Legislature(2019 - 2020)BUTROVICH 205
03/06/2020 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB120 | |
| SB179 | |
| SJR13 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 120 | TELECONFERENCED | |
| += | SB 179 | TELECONFERENCED | |
| += | SJR 13 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 179-NURSING: LICENSURE; MULTISTATE COMPACT
1:33:08 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 179, "An Act relating to the
licensure of nursing professionals; relating to a multistate
nurse licensure compact; and providing for an effective date."
He noted the committee first heard the bill on February 28,
2020. He stated his intention to hear both invited and public
testimony.
1:33:43 PM
ROSE LAWHORNE, Chief Nursing Officer, Bartlett Regional
Hospital, Juneau, Alaska, said she has been in health care for
nearly 30 years. In the last decade, she has been in a
management role. Health care facilities, especially in remote or
isolated locations, would benefit from the state joining the
Nurse Licensure Compact. She described and instance last
December when Bartlett Regional Hospital experienced a loss of
staff and an increase in the number of influenza patients. The
hospital struggled with skeleton crews and needed nursing help
immediately. Patient flow, safety, and capacity are negatively
affected when licensure processing time is delayed, sometimes up
to four months. She acknowledged that temporary licensing offers
one strategy, but it does not eliminate screening delays and
adds duplicative costs and processes.
She said the increased cost of an interstate license via the
compact would offer a permanent multistate license. Licensure
issues can reduce the hospital's ability to provide
uninterrupted care to patients without overloading existing
staff. Maintaining multiple licenses is cumbersome and costly
and is a deterrent to nurses selecting work destinations.
MS. LAWHORNE said the Nurse Licensure Compact supports a healthy
workforce and offers a broad resource pool for recruitment of
nurses. Specialty areas such as the operating room, recovery
room, infusion therapy, and oncology experience recruitment
challenges. During disasters or typical influenza outbreaks,
such as with the coronavirus, rapid mobilization of qualified
nursing staff is essential for continuity of operations. Shared
resources must be facilitated in whatever manner possible.
MS. LAWHORNE said the Nurse Licensure Compact will help fill
existing gaps in nursing resources and serve as a recruitment
tool. It is not uncommon for traveling nurses to come to Juneau
and decide to stay, which will keep dollars in Alaska that would
otherwise filter out to contract workers.
MS. LAWHORNE said that in the growing world of telemedicine,
licensure compacts facilitate effective and efficient use of
nursing resources, provide interstate educational opportunities
and collaboration for hospitals.
MS. LAWHORNE said demand for nurses is expected to grow. She
expressed concern that the nursing workforce deficit will grow
and jeopardize patient care unless the state acts. She asked
members to support SB 179.
1:38:10 PM
JIM REINEKE, Chief Nurse Executive, Providence Alaska Medical
Center, Regional Chief Nursing Officer, Providence Health and
Services Alaska, Anchorage, Alaska, said the mission of the
Alaska Board of Nursing is to actively promote and protect the
health of the citizens of Alaska through the safe and effective
practice of nursing as defined by law. Alaska's participation in
the Nurse Licensure Compact supports that mission in a manner
that provides greater opportunity for nurses considering Alaska.
A recent poll showed that over 600 nursing positions are open.
This number cannot be realistically filled with the current
registered nurse workforce or by Alaska's projected number of
nursing program graduates.
MR. REINEKE said Providence Medical Center, the state's largest
health care facility, has experienced 180 vacancies in specialty
areas, such as critical care, emergency service, and
cardiovascular care. He expressed concern for patients in
Kodiak, Seward, and Valdez for acute care, long-term care, and
home health care services. He offered his view that
participating in the compact would remove a barrier to
recruitment for nurses for short-term assignments and for long-
term, permanent employment, which is good for nurses and for
Alaskans.
MR. REINEKE said having a larger pool of nurses who can join the
workforce in a rapid manner will provide a more flexible and
sustainable nursing workforce in Alaska. This does not adversely
impact Alaskan nursing graduates from becoming licensed or
finding work in Alaska. It would also provide a more attractive
option for nurses during the tourism season.
MR. REINEKE said he would like to eliminate the need for
traveling nurses. He currently has 85 traveling nurses across
his system. Although traveling nurses do not impact the wage
scale for Providence nurses, the cost of agency staffing does
impact the overall labor cost of care. He said waiting for
nurses coming to Alaska to gain their licenses jeopardizes care.
He said the NLC is attractive to novice and experienced nurses
who to come to Alaska. There is a need for more seasoned,
experienced nurses, particularly in specialty areas.
MR. REINEKE said inclusion in the compact also provides a
recruiting opportunity for those experienced nurses who decide
to become faculty members or consider an advanced practice
opportunity in the state's changing health care atmosphere.
There are additional opportunities for Advanced Practice
Registered Nurses (APRNs) as Alaska moves outside of facility-
based care.
MR. REINEKE said prior to joining Providence Alaska Medical
Center, he was an active duty military nurse for 30 years. His
final assignment was as chief nurse at Joint Base Elemendorf-
Richardson. In that role, he has seen barriers to military
members and their spouses. A separate, Alaska-only license
delays individuals who are stationed in Alaska from rapid
employment despite clear, unrestricted licenses in other states.
Nurses who come to Alaska for a single assignment are often
reluctant to obtain a single-state license for one stay,
especially if these nurses are seeking part-time or registry
positions. The need for an Alaska license for clinical care in
those sites not covered by federal supremacy negatively impacts
collaboration for training for military nurses.
MR. REINEKE said inclusion in the compact does not negate the
appropriate review of applications. Rather, it provides a
consistent, timely process that is accepted by the majority of
Boards of Nursing nationwide. The responsibility of nurses to be
aware of and accountable to Alaska Nurse Practice Act will
continue, as does the need of facilities to ensure, safe
appropriate practice by nurses under their employ. As a member
of the compact, Alaska's administrator can vote on rules and
bylaws as a member state. This national collaboration provides a
venue for action and discussion on the current practice of
nursing in a broader forum and ensures Alaska is a partner for
national impact. It will allow Alaskan nurses to provide their
expertise on rules and policies on rural and frontier nursing
issues. He asked the committee to support SB 179, which will
support nurse, nursing, and access to care for Alaskans.
1:45:35 PM
CHAIR WILSON opened public testimony on SB 179.
1:45:58 PM
BETH FARNSTROM, Director at Large, Alaska Nurses Association,
Anchorage, Alaska, said she has been an RN for 40 years. She
served on the state Board of Nursing for eight years. Since
2007, she has been familiar with the nurse compact. The Nurse
Licensure Compact was started so nurses in states with
connecting borders could drive a short distance and work in
another state. A license to practice in multiple states sounds
great, but it is not that simple. She did not find the NLC
comparable to the driver license compact. Anyone who makes this
comparison is not aware of Alaska nursing statutes and
regulations and the complex profession of nursing. Historically,
employers have said it takes too long for some nurses to get
licensed in Alaska. As of July 2019, nursing applications are
submitted electronically, which gives applicants immediate
knowledge of any deficiencies in the application that could
cause a delay. Alaska has a diligent Board of Nursing and staff.
At the February 2020 Board of Nursing meeting, the board stated
that licensing can be done in a few weeks if an applicant has
properly completed the online application.
MS. FARNSTROM said the governor letter of support for the
nurse compact said the multistate requirement are rigorous,
exceeding those of Alaska's. After comparing the uniform
licensure requirements that compact states must adopt, the
Alaska Nurses Association disagrees with this statement. Many
compact states do not require continuing education. Alaska
values current nursing education and requires 30 contact hours
every two years for license renewal. SB 179 is not needed in
Alaska, she said.
1:48:41 PM
JANE ERICKSON, President, Alaska Nurses Association, Anchorage,
Alaska, said she has been a nurse over 32 years and works in
adult critical care at Providence Alaska Medical Center. She did
not believe that any state using the NLC can show data that
joining the compact has eliminated or reduced their nursing
shortages. Alaska nursing regulations can address health
emergencies and the board can expedite licensure for nurses. In
February and March 2007, there was a severe respiratory
infection in the northern villages that required more nurses.
The Board of Nursing successfully met the licensing needs by
using the regulation of courtesy licensing, under 12 AAC 44.318.
Alaska is part of the Emergency Management Assistance Compact
that allows full transferability of professional licensing for
disaster response.
MS. ERICKSON said military spouses have time to apply for their
Alaska license. If a nurse moves to Alaska and declares Alaska
as the primary address, the compact requires that the licensee
must apply for an Alaska compact license. Often military spouses
are employed on bases or in the Veterans Administration system
and can begin working using their out-of-state licenses. Alaska
licensing protects its citizens and the Board of Nursing staff
does an exceptional job. Employers, such as dialysis clinics,
are interested in the compact licensure because these clinics do
not want to pay for another state's licensure, which is an
employer business expense. The mission of the Board of Nursing
is to keep the public safe. If Alaska joined the NLC, nurses may
leave the state to work in another compact state, which would
increase the Alaska nursing shortage. Joining the compact will
increase the $200 [biennial] nurse license fees. She offered her
view that Alaska already has one of the highest license renewal
fees. She estimated that the additional license fees under the
compact were estimated at $60. In closing, she said the compact
will not bring more nurses to Alaska.
1:51:29 PM
SARA MASSMANN, Legislative Co-Chair, Alaska Nurses Association,
Ketchikan, Alaska, said she works fulltime as a permanent nurse
in the Intensive Care Unit at the PeaceHealth Medical Center in
Ketchikan. The committee heard testimony in opposition to the
compact from some Alaska Nurses Association members. Ketchikan
has never had an issue employing enough traveling nurses who are
already licensed in Alaska nor have nurses needed to delay their
start date awaiting licensure in Alaska. PeaceHealth permanently
employs U.S. Coast Guard spouses as registered nurses. These
nurses have given her sufficient notice upon receiving orders
for new destinations and had plenty of time to obtain their
nursing license in the new state. She has not heard of any
problems nurses had transitioning to Alaska.
1:53:35 PM
LYNDA MCCARTY, Health Care Representative, Anchorage Laborer's
Local 341, Anchorage, Alaska, said the Laborer Union opposes
SB 179. She offered her opposition to SB 179 as a registered
nurse. She expressed a number of concerns, including a loss of
state sovereignty by ceding to the compact's regulations, a
decrease in revenue from license applications, difficulty
monitoring nurses who come to Alaska to practice nursing, and
safety concerns. Under current guidelines from the Board of
Nursing, she must complete 30 hours of continuing education each
renewal period to keep up to date with changes in health care.
She graduated from nursing school four years ago and the
practices she learned are no longer considered best practices.
Some compact states do not require any continuing education for
nurses for license renewal. Eight states, plus one pending
legislation, require zero continuing education for renewal, and
five, plus one pending legislation, require 15 hours or less in
a two-year period. This falls far short of Alaska's continuing
education requirements. Becoming a compact state would not
inspire a culture of safety in hospitals, long-term care
facilities, or clinics. Alaska needs competent nurses to fill
critical positions. She offered her belief that the board needs
an overhaul. Joining the compact would dilute Alaska's strong
workforce and lower safety standards.
1:56:15 PM
NICOLE LIVANOS, Senior Associate, State Advocacy and Legislative
Affairs, National Council of State Boards of Nursing, Chicago,
Illinois, said she wanted to focus on the basics of the Nurse
Licensure Compact (NLC). The NLC was created in the late 1990s
and has been operational for almost 20 years. It is safe,
proven, and successful in addressing licensure mobility issues
in its 34-member states. About five years ago, other health care
professionals viewed the NLC as a model for building their
compacts. Today, there are six health care licensing compacts at
different stages of enactment. State lawmakers are considering
compacts for various health care professions to update the
nearly 100-year old licensure system that does not provide
flexibility for practitioners or patients demanded by today's
health care landscape.
1:57:44 PM
Ms. LIVANOS said the specifics of the NLC are best considered in
relation to the 29 other compacts in Alaska. The governing
structure for the NLC is an interstate commission. It is a
nongovernmental agency charged with administration of the
compact. The commission is comprised of one administrator from
each participating state who vote on commission business. The
commission's ability to make rules is limited to rules needed to
facilitate and coordinate implementation and administration of
the compact. Just as under Alaska's other compacts, these rules
are binding and have the force of law. The commission's meetings
are public, with notice, comment, and opportunity for public
hearings. The NLC has almost 20 years of proven safe mobility of
licensure and the NLC helps facilitate access to care across
states.
1:58:57 PM
DANETTE SCHLOEDER, Chair, Alaska Board of Nursing, Anchorage,
Alaska, said people are privileged to live in a country of
borderless health care. Any Alaskan can get care in Alaska or
can seek care outside of Alaska. Alaska does not offer every
innovation in health care. The Board of Nursing is committed to
find ways to advance the practice of nursing and allow nurses to
work safely across borders and protect the health and safety of
residents by ensuring that Alaska has the nurses to meet health
care needs.
2:00:23 PM
JARED KOSIN, President and CEO, Alaska State Hospital and
Nursing Home Association, Anchorage, Alaska, said SB 179 will
help avoid delays during the licensing process and allow nurses
to get to work quickly and more efficiently. Based on a survey
conducted in November, the state has over 670 nursing vacancies
in hospitals and nursing homes across the state. This bill will
provide a tool to help address shortages, which could be
especially useful for emergency preparedness and disaster
relief. It is good for military families because it allows
military spouses who are nurses to continue working each time
the family relocates.
2:01:34 PM
WENDY SCHRAG, Director of Advocacy and State Government Affairs,
Fresenius Medical Care, Wichita, Kansas, said several weeks
time to get a temporary license is not fast enough for dialysis
because patients need treatment three times a week. Fresenius is
supportive of the compact because there may be times when it
needs to bring nurses in quickly. If the coronavirus gets worse
and staff is impacted, it will be important to bring people in
quickly. When the enhanced version of the NLC was issued, all
member states rejoined. Since then, about eight more states have
joined the NLC, which shows that states that participate in the
compact find that it is working.
2:03:03 PM
BRIAN NORTON, Registered Nurse and Clinic Manager, Fresenius
Medical Care, Anchorage, Alaska, said his company provides
dialysis and kidney care to 334 patients in Anchorage,
Fairbanks, Juneau, Soldotna, and Wasilla. He came to Alaska as a
traveling nurse but had ample time to gain licensure before
coming to Alaska because there was no crisis. Currently, his
company employs 36 nurses and has 12 openings that it struggles
to fill. Medicaid regulations require that nurses have six
months of experience with dialysis before the nurses can
independently care for patients and newly graduated nurses must
have 12 months of dialysis experience.
He recalled at the last hearing questions arose about wages. The
compact would not change his company's hiring methods, but
nurses holding a compact license would have an advantage because
of the ease in locating them and their ability to start working
quickly, minimizing negative impacts to patient care. Currently,
his company acquires staff through three different methods:
external travel nurses, Alaska-based permanent employees, and an
internal traveler program. All nurses receive competitive wages.
External traveling nurses are paid through their agency.
Dialysis nurses receive overtime after an eight-hour shift. The
company completes background checks on all new employees.
According to a recent study by 2030, Alaska will be the state
with the highest percentage of nursing vacancies at 23 percent.
2:05:46 PM
TAMMIE PERRAULT, Northwest Regional Liaison, Department of
Defense (DOD), Joint Base Lewis-McChord, Washington, said
military families are an important community that provides
additional health care resources for Alaska. One goal of the
Department of Defense (DOD) is to remove barriers for military
spouses. The DOD wants to ensure additional capacity for the
professional careers and mobile lifestyles that military spouses
must endure for military service to country. Accordingly, the
DOD has encouraged state policymakers to engage in interstate
compacts to improve licensure portability options. In the case
of the nursing profession, 34 states have joined the enhanced
NLC. Thirty-four percent of military spouses are required to
maintain occupational licensure. It is a readiness issue for the
DOD because military spouses help to determine whether someone
will decide to stay in the military. A high percentage of
military spouses need occupational licensure in health care. In
a letter from DOD Secretary Mark Esper to the Council of State
Governors, he called on the governors to assist with ensuring
that that military spouses have access to special provisions
from states for licensure. He asked states to implement policies
that limit state-specific requirements for a wide range of
professions. He asked states to approve occupational interstate
compacts that allow licensure reciprocity for military spouses.
2:09:04 PM
KRISTY O'LAUGHLIN, representing self, Fairbanks, Alaska, said
she has worked for two of her 17 years as a registered nurse in
Alaska. She had had a compact license her entire career before
moving to Alaska. She said having a compact license means that
she can be in place to work in less than a week.
She said that when she came to Alaska, she paid nearly $500 and
waited several weeks to get her RN license by endorsement. She
fell in love with Alaska and is currently an Alaskan resident
and homeowner. Once she was hired, she was partly responsible
for hiring nurses. She reached out to a friend who is an
excellent nurse with a compact license. Due to the licensing
requirements, he found it was not worth his time to come to
Alaska. In November 2018, she had two traveling nurses lined up
to start. One nurse could start on time, but the other nurse's
license was delayed several months because of a backlog caused
by the earthquake, so her center was short staffed during the
holiday season. Concerns were raised at the hearing last week
about safety issues and criminal history issues. Every hospital
she has worked in has performed their own background checks.
Many nurses in Alaska are not licensed in Alaska because federal
facilities do not require a specific-state license. She urged
members to pass SB 179 because is important that Alaska join the
compact. If the state has a disaster and needs nurses, these
nurses could be on the next flight to Alaska.
2:11:49 PM
MINDY HURT, representing self, Wasilla, Alaska, stated agreement
with the Mr. Norton's testimony. She is the nurse manager of an
outpatient dialysis unit in Wasilla and dialysis patients would
greatly benefit from the Nurse Licensure Compact (NLC).
2:12:17 PM
AMANDA ROEDL, representing self, Solano County, California, said
she is a registered nurse with an active license in California
and inactive licenses in Alaska and Hawaii. She is a military
spouse whose husband is in the U.S. Coast Guard so her family
moves every two to three years. She works while her husband is
deployed, although it is difficult when licensure is state-
specific. SB 179 will allow military spouses to seamlessly
continue working without having to obtain a new license when
relocating. Each of her nursing licenses has a different
expiration date. Military families who are moving face many
obstacles. She is currently working in Solano County, which had
the first case of community-acquired Covid-19. She acknowledged
the demands that increase with each shift. She offered her
belief that Alaska can do something now to prepare for what is
coming. She offered her support for the NLC.
2:14:19 PM
KAREN LYON, representing self, Baton Rouge, Louisiana, said she
is the NLC commissioner for Louisiana and the executive director
and CEO of the Louisiana Board of Nursing. In July 2019,
Louisiana joined the NLC, which has been a positive experience
for nurses and employers. Louisiana has 65,000 active nurses.
The Louisiana Board of Nursing only regulates registered nurses
(RNs) and Advanced Practice Registered Nurses (APRNs). She
acknowledged Louisiana experienced some initial expenses to
implement the NLC, but the costs have not been problematic.
Louisiana is on target for 95 percent of its revenue with four
months left in the fiscal year. In Louisiana, she was the first
of 3,500 nurses who converted to the multistate license and she
found the transition seamless. Louisiana has not had any safety
issues and 350 nurses from Mississippi and 250 from Alabama who
had their multistate licenses are currently working in Louisiana
under the compact.
2:16:40 PM
CHAIR WILSON found no further testimony on SB 179.
2:16:53 PM
SARA CHAMBERS, Division Director, Division of Corporations,
Business and Professional Licensing, Department of Commerce,
Community and Economic Development, Juneau, Alaska, said the
compact is a critical piece of the large and complex health care
system in Alaska. The pressure of recent events, including
Covid-19, has highlighted this issue. Military spouses have been
requesting this change for the last several years. It is a
priority in basing decisions with the DOD. The Alaska State
Hospital and Nursing Home Association have urged the Board of
Nursing and the DCCED to move licensure forward as quickly as
possible. Although Ketchikan reported that it has no problems
hiring nurses, her division has received letters in the last
five years from Ketchikan PeaceHealth Medical Center stating it
was so desperate for nurses it might need to shut down its
emergency room. She characterized the NLC in SB 179 as an
important tool to lower costs, to give nurses more
opportunities, and above everything else, to improve patient
health in Alaska.
2:19:25 PM
SENATOR SHOWER said his wife is a nurse. He spent decades in the
military, so his family has experienced this firsthand. As an
operations officer and commander, he received feedback that this
is an issue for the military throughout the nation. It helps
spouses to get jobs when spouses are deployed. He understands
the bill quite well from the military perspective. He asked if
the bill would adversely impact Alaskans seeking jobs.
MS. CHAMBERS said this bill would increase job opportunities for
nurses in Alaska, not decrease them.
SENATOR SHOWER related his understanding that the consensus is
that nurses prefer to join the compact.
MS. CHAMBERS answered that an overwhelming majority of Alaska-
based nurses and union nurses support the compact.
2:21:25 PM
SENATOR GIESSEL asked how many nurses participated in the [Board
of Nursing] survey.
MS. CHAMBERS replied that more than 3,000 nurses participated.
SENATOR GIESSEL asked which licenses the participating nurses
held.
MS. CHAMBERS responded that the RNs and LPNs who would be
eligible to join the compact responded.
SENATOR GIESSEL observed that according to the last Board of
Nursing audit, at least 14,000 nurses were in that category. She
offered her belief that the survey was a small sample.
MS. CHAMBERS replied that it was well above statistical sampling
norms.
SENATOR GIESSEL noted that Ms. Chambers stated this would
increase nursing jobs, not decrease them, but the question was
whether this bill would decrease jobs for Alaskans.
MS. CHAMBERS responded that it will increase jobs for Alaskans.
Many nurses in Alaska would like to participate in telehealth or
telemedicine to augment their professional work. This bill will
increase nurses' ability to teach as nurse educators. It would
also give them an opportunity to work seasonally outside of
Alaska and still maintain their Alaskan nursing license. There
are many ways that this bill will assist Alaska nurses. New
nurses would like to join a compact state to lessen their cost
burden and some are leaving Alaska because it is not a compact
state. She offered her view that nurses would stay if Alaska
were a compact state.
SENATOR GIESSEL responded that the reason may be so that these
nurse can get jobs in other states.
MS. CHAMBERS said nurses want options.
SENATOR GIESSEL said Washington rejected the compact legislation
last week, which is of interest since Washington is the closest
state to Alaska. It has been pointed out that the compact would
be logical if Alaska were Iowa or Colorado and someone could
drive 30 minutes to be in another state. She said that after
reviewing the National Licensure Commission and the language in
the bill, she found that many legal questions have not been
addressed. She would like to explore the legal implications of
joining a compact. Although Alaska's executive director would
have a vote on the National Licensure Commission, it would only
be one vote so as the compact expands to other states, that vote
would be diluted. The National Licensure Commission is actually
a private entity in Illinois. She asked what it would cost to
join the commission.
MS. CHAMBERS answered that it would cost the state $6,000 a
year.
SENATOR GIESSEL pointed out that state money would be used to
fund a private, nongovernmental entity outside of Alaska that
would have jurisdiction and make decisions related to this
compact. She expressed concern that the legislature would not
have any jurisdiction over the NLC.
CHAIR WILSON said the committee should try to get their
questions answered by Legislative Legal Services.
SENATOR SHOWER asked if the Alaska Board of Nursing would lose
its ability to check on nurses.
MS. CHAMBERS replied the board would retain all of its existing
authority.
[CHAIR WILSON held SB 179 in committee.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 120 Public Input 3.5.20.pdf |
SHSS 3/6/2020 1:30:00 PM |
SB 120 |
| SJR 13 Public Input No. 1 3.5.20.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |
| SJR 13 Public Input No. 2 3.5.20.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |
| SB 179 SHSS DCEED Follow-Up Information 3.4.20.pdf |
SHSS 3/6/2020 1:30:00 PM |
SB 179 |
| SB 179 Public Input 3.5.20.pdf |
SHSS 3/6/2020 1:30:00 PM |
SB 179 |
| SB 179 Public Input 3.6.20.pdf |
SHSS 3/6/2020 1:30:00 PM |
SB 179 |
| SJR 13 Public Input 3.6.20.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |
| Lee_SB120_SHSS_03062020.pdf |
SHSS 3/6/2020 1:30:00 PM |
SB 120 |
| Bird_SJR13_SHSS_03062020.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |
| Lee_SJR13_SHSS_03062020.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |
| Brower_SJR13_SHSS_03062020.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |
| Rolph_SJR13_SHSS_03062020.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |
| Timlin_SJR13_SHSS_03062020.pdf |
SHSS 3/6/2020 1:30:00 PM |
SJR 13 |