Legislature(2023 - 2024)BELTZ 105 (TSBldg)
04/05/2024 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB115 | |
| SB135 | |
| SB257 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 115 | TELECONFERENCED | |
| += | SB 135 | TELECONFERENCED | |
| += | SB 257 | TELECONFERENCED | |
SB 115-PHYSICIAN ASSISTANT SCOPE OF PRACTICE
[CSSB 115(HSS) was before the committee]
1:38:10 PM
CHAIR BJORKMAN announced the consideration of SENATE BILL NO.
115 "An Act relating to physician assistants; relating to
physicians; and relating to health care insurance policies."
1:38:43 PM
MCKENZIE POPE, Staff, Senator Loki Tobin, Alaska State
Legislature, Juneau, Alaska, said SB 115 grants experienced
Physicians Assistants (PAs), those with more than 4,000 hours
practice experience, the flexibility to increase their ability
to see and treat patients, which will benefit the capacity of
Alaska's medical system. She said this also maintains the
collaborative agreement structure currently in place for less
experienced PAs defined in SB 44 as those with less than 4,000
hours of practice experience.
MS. POE said Alaskan PAs are asking us to let them help us to
meet our growing patient needs across the state. They will play
a vital role in meeting the growing and ongoing health care
needs of the people of Alaska, where 90 precent of PAs practice
in rural areas of Alaska and the majority of our primary care
physicians operate in urban Alaska. Currently Alaska law does
not allow PAs to operate to the fullest extent of their
expertise and knowledge. SB 115 seeks to remedy this situation
by allowing PAs to practice and to provide additional health
care options in Alaska without direct oversight from a
supervising physician. SB 115 authorizes PAs to expand their
services and will allow more patients to stay in their home
communities to receive routine medical care. SB 115 does not
sacrifice medical rigor or oversight, but simply allows
experienced and licensed PAs in the State of Alaska to continue
to offer high quality medical care within their scope of
practice.
1:40:51 PM
SENATOR DUNBAR mentioned the suggestion from some with concerns
about SB 115 that the 4,000 hours of experience should occur in
the specialized area of practice, for example, dermatology or
cardiology, prior to independent practice. He asked whether the
sponsor would support an amendment to define the hours of
experience by specialty.
1:41:43 PM
MS. POPE answered that the sponsor is aware of those concerns,
and she deferred to representatives of the Academy of Physicians
Assistants, attending online to help answer questions regarding
the specifics of operating as a PA in the state of Alaska. She
said it is the opinion of Senator Tobin's office that the
education of and licensing requirements of PAs should suffice to
equip them to practice as SB 115 describes. She said the 4,000-
hour requirement in SB 115 is in addition to the multiple years
of education and 3,000 or more hours of direct patient contact
PA's receive prior to licensing. She said once PA students enter
an accredited training program, they have 27 months of training
and 100 hours of continuing medical education every two years, a
comprehensive exam to become licensed and a large comprehensive
exam every ten years. She repeated the opinion of the sponsor's
office that these requirements suffice to prepare PAs [for
independent practice as described by SB 115].
1:43:52 PM
CHAIR BJORKMAN opened public testimony on SB 115.
1:44:25 PM
SENATOR BISHOP joined the meeting.
1:44:44 PM
CANDANCE HICKEL, representing self, Anchorage, Alaska, said that
as a physician assistant (PA) she was testifying in support of
SB 115 and that she practices in Anchorage at Providence Medical
Center in cardiothoracic surgery. She has worked there for the
past six years and for ten years before that she practiced in
neurosurgery, also in Anchorage. She said she has served as a PA
educator through the University of Washington since 2009. She
said there is widespread support for SB 115 among her PA
colleagues and that passage of the bill is essential for the
future of providing reliably available high quality health care
in the state of Alaska.
MS. HICKEL emphasized her family's commitment to the future of
Alaska, noting their boys are fifth generation Alaskans. She
said passing SB 115 aligns the future of healthcare in our state
in the right direction. She encouraged the committee to pass SB
115.
1:46:30 PM
BETSY DOUDS-PACZAN, President, Alaska Academy of Physician
Assistants, Anchorage, Alaska, said she was testifying in
support of SB 115. She said she is the president of the Academy
of Physician Assistants, and she works in addiction medicine and
behavioral health in Anchorage. She noted the opioid crisis and
the struggle with too few resources for care in every aspect of
medicine. She said SB 115 would remove obstacles to care and
enable PAs to practice to the full extent of their training and
experience. She said Alaska statutes that currently define the
scope of practice for PAs in Alaska were signed by the Alaska
Board of Medical Examiners in 1979, 45 years ago. She said the
statutes have not been rewritten since then though the
requirements for entry into a PA program are more seriously
competitive than ever. She said the programs themselves continue
to increase in the academic rigor and clinical training. She
said the profession has evolved and it is time for statute to
adjust appropriately.
MS. DOUDS-PACZN said the very particular set of circumstances
that contributed to the tenor of the 1979 statutes no longer
exist. She said there are now more than 168,300 PAs in the U.S.
engaging in more than 500 million patient interactions each
year. She said 18 countries utilize PAs or PA equivalents and
there are 306 accredited training programs for PAs.
MS. DOUDS-PACZN concluded, saying that PAs are neighbors,
friends and family members and they are constantly striving to
serve with expertise, compassion and integrity. She said SB 115
would allow PAs to continue to do so. She said PAs are
absolutely seeking to practice in collaboration as a part of a
team, but without a specified relationship with a single
[overseeing] provider. She said SB 115 is a tool that will move
us toward the end goal of quality care for all Alaskans. She
urged the committee to join in the effort to modernize Alaska
statute by passing SB 115.
1:48:59 PM
SENATOR DUNBAR restated the question about the specificity of
the requirement of 4,000 hours of experience in order to
practice without a collaborative agreement. He asked whether the
4,000 hours should be specific experience in a given specialty.
1:49:48 PM
MS. DOUDS-PACZAN answered that PAs receive a broad education in
all fields of medicine and the clinical training is 45 weeks or
approximately 2,000 hours of supervised clinical training
experience. She said each of those are within specialty settings
and PAs are often offered positions from those clinical
settings. She said when PAs join a practice, they do so with a
foundation of general knowledge and the training is "on the
job".
1:51:13 PM
SENATOR DUNBAR sought further clarification on training hours
over days, because hours of experience are specified by SB 115.
He asked whether the 4,000 hours required to practice
independently would be met during the initial [general] training
or thereafter during the "on the job" training.
1:51:53 PM
MS. DOUDS-PACZAN said that at the end of 45 weeks, PAs would
gain about 2,000 hours of supervised clinical experience. She
said in a 12-month period, most programs are set up for nine
four-week rotations, working full-time or more than full-time in
a supervised situation, such as surgery, emergency care,
obstetrics or primary care, for example. She compared the PA
requirements to those for a Nurse Practitioner (NP) who receive
an average of 27.5 weeks of supervised clinical training which
equates to about 1100 hours, or about half of the training hours
PAs receive.
1:54:00 PM
GAYLE HORNBERGER, D.O., representing self, Fairbanks, Alaska,
said she had 31 years of medical experience working in Alaska,
the past 27 years working in Fairbanks as a family physician.
She said her experience included Emergency Medical Services
(EMS), Community Health, Private Practice and Indian Health. She
said over those years she worked with, educated, mentored, and
employed PAs at all levels of their careers. She said the
original PA programs were focused on individuals who had
experience in health care such as military corpsmen, nurses and
paramedics who brought a significant wealth and depth of
knowledge with them. She said their experience helped to form a
level of trust and confidence necessary for physicians to feel
comfortable including PAs in their practice of medicine. PA
training is one year of basic sciences and one year of clinical
training before graduation. She opined that most PA training
programs today do not have the significant depth and wealth of
experience that the original PA students had.
DR. HORNBERGER said a PA with 4,000 hours of post-graduate hours
of specific experience does not equate with a medical school
graduate with over 8,000 hours of training plus 6,000 hours or
more of residency hours. Thus, she said, to request to remove
the requirement of working under a collaborating physician after
4,000 hours of experience is inappropriate. She said, keeping in
mind the need for patient safety and adequate knowledge to
provide medical care, the minimum equivalent of four years of
medical school and two years of family medicine residency are
roughly 14,500 hours minimum.
1:56:26 PM
KATHERINE VAN ATTA, representing self, Wasilla, Alaska, said she
has served as a PA for 18 years and she has also been a
Certified Nurse-Midwife (CNM) for five years. She said her
health care training has included two bachelor's degrees, two
Master's degrees education and a post-graduate fellowship during
which she served as a PA for four years, embedded in a physician
residency program working alongside physician residents. She
said she worked in a variety of positions in Alaska over the
past 15 years including almost three years on Adak Island in the
Aleutians, which is 1200 miles from the nearest accessible
physician or hospital. She said she currently divides her time
between working as a PA at a rural clinic in Bristol Bay and as
a CNM in the Mat-Su valley. She said she is also a courtesy
faculty member at the University of Washington, educating
Washington, Wyoming, Alaska Montana, Idaho (WWAMI) medical
students. She sought to make two main points.
1. Modernizing the statutes and regulations is a good idea.
She said there was a recent effort to modernize PA
regulations, but while the effort was appreciated, the
result was terrifying because the new proposed regulations
would have made it virtually impossible for PAs to work in
rural areas at all. The statutes would have eliminated
nearly 50 percent of the providers at the rural clinic
where she currently works. Instead of improving care, they
would have dramatically decreased access to care for rural
Alaskans.
2. As a Certified Nurse-Midwife (CNM), she said she is
licensed to practice independently as an Advanced Practice
Registered Nurse (APRN). She said some of her clients will
have to have cesarean sections and other procedures that
she does not do, which does not impair her ability to do
her job or collaborate when needed.
1:58:49 PM
KEILS KITCHEN, representing self, Anchorage, Alaska, said he has
worked as a PA in Alaska for the last 15 years, both in
Anchorage and remotely. He promoted removing the requirement for
[a formal] relationship between a PA and collaborating
physician. He noted that it is difficult to recruit medical
providers, physicians, PAs, or NPs to work in remote villages in
Alaska. The sites and communities present challenges unlike
anywhere else in the U.S. He said many of the communities do not
have enough funding available to attract physicians to work in
their clinics as providers or as administrator/medical director.
He said the current PA regulations prevent clinics from hiring
PAs due to the requirement for collaborative practice agreement
with a specific physician. He shared his experience of having
worked in clinics who were unable to renew his contract when the
physician/medical director left. The clinic could only consider
[hiring] NPs since NPs are allowed to practice without a
collaborative plan. The NPs that were hired were from out of
state and significantly less experienced in remote Alaska
medicine. He said hiring websites for remote Alaska show many
jobs that will only consider NPs due to the increased
requirements and administrative burden associated with employing
PAs. He said SB 115 would remove those administrative burdens
and allow those clinics to utilize experienced PAs along with
NPs to provide care to the underserved communities and increase
the pool of potential providers. He urged the committee to
support SB 115.
2:00:58 PM
JONATHAN TOWER, representing self, Anchorage, Alaska, said he is
a PA practicing in Anchorage, having graduated from MEDEX, a
program collaboratively taught with the University of Washington
(UW) between the University of Alaska Anchorage (UAA) campus and
the UW campus in Seattle. He said the past 5 years he has worked
as a cardiology PA. He thanked the committee hearing SB 115 and
sought to address Senator Dunbar's question about how many hours
would be sufficient [to prepare for] unsupervised or
uncollaborative PA practice within a specialty environment. He
said his current practice as part of a highly developed medical
team working directly with physicians who are on-call. He said
the current collaborative agreement requires that he designate
several of the physicians as his collaborators, though those
doctors may not be on shift with him and at the end of the year,
they are required to go through charts. He said the physicians
would have been required to sign off on these charts as part of
the existing modern collaborative medical environment. He opined
that it would not be reasonable to assign an arbitrary number of
hours as a measure of competency in a collaborative environment.
He said PAs are trained to be collaborative providers as are all
modern providers and collaboration is inherent in any
profession. He suggested that an administrative hurdle should
not be required to demonstrate a PAs ability to perform their
roles admirably in generalist or in specialist roles.
2:02:57 PM
DAVID WILKERSON, representing self, Anchorage, Alaska, said he
had worked as a PA for ten years and had graduated from MEDEX.
He served as an Army PA Lieutenant for three years as well as in
primary care settings, fast track settings, CDC, private
individuals, corporate companies, federal government and
contracting roles. He found during the Covid-19 response his
practice included multiple specialties and that he had over
2,000 hours in a number of them. He told about working as a
contracted employee during the Covid-19 response, primarily in
administrative roles that required a PA license to review
diagnostic tests. He said these positions were non-treating, low
acuity and in some cases, no direct patient care, but it was so
difficult to find physicians who would agree to sign off as
collaborators with PAs, though these roles were critical for
medical care during the response to Covid-19. He said that,
though a lot of requirements were removed nationally for
licensure [to facilitate Covid-19 response] the scramble to find
a collaborative agreement in order to practice was very
cumbersome. He urged passage of SB 115 to make it easier for PAs
to practice.
2:05:25 PM
PAM VENTGEN, Executive Director, Alaska State Medical
Association (ASMA), Anchorage, Alaska, said she worked in the
medical field all her adult life. She was a clinical medical
assistant, managed medical offices, worked for the medical
board, taught in the allied health programs at the University of
Alaska. She said the Alaska State Medical Association (ASMA)
opposes SB 115 in its current form. She said the ASMA's position
is that the collaborative relationship between physicians and
PAs must be a formal relationship. She reported that physician
members of the ASMA board were shocked and appalled to learn
that some PAs reportedly had to pay physicians to serve in that
collaborative relationship. She said ASMA agrees the need for an
alternate collaborative agreement is cumbersome and of little
benefit. She said they agree there is a need to update the
regulations for PAs. They agree there is a need to better define
remote locations and practice agreements in Alaska. She said
ASMA would like to work collaboratively with the Physician
Assistant Association and academy, the medical board and with
physicians to update and modernize these regulations. She said
ASMA believes SB 115 is not the best way to do so. She urged the
committee to hold SB 115 and promote collegial negotiations to
resolve the very real issues and concerns on the table.
2:07:41 PM
CHAIR BJORKMAN asked whether there had been any negotiations
since January about the concepts and ideas between ASMA and the
PA associations.
2:07:54 PM
MS. VENTGEN answered there had not. She reported that the
medical board was very challenging to work with. She said the
chairman of the medical board resigned effective March 1st.
2:08:33 PM
ALISON STARR, representing self, Kodiak, Alaska, said she
practices all over Alaska as a primary care PA and has served in
multiple rural locations. She said she often practiced in remote
settings where there was not a physician available for miles.
She also had jobs where she never met her collaborating
physician, and the relationship was simply to "check a box" for
employment or licensure. She said her employers obviously trust
her scope of practice to care for rural and underserved
communities. She opined that it is a waste of resources and
money to continue to require experienced PAs who have over 4,000
clinical hours have a written agreement with a physician. She
said this requirement further limits access to health care for
rural and underserved communities. She said advanced practice
colleagues, including NPs do not have this restriction and are
able to practice independently as soon as they graduate from
their training programs. She said the current regulations often
restrict experienced PAs from other states from practicing or
relocating to Alaska, especially rural and underserved Alaska
where she said it is already so difficult to get health care. It
also keeps PAs from other places from coming to Alaska because
it is difficult for them to find a collaborative physician when
they are applying for initial licensure, further limiting access
to high quality health care in Alaska.
2:10:34 PM
JON ZASADA, Director, Government and External Affairs, Alaska
Primary Care Association (APCA), Anchorage, Alaska, said the
APCA enthusiastically supports SB 115. He said health centers
have been pioneers in the institution of PAs as core primary
care providers in their practices for decades. He reported that
in 2022, 82 PAs provided care to over 7,000 patients through
72,000 visits. He said PAs account for one third of all the
Community Health Centers (CHC) medical providers in Alaska. He
said APCA believes SB 115 creates a valuable opportunity to
expand access to care in communities across the state and
enables the valuable providers to practice independently to the
full extent of their experience. he said SB 115 addresses an
acute challenge in serving patients. He expressed confidence
that PAs would continue to consult and collaborate with
physicians and other members of their patient care teams to
improve health.
2:11:59 PM
CHRIS MILLER, representing self, Juneau, Alaska, urged the
committee to move SB 115 forward. He said he was a practicing PA
in dermatology for 23 years in Juneau and Southeast Alaska,
treating thousands of patients. He said he delivered high-
quality, dermatological care to a medically underserved region.
He said he is very proud of the differences his practice had
made for people in Southeast Alaska communities. Without the
passage of SB 115 this session, Mr. Miller said he would no
longer be able to provide care for his patients after the
retirement of his collaborating physician in June. He said his
circumstances highlight the urgency and importance of SB 115. He
said he has been trying to secure another collaborating
dermatologist agreement for three years and the fact is there
are not enough dermatologists in the United State, much less
Alaska. Despite his decades of experience and value to the
communities he has served, the retirement of his collaborating
physician will shut him down and the practice will close. He
said he was sincerely concerned for the ongoing care of his
patients. He said SB 115 was his last hope to continue providing
services for his patients. He urged that SB 115 be moved forward
for a vote.
2:13:37 PM
SENATOR DUNBAR asked whether Mr. Miller could say at what point
in his dermatology practice he gained enough experience to
practice without a collaborative agreement. He acknowledged that
PAs are required by law to have a collaborative physician
agreement. He asked at what point he would have been comfortable
practicing without the agreement.
2:14:26 PM
MR. MILLER said people continue to learn throughout our careers.
He acknowledged that even after so many hours, he would not be
"ready" to practice completely independently. He said he knows
he doesn't know everything, but he knows what he knows, and he
knows to get help when he doesn't know. He said that awareness
is incumbent on any PA or physician. He said practitioners can't
know everything and need to be able to get help. He said after
two years [of collaborative practice] he was able to offer a
wide breadth of service.
2:15:32 PM
MARY SWAIN, CEO, Cama'i Community Health Center, Naknek, Alaska
said the Cama'i Community Health Center's scope of practice is
primary care, age 0 to end-of-life, as well as urgent and
emergent care. She said the health center is the receiving
facility for all 911 and EMS emergencies in their borough. Last
year they saw 214 patients in the ER and over 3000 patient
visits in total. She expressed full support for SB 115 for their
health center. She said the health center had not been able to
employ a physician for 15 years due to their remote location.
They employ PAs and NPs, and they need practitioners who are
able to practice to the full spectrum of the patients they see.
She said they must have primary care and extensive emergency
medical care training to work in their rural facility. She said
they pay, on a contract basis, two physicians to collaborate for
any PA. They are both highly trained physicians with over 60
years of experience between them. She said that in this time of
increasing inflation and flat funding for health centers
nationally, she is faced with the real decision of potentially
being unable to keep a PA due to the cost of the physician's
contracts for collaborative agreements. In addition, the time
required to file a collaborative agreement and have it approved
by the State of Alaska is problematic for her clinic. A recent
example was that a provider scheduled to work in September was
not able to work because her collaborative plan was not approved
in time. She asserted that other states are modernizing PA
requirements and she expressed enthusiasm for Alaska to follow
suit and for passage of SB 115.
2:17:48 PM
MARK RESTAD, representing self, Homer, Alaska, said he has been
a PA since 1995, practicing in Tok, Fairbanks, Kotzebue, and for
many years on the Kenai Peninsula. He said he works in primary
care in Homer and in Kenai. He is in support of SB 115. The
clinic where he works has been trying to hire another PA for
several months and finding a collaborative physician and getting
all the arrangements made has been rigorous and requires
extensive time. He said he had taken the board exam to be a PA
several times and he reported that it encompasses primary care
and specialty care. He asserted that to pass the exam required
that a provider be well-rounded [in their education and
experience]. He recommends that new PAs begin by practicing in a
general care setting for a year instead of a specialty setting
to get their practice style down before they pursue their
special area of interest. He opined they could then return to
primary care later. He expressed concern about PAs who go to
Anchorage to practice specialty care and then want to go "home"
to a community they were from and enter a supervised position.
He said he thought that was redundant and inefficient.
2:19:49 PM
FOLUSHO OGUNFIDITIMI, D.M., President, American Academy of
Physician Associates (AAPA), Daytona Beach, Florida, said the
AAPA is the national professional society of PAs across the
nation, representing about 168,000 PAs across all medical and
surgical subspecialties in all 50 states, the District of
Columbia, U.S. territories and the uniformed services. He said
the APAA supports SB 115. He said he had over 23 years of
administrative and clinical experience in health care
administration and urology. SB 115 would eliminate outdated
administrative burdens and allow PAs to practice to the full
extent of their education, training, and experience. He said
about 40 percent of Alaskans live in regions without adequate
access to primary care and urged that all can agree that is
unacceptable. As trusted, highly qualified professional
clinicians who often serve patients in primary care settings,
PAs are ready to do their part to expand patient access to care.
He referred to a recent Harris Poll survey finding that 91
percent of U.S. adults agree that PAs are part of the solution
to solve the shortage of health care providers across the
country. He said there are more than 800 licensed PAs in Alaska
who practice in all settings and specialties and to recruit and
retain more PAs, Alaska needs to update its PA practice laws. He
said SB 115 is an essential step to update PA practice
legislation to align legislative language with the way PAs
currently practice as trusted members of the health care team.
He said SB 115 would modernize PA practice in Alaska, allowing
PAs with more than 4,000 hours [of collaborative service] to be
exempt from collaborative agreement requirements. He emphasized
that SB 115 would not change the day to day care provided by PAs
and that PAs would continue, like all health care providers to
refer, consult and collaborate with physicians to ensure needed
care delivery.
2:22:09 PM
SENATOR DUNBAR referred to states that have already eliminated
collaborative agreement requirements. He asked whether they have
seen a change in the rates for malpractice insurance. He also
asked whether there was a difference in malpractice insurance in
those states for PAs that do primary care versus those who
specialty care.
2:22:39 PM
MR. OGUNFINDITIMI said there has not been a significant change
in malpractice insurance coverage or claims in states that had
reduced or eliminated the direct tether between a PA and a
physician. He explained that he says "direct tether" because
there would not be a complete break in the relationship with
physicians. He said it is about PAs being able to practice to
the fullness of their education and knowledge without the
administrative barriers [of direct collaborative agreement
requirements]. He said there was a recent study published in the
Journal of Medical Regulation that examined ten years of medical
malpractice payment reports from national practitioner database
that found that states where barriers to PA practice were lifted
maintained patient safety and made it easier to access high
quality, cost-effective care. He said there was over ten years
of data to suggest that lifting the barriers appeared to improve
as opposed to worsen malpractice claims.
2:23:48 PM
CHAIR BJORKMAN thanked testifiers for public input.
2:24:16 PM
MAGUERITE MCINTOSH, M.D., representing self, Sterling, Alaska,
said she has practiced as a physician in Alaska for over 23
years and has practiced with several PAs. She said her
relationship with them was not a monetary relationship; she
never charged for her collaboration with them. She said the PAs
had extensive experience and she was always impressed with their
knowledge and capabilities, and she supported SB 115 and it's
intent to relieve the administrative burden they now have. She
said she is currently working with a PA specializing in
substance abuse medication and he is teaching her from his
extensive experience. She said physicians can learn from and
collaborate with PAs just as they collaborate with specialists
when necessary.
2:25:59 PM
DALE WALASZEK, representing self, Kasilof, Alaska, said he has
been a PA for 27 years and worked in a variety of clinical
situations in extremely remote Alaska as well as civilian and
military worlds and in New Mexico. He echoed that PAs can work
independently without direct physician oversight or having a
collaborative agreement and provide excellent service and care
to patients. He has never had a malpractice lawsuit in 27 years,
despite working in pretty tense situations at times. He
appreciated the experience of reaching out and collaborating
with fellow colleagues in different areas of medicine to provide
the best care for patients.
2:27:06 PM
JOHN MOORE, representing self, Willow, Alaska, said he is
working part time as a PA, though trying to go back to work has
been an ordeal. He said his friend and colleague runs a clinic
and is a PA. The friend's collaborating physician refused to
take Mr. Moore on [as an additional collaborative PA] because of
the added responsibility. He said the fee to collaborate with
other physicians was exorbitant. He said it would have been less
expensive to hire a NP for the clinic because of the requirement
for a collaborative physician agreement. He supports SB 115
wholeheartedly because there are many people in need of health
care who do not receive health care. He noted that other states
have not experienced negative outcomes by granting PAs greater
autonomy. He said he would like to go back to work but is
hindered by the current regulations. He said there are people
who need care that PAs could provide.
2:29:10 PM
RICK BLAKE, representing self, Wasilla, Alaska said he currently
works at Cottonwood Clinic and has worked as a PA in Alaska
since 2000. He said PAs and other medical providers are trained
and constantly collaborate with other providers in all areas get
the information they need to provide the best care to the
patient. He urged the committee members to understand that even
if the working relationship is "untethered" practitioners
collaborate constantly in all fields of medicine.
2:30:12 PM
MARIA ROLLINS, representing self, Anchorage, Alaska, serves as a
psychiatric PA for one of Alaska's most underserved populations.
She said she has served for eight years at the Alaska
Psychiatric Institute (API). She said her work focuses on
providing crucial mental health services in Alaska. She said
supporting SB 115 is imperative to modernize the PA profession
in Alaska. It is essential to providing access to essential
health care, including vital psychiatric services. In her years
of practice at API she said she has encountered countless
barriers, not by the complexities of mental health conditions,
but by outdated statutes and regulations that restrict the
ability to offer care to the full extent of a PAs education,
training and experience. These limitations, such as the
exclusion of PAs to be listed as mental health professionals in
AS 47.39.15, does not just hinder the professional's
capabilities, but also significantly affect the wellbeing of the
communities they strive to serve, where access to psychiatric
care is often a matter of urgency. She advocated defining the
scope of practice for PAs at the statute level and removing the
requirement for collaborative plan, crucial in psychiatry. She
said these changes are vital, especially in rural and remote
areas where psychiatric services are scarce, and the rates of
mental health issues are often higher than the national average.
She said the changes proposed by SB 115 would allow psychiatric
PAs like her to fill critical gaps in mental health care, reduce
wait times for psychiatric services and ultimately save lives.
As a PA she is trained to diagnose, treat and manage complex
mental health conditions safely and effectively. Evidence from
other state with modern PA practices support that PAs can
significantly improve access to mental health care without
compromising the quality of care provided.
2:32:12 PM
CHAIR BJORKMAN closed public testimony on SB 115 and sought the
will of the committee.
2:32:23 PM
SENATOR MERRICK moved to report CSSB 115(HSS), work order 33-
LS0542\U, from committee with individual recommendations and
attached fiscal note(s).
2:32:38 PM
CHAIR BJORKMAN found no objection and CSSB 115(HSS) was reported
from the Senate Labor and Commerce Standing Committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB115 Public Testimony-Combined 02.28-03.12.24.pdf |
SL&C 4/5/2024 1:30:00 PM |
SB 115 |
| SB115 Sectional Analysis -corrected- ver U 03.05.24.pdf |
SL&C 4/5/2024 1:30:00 PM |
SB 115 |
| SB135 Public Testimony-ACLI Letter Opposing 02.14.24.pdf |
SL&C 4/5/2024 1:30:00 PM |
SB 135 |
| SB135 Public Testimony-Letters of Support 04.05.24.pdf |
SFIN 5/10/2024 9:00:00 AM SL&C 4/5/2024 1:30:00 PM |
SB 135 |
| SB135 Blank Draft Proposed CS ver U.pdf |
SL&C 4/5/2024 1:30:00 PM |
SB 135 |
| SB135 Public Testimony-Letter_NFIB opposition 04.03.24.pdf |
SL&C 4/5/2024 1:30:00 PM |
SB 135 |
| SB115 Public Testimony-Letter_ACEP_Opposition 04.02.24.pdf |
SL&C 4/5/2024 1:30:00 PM |
SB 115 |
| SB115 Public Testimony-AMA Issue Brief_Summary of Studies.pdf |
SL&C 4/5/2024 1:30:00 PM |
SB 115 |