole, Alaska,
testified in support of SB 74. She is the clinical manager at
North Pole Physical Therapy. She agreed with the testimony of
previous witnesses. The administrative burden of potential
Alaska licensees hurts the industry's healthcare delivery by
limiting services. North Pole Physical Therapy cannot
effectively take care of the community. Due to the labor
shortage, there are more patients than the clinic can see. She
offered the following story to illustrate her frustration. The
clinic hired a physical therapist who started his license
application in January; he is still without his license and is
scheduled to start work next week. The clinic cannot begin his
contract without his license; meanwhile, clients are waiting to
see him. The PT Compact would eliminate this problem. This
happens regularly. She said the clinic interviewed contract
therapists who declined the position because Alaska is not a PT
Compact member state. Another struggle is that the clinic cannot
start credentialing for TRICARE until licensure is complete and
the clinic has the applicant's license. North Pole has a huge
military clientele, dependent veterans, and active-duty
personnel. TRICARE credentialing takes up to 120 days. This
further compounds the delay from the point of hire to providing
care. There are many challenges to staffing a rural clinic in
Alaska. Allowing the state to join the PT Compact would
alleviate many of these challenges.
2:27:12 PM
CHAIR BJORKMAN held public testimony open on SB 74.
CHAIR BJORKMAN held SB 74 in committee.
2:27:16 PM
At ease.
2:29:13 PM
CHAIR BJORKMAN reconvened the meeting and asked Senator Wilson
to present SB 75.
2:29:34 PM
SENATOR DAVID WILSON, District N, Alaska State Legislature,
Juneau, Alaska, sponsor of SB 75, said the presentation for SB
75 is similar to that for SB 74, Physical Therapy (PT) Compact.
Workforce shortages are an issue among many professions.
However, the state needs qualified audiologists and speech-
language pathologists, which are crucial for young people in
Alaska. Medicaid data show that most Medicaid recipients are
between the ages of 0 and 24. If complex issues are dealt with
early before they become chronic care issues, the state's
financial burden is less, and those individuals have a better
quality of life. He said that physical therapists, speech-
language pathologists, and audiologists are crucial professions
in Alaska, but more so for speech-language pathologists and
audiologists.
2:30:58 PM
JASMINE MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, Juneau, Alaska, presented the sectional analysis on
SB 75, version B. She said the bill allows Alaska to join the
Audiology and Speech-Language Interstate Compact. The sectional
analysis is available in BASIS under the bill. She highlighted
the following sections of the sectional analysis:
Section 1: Amends AS 08.11.010.
Adds section (5) which requires an applicant for an
audiologist license to be fingerprinted and pay fees
for a criminal background check.
Section 2: Amends AS 08.11.015.
Adds section (6) which requires an applicant for a
speech-language pathologist license to be
fingerprinted and pay fees for a criminal background
check.
Section 3: Amends AS 08.11.050.
Allows the Department of Commerce, Community, and
Economic Development to charge fees for a compact
privilege.
Section 4: Amends AS 08.11.100.
Allows a person granted a compact privilege to
practice as an audiologist or speech language
pathologist in Alaska.
Section 5: Amends AS 08.11 to add Article 2.
Audiologist and Speech-Language Interstate Compact.
This section contains the uniform compact language
adopted by all states entering the compact.
2:31:24 PM
MS. MARTIN said Section 5 is the compact piece of this
legislation. States that enacted this compact adopted the
uniform language in this section.
Compact Section 1. Purpose:
Defines the purpose of the Interstate Audiology and
Speech Language Pathology Compact.
Compact Section 2. Definitions:
Definition section.
Compact Section 3. State Participation in the Compact:
This section explains what requirements must be met by
states to join the compact. To provide the services
allowed by this compact the professional must hold a
home state license in a compact state.
Compact Section 4. Compact Privileges:
Explains the requirements the state must meet to
participate in the agreement.
Compact Section 5. Compact Privilege to Practice
Telehealth:
By accepting the compact the jurisdiction will allow
for the practice of telehealth.
Compact Section 6. Active Duty Military Personnel or
Their Spouses:
Active duty military personnel, or their spouse, may
designate a home state where the individual has a
current license in good standing. The individual may
retain the home state designation during the period
the service member is on active duty.
2:32:24 PM
Compact Section 7. Adverse Actions:
This section explains how the compact, home, and
remote states will conduct and report adverse actions.
As well as the consequences for an audiologist or
speech-language pathologist who receives adverse
actions.
Compact Section 8. Establishment of the Audiology and
Speech Language Pathology Compact Commission:
This section establishes the ruling commission of the
compact. The compact is not a waiver of sovereign
immunity.
Compact Section 9. Data System:
This section denotes the requirement of sharing
licensee information for all compact states.
Notwithstanding any other provision of state law to
the contrary, a compact state shall submit a uniform
dataset to the Coordinated Database on all ASLP-IC
audiologists and speech-language pathologists to whom
this compact is applicable as required by rules of the
Commission. This database will allow for the expedited
sharing of adverse actions against compact
audiologists and speech-language pathologists. The
coordinated database information will be expunged by
the law of the reporting compact state.
2:32:57 PM
MS. MARTIN noted that this is the same language used in SB 74,
Compact Section 8 of the Physical Therapy Licensure Compact.
Compact Section 10. Rulemaking:
This section describes the process for creating rules
that will govern compact operations once the compact
is accepted by the first ten states.
Compact Section 11. Oversight, Dispute Resolution, and
Enforcement:
This section details the oversight and enforcement of
the compact by member states.
Compact Section 12. Date of Implementation of the
Interstate Commission for Audiology and Speech-
Language Pathology Practice and Associated Rules,
Withdrawal, and Amendment:
This section details when the Compact and rules become
effective.
2:33:23 PM
MS. MARTIN noted that this is the same language used in SB 74,
Compact Section 11 of the Physical Therapy Licensure Compact.
Compact Section 13. Construction and Severability:
This section states that this compact shall be
liberally construed so as to effectuate the purpose
thereof. If this compact shall be held contrary to the
constitution of any state member thereto, the compact
shall remain in full force and effect as to the
remaining states.
2:33:27 PM
MS. MARTIN noted that this is the same language used in SB 74,
Compact Section 12 of the Physical Therapy Licensure Compact.
Compact Section 14. Binding Effect of Compact and
Other Laws:
States that this compact shall be binding among and
upon all members states and shall supersede any
conflict with state law.
MS. MARTIN said that Compact Section 14 concludes the compact
language of SB 75.
Section 6: Amends AS 12.62.400.
Adds section (a)(23), adding audiologists and speech-
language pathologists to the list of fingerprints that
may be submitted to the FBI for a national criminal
history check.
Section 7: Amends uncodified law.
Sets transition language for audiologists and speech-
language pathologists who are currently licensed who
have not been fingerprinted. Allows them to continue
to practice.
Section 8: Effective Date.
Sets an effective date for this legislation of July 1,
2024.
2:34:31 PM
SENATOR DUNBAR prefaced his question by noting these professions
do not have prescribing authority. Many professions have access
to relatively sensitive data or work with sensitive populations
and do not have to have a criminal background check. He asked
why this legislation requires a background check and
fingerprints.
MS. MARTIN answered this legislation allows people to move and
practice between state lines quickly. Licensees have not
necessarily practiced in a remote state for the length of their
license, so requiring background checks offers more assurance
that the privilege to practice is granted to quality, safe
individuals.
2:35:40 PM
SENATOR WILSON answered that this is similar to when Alaska
instituted some of the Medicaid Barrier Crime Laws. He spoke
about federal background checks and that states practicing
within the compact have those statutes. States are uniformly up
to the highest level to practice within compacts.
2:36:13 PM
SENATOR DUNBAR said both answers have valid points. The issue of
barrier crimes is interesting. He said it is problematic in
that, in many cases, it prevents people from practicing their
profession after fulfilling their debt to society. He asked
about barrier crimes and whether member states with them
affected member states without them.
SENATOR WILSON answered no, saying he may have used a bad
example. It would be a federal crime. An individual would
register as part of that background check. He deferred the
question to David Jamison.
2:37:53 PM
DAVID JAMISON, Member, Alaska Speech and Hearing Association
and, Owner of a Small Outpatient Clinic, Fairbanks, Alaska. He
deferred the question to Nancy Lovering. He explained that most
people who receive speech-language pathologists' services have
communication issues. They are often vulnerable populations who
cannot advocate for themselves or functionally communicate, and
it is important to lower the threshold for risk and adverse
effects from people who should not be offering them services.
2:38:54 PM
CHAIR BJORKMAN advanced to invited testimony on the agenda for
SB 75. He asked Nahale Kalfas to put herself on record.
2:39:05 PM
NAHALE KALFAS, General Counsel, Audiology and Speech-Language
Pathology Interstate Compact Commission (ASLP ICC), Raleigh,
North Carolina, gave invited testimony on SB 75. The compact is
in 23 states, soon to be 24. It has been introduced in another
13 or 14 states. She is the co-primary drafter of this piece of
legislation and legal counsel for The Council of State
Governments.
MS. KALFAS expressed her belief that most of the public assumes
people who come into their homes to provide speech-language
pathology to their children or other vulnerable populations have
had a background check. She clarified that the language of this
compact does not dictate the terms by which a previous criminal
conviction would exclude an individual. That is left to the
member states to determine. There is no outright ban regarding a
particular crime because member states trust that their sister
member states determined whether or not there is a nexus between
the crime and the ability to competently practice the
profession. She spoke to whether a state would be precluded from
participation based on another state's discretionary
determination. She said that would only be true in the
individual's home state. She explained the home state license
punches an individual's ticket to participate with the privilege
to practice in every member state an individual chooses. So, if
an individual loses their home state license, they lose their
privilege to practice under the compact unless they move to
another home state and requalify with an application. It is a
state sovereignty issue, and the determination is left to the
states. Practicing beyond borders requires a higher standard of
public protection and an enhanced level of trust for interstate
travel. Compacts, like state licensing boards, protect the
public. It is incumbent upon all member states to protect their
sister states when allowing practitioners across borders. It is
important that member states properly vet their practitioners
before allowing them to have this sort of licensure portability.
2:42:39 PM
MS. KALFAS said this does not mean that a person who might not
otherwise qualify cannot get a single-state license; they can.
This only speaks to the compact, which is another pathway for
licensure. It does not preclude or subsume any sort of
reciprocity or uniform licensure. It is just another pathway to
licensure but with its own criteria. Compacts are contractual;
each state agrees not to act unilaterally. However, each state's
scope of practice is preserved and respected, and the terms of
the compact are what member states agree to uphold.
2:43:55 PM
CHAIR BJORKMAN invited the next invited testifier, Nancy
Lovering, to put herself on the record.
2:44:07 PM
NANCY LOVERING, Member, Alaska Speech and Hearing Association
(AKSHA), and representing self as a private practice owner,
Anchorage, Alaska, gave invited testimony in support of SB 75.
AKSHA provided members with opportunities for education and
input regarding the compact. The Alaska Speech and Hearing
Association members support the interstate compact. She said
that as a small business owner working with children with
disabilities, she wanted to discuss military families relocated
to other states during COVID. Some families wanted to continue
their children's therapeutic relationship with her. She
continued to see those children in other states through
teletherapy. The problem as a small business owner is that
without the compact, she was required to license in multiple
states to serve those children who had moved. She said that it
was something she was willing and happy to do to help the
families, but at the same time, it was a big expense for a small
business owner. She agreed with previous speakers who testified
about the difficulty of recruiting and retaining.
MS. LOVERING noted that Alaska does not have a licensing board
for speech pathology and audiology. Those who process
applications and work for the State of Alaska licensing agency
address consumer complaints or concerns. She said she had been
consulted many times regarding licensing and consumer
complaints. She does her best to represent the association and
answer questions. She said that she also refers questions to the
national association. She said Alaska would benefit from the
compact and member states.
2:47:15 PM
CHAIR BJORKMAN opened public testimony on SB 75.
2:47:47 PM
DAVID JAMISON, Member, Alaska Speech and Hearing Association
and, Owner of a Small Outpatient Clinic, Fairbanks, Alaska, said
his clinic has been in operation for 20 years, and there has
been a six to twelve-month waiting list for that entire time.
The clinic cannot serve all the community's needs. This is a
common occurrence for all the school districts, other private
practices in town, and a handful of providers that work
privately. He supports the compact because one of the primary
barriers to getting new employees is licensing. Individuals get
their degrees and licenses, and then they must get credentialed
by each insurance company before they can begin practicing. He
said when interviewing applicants, he often has to tell them the
wait will be two to three months before they can start working.
Most people who take these positions are new graduates from the
Lower 48. There is a program in Alaska that snaps up new
graduates who do their internships in the state. Two or three
months to start work is too long for these new graduates to
wait. Streamlining the licensing process through this compact
would not solve all the problems, but it would reduce the
processing time to one to two months.
MR. JAMISON expressed concern about the military community's
Exceptional Family Member Program (EFMP). He explained that the
military often refuses to move a military family with a special
needs child to a station that does not have services to support
that child. Alaska needs to put itself in the position of
providing the infrastructure that supports military populations
and to avoid losing military families and investments.
2:50:50 PM
CHAIR BJORKMAN held public testimony open.
CHAIR BJORKMAN held SB 75 in committee.