Legislature(2023 - 2024)BARNES 124

05/06/2024 03:15 PM House LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Delayed to 10 Minutes Following Session --
+ SB 182 EXTEND BIG GAME COMM SERVICES BOARD TELECONFERENCED
<Bill Hearing Rescheduled to 05/08/24>
+ SB 234 EXTEND MARIJUANA CONTROL BOARD TELECONFERENCED
<Bill Hearing Rescheduled to 05/08/24>
+ SB 115 PHYSICIAN ASSISTANT SCOPE OF PRACTICE TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+ HJR 27 SUPPORTING CERTAIN US TRADE POLICIES TELECONFERENCED
<Bill Hearing Rescheduled to 05/08/24>
+= SB 89 AGE FOR TOBACCO/NICOTINE/E-CIG; TAX E-CIG TELECONFERENCED
Moved HCS CSSB 89(L&C) Out of Committee
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                         
                          May 6, 2024                                                                                           
                           7:10 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Jesse Sumner, Chair                                                                                              
Representative Justin Ruffridge, Vice Chair                                                                                     
Representative Stanley Wright                                                                                                   
Representative Mike Prax                                                                                                        
Representative Ashley Carrick                                                                                                   
Representative Dan Saddler                                                                                                      
Representative Zack Fields                                                                                                      
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CS FOR SENATE BILL NO. 89(FIN)                                                                                                  
"An  Act  relating  to   tobacco,  tobacco  products,  electronic                                                               
smoking  products, nicotine,  and  products containing  nicotine;                                                               
raising  the  minimum  age  to  purchase,  exchange,  or  possess                                                               
tobacco, a product containing nicotine,  or an electronic smoking                                                               
product;  relating to  the tobacco  use  education and  cessation                                                               
fund;  relating to  the taxation  of electronic  smoking products                                                               
and vapor products; and providing for an effective date."                                                                       
                                                                                                                                
     - MOVED HCS CSSB 89(L&C) OUT OF COMMITTEE                                                                                  
                                                                                                                                
CS FOR SENATE BILL NO. 115(HSS) AM                                                                                              
"An   Act  relating   to   physician   assistants;  relating   to                                                               
physicians; and relating to health care insurance policies."                                                                    
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 182                                                                                                             
"An  Act  extending   the  termination  date  of   the  Big  Game                                                               
Commercial Services Board; and providing for an effective date."                                                                
                                                                                                                                
     - BILL HEARING RESCHEDULED TO 5/8/24                                                                                       
                                                                                                                                
SENATE BILL NO. 234                                                                                                             
"An Act  relating to the  Marijuana Control Board;  and providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
     - BILL HEARING RESCHEDULED TO 5/8/24                                                                                       
                                                                                                                                
HOUSE JOINT RESOLUTION NO. 27                                                                                                   
Supporting trade policies for the  United States that hold China,                                                               
Russia,  and other  countries accountable,  reward leadership  in                                                               
clean   production  standards,   reward  superior   environmental                                                               
performance,  support  economic   development,  and  support  the                                                               
rebuilding of supply chains in the United States.                                                                               
                                                                                                                                
     - BILL HEARING RESCHEDULED TO 5/8/24                                                                                       
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB  89                                                                                                                  
SHORT TITLE: AGE FOR TOBACCO/NICOTINE/E-CIG; TAX E-CIG                                                                          
SPONSOR(s): SENATOR(s) STEVENS                                                                                                  
                                                                                                                                
3/1/2023 (S) READ THE FIRST TIME REFERRALS                                                                                      
3/1/2023 (S) L&C, FIN                                                                                                           
3/1/2023 (S) COSPONSOR(S): GIESSEL, GRAY-JACKSON, KIEHL, TOBIN                                                                  
3/24/2023 (S) LABOR & COMMERCE at 01:30 PM BELTZ 105 (TSBldg)                                                                   
3/24/2023 (S) Heard & Held                                                                                                      
3/24/2023 (S)  Minutes (SL&C)                                                                                                   
3/31/2023 (S) LABOR & COMMERCE at 01:30 PM BELTZ 105 (TSBldg)                                                                   
3/31/2023 (S) Heard & Held                                                                                                      
3/31/2023 (S)  Minutes (SL&C)                                                                                                   
4/3/2023 (S) LABOR & COMERCE at 01:30 PM BELTZ 105 (TSBldg)                                                                     
4/3/2023 (S) Heard & Held                                                                                                       
4/3/2023  (S)  Minutes (SL&C)                                                                                                   
4/21/2023 (S) LABOR & COMMERCE at 01:30 PM BELTZ 105 (TSBldg)                                                                   
4/21/2023 (S) Moved CSSB 89(L&C) Out of Committee                                                                               
4/21/2023 (S)  Minutes (SL&C)                                                                                                   
4/24/2023 (S) L&C RPT CS 4DP NEW TITLE                                                                                          
4/24/2023 (S) DP: BJORKMAN, DUNBAR, BISHOP, GRAY-JACKSON                                                                        
4/24/2023 (S)  FN1: ZERO(CED)                                                                                                   
4/24/2023 (S)  FN2: ZERO(ADM)                                                                                                   
4/24/2023 (S)  FN3: ZERO(ADM)                                                                                                   
4/24/2023 (S)  FN4: ZERO(DOH)                                                                                                   
4/24/2023 (S) FN5: (REV)                                                                                                        
4/24/2023 (S)  FN6: ZERO(DPS)                                                                                                   
4/24/2023 (S)  FN7: ZERO(LAW)                                                                                                   
5/4/2023 (S) FINANCE at 09:00 AM SENATE FINANCE 532                                                                             
5/4/2023 (S) Heard & Held                                                                                                       
5/4/2023  (S)  Minutes (SFIN)                                                                                                   
5/11/2023 (S) FINANCE at 9:00 AM SENATE FINANCE 532                                                                             
5/11/2023 (S) Moved CSSB 89(FIN) Out of Committee                                                                               
5/11/2023 (S)  Minutes (SFIN)                                                                                                   
5/11/2023 (S) FINANCE at 01:30 PM SENATE FINANCE 532                                                                            
5/11/2023 (S) <Bill Hearing Canceled>                                                                                           
5/11/2023 (S)  Minutes (SFIN)                                                                                                   
5/13/2023 (S) FIN RPT CS 3DP 2NR 1AM NEW TITLE                                                                                  
5/13/2023 (S) DP OLSON, KIEHL, BISHOP                                                                                           
5/13/2023 (S) NR: STEDMAN, MERRICK                                                                                              
5/13/2023 (S) AM: WILSON                                                                                                        
5/13/2023 (S)  FN1: ZERO(CED)                                                                                                   
5/13/2023 (S)  FN2: ZERO(ADM)                                                                                                   
5/13/2023 (S)  FN3: ZERO(ADM)                                                                                                   
5/13/2023 (S)  FN4: ZERO(DOH)                                                                                                   
5/13/2023 (S)  FN6: ZERO(DPS)                                                                                                   
5/13/2023 (S)  FN7: ZERO(LAW)                                                                                                   
5/13/2023 (S) FN8: (REV)                                                                                                        
5/13/2023 (S)  FN9: ZERO(AJS)                                                                                                   
5/13/2023 (S) RULES TO CALENDAR 5/13/23                                                                                         
5/13/2023 (S) READ THE SECOND TIME                                                                                              
5/13/2023 (S) FIN CS ADOPTED UC                                                                                                 
5/13/2023 (S) ADVANCED TO THIRD READING 5/14 CAL                                                                                
5/14/2023 (S) NOT TAKEN UP 5/14 - ON 5/15 CAL                                                                                   
5/15/2023 (S) READ THE THIRD TIME CSSB 89(FIN)                                                                                  
5/15/2023 (S) RETURN TO SECOND FOR AMDS UC                                                                                      
5/15/2023 (S) AM NO 1 FAILED Y5 N15                                                                                             
5/15/2023 (S) AM NO 2 FAILED Y5 N15                                                                                             
5/15/2023 (S) AUTOMATICALLY IN THIRD READING                                                                                    
5/15/2023 (S) HELD IN THIRD READING TO 5/16/CAL                                                                                 
5/16/2023 (S)  PASSED Y14 N6                                                                                                    
5/16/2023 (S) EFFECTIVE DATE(S) SAME AS PASSAGE                                                                                 
5/16/2023 (S) TRANSMITTED TO (H)                                                                                                
5/16/2023 (S) VERSION CSSB 89(FIN)                                                                                              
1/16/2024 (H) READ THE FIRST TIME REFERRALS                                                                                     
1/16/2024 (H) L&C, FIN                                                                                                          
1/31/2024 (H) LABOR & COMMERCE at 03:15 PM BARNES 124                                                                           
1/31/2024 (H) <Bill Hearing Canceled>                                                                                           
1/31/2024 (H)  Minutes (HL&C)                                                                                                   
2/9/2024 (H) LABOR & COMMERCE at 03:15 PM BARNES 124                                                                            
2/9/2024 (H) -- MEETING CANCELED --                                                                                             
2/28/2024 (H) LABOR & COMMERCE at 03:15 BARNES 124                                                                              
2/28/2024 (H) -- MEETING CANCELED --                                                                                            
3/4/2024 (H) LABOR & COMMERCE at 03:15 PM BARNES 124                                                                            
3/4/2024 (H) Heard & Held                                                                                                       
3/4/2024  (H)  Minutes (HL&C)                                                                                                   
5/6/2024 (H) LABOR & COMMERCE at 03:15 PM BARNES 124                                                                            
                                                                                                                                
BILL: SB 115                                                                                                                  
SHORT TITLE: PHYSICIAN ASSISTANT SCOPE OF PRACTICE                                                                              
SPONSOR(s): SENATOR(s) TOBIN BY REQUEST                                                                                         
                                                                                                                                
3/27/2023 (S) READ THE FIRST TIME - REFERRALS                                                                                   
3/27/2023 (S) HSS, L&C                                                                                                          
4/11/2023 (S) COSPONSOR(S): GIESSEL                                                                                             
1/23/2024 (S) HEALTH & SOCIAL SERVICES at 03:30PM BUTROVICH 205                                                                 
1/23/2024 (S) Heard & Held                                                                                                      
1/23/2024 (S) Minutes (SHSS)                                                                                                    
1/31/2024 (S) COSPONSOR(S): GRAY-JACKSON, HUGHES                                                                                
2/6/2024 (S) HEALTH & SOCIAL SERVICES at 03:30PM BUTROVICH 205                                                                  
2/6/2024 (S) Heard & Held                                                                                                       
2/6/2024 (S)  Minutes (SHSS)                                                                                                    
2/15/2024 (S) HEALTH & SOCIAL SERVICES at 03:30PM BUTROVICH 205                                                                 
2/15/2024 (S) Moved CSSB 115(HSS) Out of Committee                                                                              
2/15/2024 (S) Minutes (SHSS)                                                                                                    
2/19/2024 (S) HSS RPT CS 3DP 2AM SAME TITLE                                                                                     
2/19/2024 (S) DP: WILSON, KAUFMAN, DUNBAR                                                                                       
2/19/2024 (S) AM: TOBIN, GIESSEL                                                                                                
2/19/2024 (S) FN1: ZERO(CED)                                                                                                    
2/19/2024 (S) COSPONSOR(S): DUNBAR                                                                                              
2/28/2024 (S) LABOR & COMMERCE at 01:30 PM BELTZ 105 (TSBldg)                                                                   
2/28/2024 (S) Heard & Held                                                                                                      
2/28/2024 (S) Minutes (SL&C)                                                                                                    
4/5/2024 (S) LABOR & COMMERCE at 01:30 PM BELTZ 105 (TSBldg)                                                                    
4/5/2024 (S) Moved CSSB 115(HSS) Out of Committee                                                                               
4/8/2024 (S) L&C RPT CS(HSS) 2DP 1NR 1AM                                                                                        
4/8/2024 (S) AM: BJORKMAN                                                                                                       
4/8/2024 (S) DP: DUNBAR, BISHOP                                                                                                 
4/8/2024 (S) NR: MERRICK                                                                                                        
4/8/2024 (S) FN1: ZERO(CED)                                                                                                     
4/22/2024 (S) RULES TO CALENDAR 4/22/2024                                                                                       
4/22/2024 (S) READ THE SECOND TIME                                                                                              
4/22/2024 (S) HSS CS ADOPTED UC                                                                                                 
4/22/2024 (S) ADVANCED TO THIRD READING 4/24 CAL                                                                                
4/24/2024 (S) READ THE THIRD TIME CSSB 115(HSS)                                                                                 
4/24/2024 (S) RETURN TO SECOND FOR AM 1 UC                                                                                      
4/24/2024 (S) AM NO 1 ADOPTED Y17 N3                                                                                            
4/24/2024 (S) AUTOMATICALLY IN THIRD READING                                                                                    
4/24/2024 (S) PASSED Y19 N1                                                                                                     
4/24/2024 (S) TRANSMITTED TO (H)                                                                                                
4/24/2024 (S) VERSION CSSB 115(HSS) AM                                                                                          
4/26/2024 (H) READ THE FIRST TIME - REFERRALS                                                                                   
4/26/2024 (H) HSS, L&C                                                                                                          
5/2/2024 (H) HEALTH & SOCIAL SERVICES at 03:00 PM DAVIS 106                                                                     
5/2/2024 (H) Moved CSSB 115(HSS) AM Out of Committee --                                                                         
          Delayed to 20 Minutes Following Session                                                                               
5/3/2024 (H) HSS RPT 5NR 1AM                                                                                                    
5/3/2024 (H) NR: RUFFRIDGE, MCCORMICK, MINA, SADDLER, PRAX                                                                      
5/3/2024 (H) AM: SUMNER                                                                                                         
5/3/2024 (H) FN1: ZERO(CED)                                                                                                     
5/6/2024 (H) LABOR & COMMERCE at 03:15 PM BARNES 124                                                                            
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
TIM LAMKIN, Staff                                                                                                               
Senator Gary Stevens                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Provided the summary of changes for                                                                      
proposed under Version Y, a proposed House committee substitute                                                                 
for CSSB 89(FIN).                                                                                                               
                                                                                                                                
BEVERLY WOOLEY, representing self                                                                                               
Big Lake, Alaska                                                                                                                
POSITION STATEMENT:  Testified in support of SB 89.                                                                           
                                                                                                                                
JESSICA IVANOFF, representing self                                                                                              
Nome, Alaska                                                                                                                    
POSITION STATEMENT:  Testified in support of SB 89.                                                                           
                                                                                                                                
DOROTHY ARMSTRONG, representing self                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during the hearing on SB 89.                                                                   
                                                                                                                                
SENATOR L?KI TOBIN                                                                                                              
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, presented CSSB 115(HSS).                                                               
                                                                                                                                
HAROLD JOHNSTON, MD, Chair                                                                                                      
Policy & Advocacy Committee                                                                                                     
Alaska Primary Care Association (PCA)                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Gave invited testimony in support of CSSB
115(HSS).                                                                                                                       
                                                                                                                                
JENNIFER FAYETTE, PA                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Gave invited testimony in support of CSSB
115(HSS).                                                                                                                       
                                                                                                                                
KRISTIN M. MITCHELL, MD, FACP, President                                                                                        
Alaska State Medical Association                                                                                                
Soldotna, Alaska                                                                                                                
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
ROXANNE JONES, MD, Secretary of the Board                                                                                       
Alaska Academy of Family Physicians                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
CANDACE HICKEL, Physician Assistant                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of CSSB 115(HSS).                                                                   
                                                                                                                                
KARI BERNARD, Physician Assistant                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 115.                                                                          
                                                                                                                                
BETSY DOUDS-PACVAN, PA, President                                                                                               
Alaska Academy of Physician's Assistants                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of CSSB 115(HSS).                                                                   
                                                                                                                                
KATHERINE VAN ATTA, PA                                                                                                          
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified in support of CSSB 115(HSS).                                                                   
                                                                                                                                
DANIEL REYNOLDS, DO                                                                                                             
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of CSSB 115(HSS).                                                                   
                                                                                                                                
CHRISTI FROILAND, PA                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of CSSB 115(HSS).                                                                   
                                                                                                                                
ETHAN MCWILLIAMS, CEO                                                                                                           
Wilderness Medical Staffing                                                                                                     
(No address provided)                                                                                                           
POSITION STATEMENT:  Testified in support of CSSB 115(HSS).                                                                   
                                                                                                                                
MOLLY SOUTHWORTH, MD, Internist and Endocrinologist                                                                             
American College of Physicians, Alaska Chapter                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
JOHNNA KOHL, MD                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
MEGHAN HALL, PA                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support in CSSB 115(HSS).                                                                   
                                                                                                                                
MURRAY BUTTNER, MD                                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of CSSB 115(HSS).                                                                   
                                                                                                                                
MARGARET CARLSON, MD, Family Medicine Physician                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
CAMILLA SULAK, MD, Board Member                                                                                                 
American College of Emergency Physicians, Alaska Chapter                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
KATHRYNE MITCHELL, representing self                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
DANA KERR, MD                                                                                                                   
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in opposition to CSSB 115(HSS).                                                                
                                                                                                                                
GLENN SAVIERS, Deputy Director                                                                                                  
Division of Corporations, Business, & Professional Licensing                                                                    
Department of Commerce, Community & Economic Development (DCCED)                                                                
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Answered questions  during the  hearing on                                                             
CSSB 115(HSS).                                                                                                                  
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
7:10:50 PM                                                                                                                    
                                                                                                                                
CHAIR JESSE SUMNER  called the House Labor  and Commerce Standing                                                             
Committee  meeting  to  order  at   7:10  p.m.    Representatives                                                               
Ruffridge, Wright, Carrick,  and Sumner were present  at the call                                                               
to order.   Representatives Prax, Saddler, and  Fields arrived as                                                               
the meeting was in progress.                                                                                                    
                                                                                                                                
        SB 89-AGE FOR TOBACCO/NICOTINE/E-CIG; TAX E-CIG                                                                     
                                                                                                                                
7:11:30 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced that the  first order of business would be                                                               
CS  for SENATE  BILL NO.  89(FIN), "An  Act relating  to tobacco,                                                               
tobacco  products,  electronic  smoking products,  nicotine,  and                                                               
products  containing   nicotine;  raising  the  minimum   age  to                                                               
purchase,  exchange, or  possess  tobacco,  a product  containing                                                               
nicotine,  or  an electronic  smoking  product;  relating to  the                                                               
tobacco  use  education  and  cessation  fund;  relating  to  the                                                               
taxation of  electronic smoking products and  vapor products; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
7:11:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  moved  to  adopt  the  proposed  House                                                               
committee substitute (HCS) to  CSSB 89)FIN), Version 33-LS0247\Y,                                                               
Nauman, 5/6/24, as the working document.                                                                                        
                                                                                                                                
REPRESENTATIVE CARRICK objected.                                                                                                
                                                                                                                                
7:12:19 PM                                                                                                                    
                                                                                                                                
TIM   LAMKIN,  Staff,   Senator   Gary   Stevens,  Alaska   State                                                               
Legislature, provided the  summary of changes for  Version Y, the                                                               
proposed  House  committee  substitute  for  CSSB  89(FIN).    He                                                               
reiterated that  Version Y  would strike from  the title  and the                                                               
remainder  of  the  bill  any  reference to  the  new  state  tax                                                               
program.   He noted that that  was the substance of  the bill and                                                               
offered to elaborate  at the will of the committee.   In response                                                               
to  Representative  Ruffridge, he  confirmed  that  that was  the                                                               
singular most substantive change proposed under Version Y.                                                                      
                                                                                                                                
7:13:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK  explained her objection to  Version Y was                                                               
the tax provision.                                                                                                              
                                                                                                                                
7:14:26 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease 7:14 p.m.                                                                                    
                                                                                                                                
7:15:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  said  that  he supported  Version  Y  but                                                               
preferred to keep the tax (indisc.).                                                                                            
                                                                                                                                
7:15:12 PM                                                                                                                    
                                                                                                                                
A roll call vote was  taken.  Representatives Ruffridge, Saddler,                                                               
Wright, Fields, Prax,  and Sumner voted in favor  of adopting the                                                               
proposed  House committee  substitute for  CSSB 89(FIN),  Version                                                               
33-LS0247\Y,   Nauman,   5/6/24,   as   the   working   document.                                                               
Representative Carrick  voted against  it.  Therefore,  Version Y                                                               
was before the committee by a vote of 6-1.                                                                                      
                                                                                                                                
7:15:42 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER opened public testimony on SB 89.                                                                                  
                                                                                                                                
7:16:08 PM                                                                                                                    
                                                                                                                                
BEVERLY  WOOLEY, representing  self, testified  in support  of SB
89.   She spoke  about her  work in public  health and  asked the                                                               
committee to  support keeping young people  healthy by increasing                                                               
the age  to buy tobacco  products and she also  supported levying                                                               
larger  taxes.   She gave  examples  of how  effective the  anti-                                                               
nicotine program  at the  state helped youths.   She  pointed out                                                               
that  young  people are  price  sensitive,  and she  offered  her                                                               
belief that the bill is an important step.                                                                                      
                                                                                                                                
7:18:44 PM                                                                                                                    
                                                                                                                                
JESSICA IVANOFF,  representing self,  testified in support  of SB
89.   As  a mother  of  teenagers, she  spoke to  her concern  of                                                               
vaping and  the health risks  that result  from the use  of these                                                               
types  of products,  and offered  further examples  of the  steps                                                               
youths will take to obtain  vaping products.  She urged committee                                                               
members to approve SB 89.                                                                                                       
                                                                                                                                
7:20:16 PM                                                                                                                    
                                                                                                                                
DOROTHY ARMSTRONG, representing self, stated  that she was a high                                                               
school senior and related how  tobacco use affects people and the                                                               
physical toll it took on them.   She shared how the smells of the                                                               
vapes  are prevalent  and  that  she could  not  avoid  it in  or                                                               
outside  the classroom.   She  stressed  that people  who are  19                                                               
attempt  to sell  vapes to  youths but  only some  youths refuse.                                                               
She stated she felt responsible  to provide information to fellow                                                               
students, and she thanked the committee for their time.                                                                         
                                                                                                                                
7:22:25 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER, after  ascertaining  that no  one  else wished  to                                                               
testify, closed public testimony on SB 89.                                                                                      
                                                                                                                                
7:22:30 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 7:22 p.m. to 7:23 p.m.                                                                       
                                                                                                                                
7:23:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT  moved to report  HCS CSSB 89,  Version 33-                                                               
LS0247\Y,  Nauman,  5/6/24,  out  of  committee  with  individual                                                               
recommendations and the accompanying fiscal notes.                                                                              
                                                                                                                                
7:24:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE objected.   He said he is  in support of                                                               
the  bill  but  in  looking  at  language  in  Version  Y  around                                                               
shipping.  He  offered a suggestion to hear from  the U.S. Postal                                                               
Service (USPS).                                                                                                                 
                                                                                                                                
CHAIR  SUMNER  listed  other  options  in  buying  and  receiving                                                               
tobacco.                                                                                                                        
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  restated  that  his  concern  was  the                                                               
language surrounding the delivery of  products and he pointed out                                                               
that the  deliverer would have  to verify  the person's age.   He                                                               
reiterated his uncertainty of how this would work.                                                                              
                                                                                                                                
7:27:25 PM                                                                                                                    
                                                                                                                                
MR.  LAMKIN stated  that the  amendments [within  Version Y]  are                                                               
conforming in nature  and he related an  example regarding buying                                                               
an  age-restricted product  such  as alcohol  and  there being  a                                                               
requirement  to  check  the identification  (ID)  of  the  person                                                               
receiving the product.  It is common carrier language, he said.                                                                 
                                                                                                                                
7:28:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX commented that he  knew nothing about how the                                                               
products get shipped  and said he would not expect  that they are                                                               
shipped through Lynden, but maybe FedEx or USPS.                                                                                
                                                                                                                                
MR. LAMKIN reiterated  that there is an allowance  for "this type                                                               
of thing" at USPS and it is common  practice.  When one is at the                                                               
post office  counter with an  agent and  the package has  a label                                                               
requiring  age verification,  the person  picking up  the package                                                               
must be asked for proof of age.                                                                                                 
                                                                                                                                
7:29:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS noted  that the  processes are  already in                                                               
place for alcohol so it should not be a big deal.                                                                               
                                                                                                                                
7:29:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WRIGHT  inquired   whether  someone  who  ordered                                                               
tobacco  online and  were  not  home for  the  delivery would  be                                                               
required to go to the post office and show identification.                                                                      
                                                                                                                                
MR. LAMKIN said  he was not certain whether  tobacco products are                                                               
delivered through  USPS, but if it  were UPS or FedEx,  the agent                                                               
would  have  to check  the  recipient's  ID upon  delivering  the                                                               
product.                                                                                                                        
                                                                                                                                
REPRESENTATIVE WRIGHT  offered his belief  that it could  cause a                                                               
problem with people receiving their goods in a timely manner.                                                                   
                                                                                                                                
MR. LAMKIN  responded that there are  a lot of components  to the                                                               
bill  and  indicated that  continuing  to  ask more  hypothetical                                                               
questions  would  result in  "losing  sight  of  the ball."    He                                                               
suggested that committee  members not lose track of  the point of                                                               
the bill.                                                                                                                       
                                                                                                                                
7:31:23 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER  pointed out  that  some  packages need  signatures                                                               
whether they  contain age  restricted products or  not.   He gave                                                               
personal  examples of  having to  pick  up packages  at the  post                                                               
office after receiving a notice.                                                                                                
                                                                                                                                
REPRESENTATIVE  WRIGHT reiterated  his  concern  about those  who                                                               
cannot get  to the  post office after  hours resulting  in delays                                                               
for people getting their goods.                                                                                                 
                                                                                                                                
7:32:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  questioned what the process  would look                                                               
like, and  whether or not  it would cause  some other step  to be                                                               
taken  by  those  who  have   already  had  their  identification                                                               
checked.  He  said he would feel more at-ease  about the shipping                                                               
language   in  the   proposed  legislation   if  there   were  an                                                               
understanding of the affidavit from the shipper.                                                                                
                                                                                                                                
MR.  LAMKIN  replied  that  he   did  not  know  how  to  further                                                               
articulate.   If  ID checks  were eliminated,  then youths  would                                                               
have easier access, he proffered.                                                                                               
                                                                                                                                
REPRESENTATIVE RUFFRIDGE stressed  that the committee's intention                                                               
was not to make tobacco easier to obtain.                                                                                       
                                                                                                                                
7:36:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CARRICK  shared  her confusion  in  reference  to                                                               
deliveries and  what is in  statute regarding  [ID] verification.                                                               
She  further  inquired  about  the   conforming  changes  in  the                                                               
proposed legislation.                                                                                                           
                                                                                                                                
MR. LAMKIN clarified that it  was intended to target online sales                                                               
and to put a stopgap on  these products getting into the hands of                                                               
youth.                                                                                                                          
                                                                                                                                
REPRESENTATIVE CARRICK  asked whether the conforming  language is                                                               
new language being put in place.                                                                                                
                                                                                                                                
MR.  LAMKIN confirmed  that  it is  new  language for  electronic                                                               
smoking products.                                                                                                               
                                                                                                                                
7:38:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  referred to  Title 11  and that  there are                                                               
prohibitions on selling  to those underage.   He shared anecdotes                                                               
about  receiving mail  and  signing  for it.    He noted  special                                                               
software that vendors can use for age verification online.                                                                      
                                                                                                                                
7:40:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   RUFFRIDGE   shared   his  concerns   about   the                                                               
transition  happening  with  alcohol   products,  and  he  sought                                                               
further discussion  on the  shipping language  and what  it looks                                                               
like "in real life."  He removed his objection.                                                                                 
                                                                                                                                
7:41:36 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER announced  there being  no  further objection,  HCS                                                               
CSSB  89(L&C)  was  reported  out of  House  Labor  and  Commerce                                                               
Standing Committee.                                                                                                             
                                                                                                                                
7:41:46 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 7:41 p.m. to 7:44 p.m.                                                                       
                                                                                                                                
          SB 115-PHYSICIAN ASSISTANT SCOPE OF PRACTICE                                                                      
                                                                                                                                
7:44:48 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced that the  final order of business would be                                                               
CS FOR  SENATE BILL NO.  115(HSS), "An Act relating  to physician                                                               
assistants; relating  to physicians; and relating  to health care                                                               
insurance policies."                                                                                                            
                                                                                                                                
7:44:57 PM                                                                                                                    
                                                                                                                                
SENATOR L?KI  TOBIN, Alaska State Legislature,  as prime sponsor,                                                               
presented  CSSB 115(HSS)  and paraphrased  the sponsor  statement                                                               
[included  in  the  committee  packet],  which  read  as  follows                                                               
[original punctuation provided]:                                                                                                
                                                                                                                                
     We have all heard about  long wait times and difficulty                                                                    
     accessing care across  Alaska which frustrates patients                                                                    
     and   creates  impediments   to  quick   diagnosis  and                                                                    
     treatment.  Senate  Bill  115 would  allow  experienced                                                                    
     physician   assistants   to   practice   medical   care                                                                    
     independently   to   the   fullest  extent   of   their                                                                    
     licensing, thus increasing the  capacity of our medical                                                                    
     system  and reducing  unnecessarily strict  regulations                                                                    
     on physician assistants.                                                                                                   
                                                                                                                                
     Senate   Bill   115    grants   experienced   physician                                                                    
     assistants  the flexibility  to increase  their ability                                                                    
     to  see  and treat  patients,  which  will benefit  the                                                                    
     capacity   of  Alaska's   medical  system.   This  also                                                                    
     maintains   the   collaborative   agreement   structure                                                                    
     currently  in  place  for  less  experienced  physician                                                                    
     assistants.                                                                                                                
                                                                                                                                
     Alaska   has  a   demonstrated   need  for   increasing                                                                    
     accessible medical  care, reducing high  medical costs,                                                                    
     and   decreasing   barriers  to   experienced   medical                                                                    
     practitioners across Alaska. Over  90% of the physician                                                                    
     assistants   in  Alaska   practice   in  rural   areas.                                                                    
     Increasing the medical care  available locally in rural                                                                    
     Alaska  produces  better  outcomes and  less  expensive                                                                    
     care. This also  allows patients to stay  in their home                                                                    
     communities,   thereby    reducing   strain    on   hub                                                                    
     communities.  Additionally, Alaskans  will  be able  to                                                                    
     receive care in their  place of home, maintaining their                                                                    
     support  networks  and  reducing the  need  for  costly                                                                    
     inpatient services.                                                                                                        
                                                                                                                                
     Senate  Bill 115  does not  sacrifice medical  rigor or                                                                    
     oversight, but  simply allows experienced  and licensed                                                                    
     physician assistants to continue  to offer high quality                                                                    
     medical care within their scope of practice. Thank you                                                                     
     for considering this prudent legislation.                                                                                  
                                                                                                                                
7:52:24 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER noted  that there  would not  be a  reading of  the                                                               
sectional  analysis for  CSSB 115(HSS)  and  the committee  would                                                               
hear invited testimony.                                                                                                         
                                                                                                                                
7:52:37 PM                                                                                                                    
                                                                                                                                
HAROLD JOHNSTON,  MD, Chair, Policy &  Advocacy Committee, Alaska                                                               
Primary  Care  Association  (PCA),   gave  invited  testimony  in                                                               
support of CSSB  115(HSS).  He provided a  background and related                                                               
the number of physician assistants  (PAs) there are in the state.                                                               
He  stressed  strong  support  for CSSB  115(HSS)  on  behalf  of                                                               
himself and PCA.   He said the system is  outdated and created an                                                               
unnecessary   expense  for   community  health   centers  thereby                                                               
becoming  a barrier  to recruitment.    He opined  that the  bill                                                               
would  not  decrease  the  quality   of  care  and  collaborative                                                               
agreements would continue.  He said  it was time to recognize the                                                               
value that physician assistants provide  and their unique role in                                                               
Alaska's health care system.                                                                                                    
                                                                                                                                
7:56:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked whether  PCA collaborated remotely or                                                               
only at specific clinic sites.                                                                                                  
                                                                                                                                
DR. JOHNSTON  responded that it  depended on the number  of staff                                                               
available.                                                                                                                      
                                                                                                                                
REPRESENTATIVE  FIELDS asked  whether the  medical doctors  (MDs)                                                               
the  PAs are  collaborating with  are not  part of  the federally                                                               
qualified health center (FQHC).                                                                                                 
                                                                                                                                
DR. JOHNSTON answered  that if FQHC does not  have any physicians                                                               
on staff then [the MDs] are not part of the FQHC.                                                                               
                                                                                                                                
REPRESENTATIVE FIELDS questioned whether  there was anything that                                                               
prohibited PCA from collaborating  with multiple rural sites that                                                               
may not have MDs on site at the time.                                                                                           
                                                                                                                                
DR. JOHNSTON  replied that PCA  does not do direct  patient care,                                                               
and for them to have a physician  employed by PCA would be a very                                                               
challenging situation.                                                                                                          
                                                                                                                                
REPRESENTATIVE FIELDS  noted that some  HQFCs are part  of tribal                                                               
health systems.  He asked  who the collaborative MDs were working                                                               
for.                                                                                                                            
                                                                                                                                
DR.  JOHNSTON replied  that  he  had not  worked  for the  health                                                               
tribal  systems but  offered his  understanding  that the  tribal                                                               
partners  collaborate  with MDs  employed  by  the tribal  health                                                               
system.                                                                                                                         
                                                                                                                                
7:59:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  asked whether  it was  PCA's goal  to have                                                               
PAs run the clinics.                                                                                                            
                                                                                                                                
DR. JOHNSTON answered  that it varies and further  noted that PCA                                                               
does not run anything itself.                                                                                                   
                                                                                                                                
8:01:24 PM                                                                                                                    
                                                                                                                                
JENNIFER FAYETTE, PA,  gave invited testimony in  support of CSSB
115(HSS).   She said that in  current times, PAs are  involved in                                                               
almost every specialty and, in  addition, their scope of practice                                                               
includes examining,  diagnosing and treating their  own patients.                                                               
She said  CSSB 115(HSS) does  not increase the scope  of practice                                                               
but  puts responsibility  on  it.   She  stressed  that PAs  help                                                               
Alaska as well as other  states navigate provider shortages.  She                                                               
opined that current  statute is not supportive  to the profession                                                               
and  must be  modernized.    Passage of  CSSB  115(HSS) is  about                                                               
recognizing PAs full authority to fill the gaps in healthcare.                                                                  
                                                                                                                                
8:04:07 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  asked whether there are  smaller community                                                               
clinics that are not served by a tribal health provider.                                                                        
                                                                                                                                
MS. FAYETTE offered  her belief that there  was another testifier                                                               
who could best speak to the question.                                                                                           
                                                                                                                                
REPRESENTATIVE FIELDS  asked whether the goal  of the legislation                                                               
was for PAs to provide primary care.                                                                                            
                                                                                                                                
MS. FAYETTE  answered that the bill  is about access to  care and                                                               
stressed that  people are waiting  for care, especially  in rural                                                               
communities.                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  indicated that he struggled  with the idea                                                               
of doctors who have received training  versus a PA with much less                                                               
training.                                                                                                                       
                                                                                                                                
MS.  FAYETTE  said it  became  harder  to find  collaborators  in                                                               
Anchorage.                                                                                                                      
                                                                                                                                
[The committee heard public testimony beginning here:}                                                                          
                                                                                                                                
8:08:41 PM                                                                                                                    
                                                                                                                                
KRISTIN M.  MITCHELL, MD, FACP,  President, Alaska  State Medical                                                               
Association, said she  was opposed to CSSB  115(HSS), as written.                                                               
She listed medical entities that  agree that medical teams should                                                               
be led  by physicians,  as they are  uniquely qualified  and have                                                               
extensive training.   She noted  prior testimony  surrounding PAs                                                               
and close collaboration,  and she stated that even  PAs with many                                                               
years of  clinical experience do  not have the same  training and                                                               
are not interchangeable with physicians.   She clarified that the                                                               
Alaska State  Medical Board  is distinct  from the  State Medical                                                               
Board,  which has  undergone leadership  changes  recently.   She                                                               
gave examples  of other  states' procedures  regarding PAs.   She                                                               
mentioned nationwide  experiments in  primary care  utilizing PAs                                                               
to ease  the burden  of access,  and the  results lead  to higher                                                               
costs for patients  and health systems.  She said  wait lists for                                                               
specialists can  grow from  weeks to months.   She  stressed that                                                               
the current systems needed improvement  and that the Alaska State                                                               
Medical  Association  would  like  to  streamline  licensing  and                                                               
administration to  focus on providing  the best  possible patient                                                               
care.    Eliminating  collaborative   agreements  could  lead  to                                                               
unintended  consequences, she  said, and  without a  physician to                                                               
give ultimate responsibility for a  patient's care, she foresaw a                                                               
rise  in malpractice  insurance.   She said  CSSB 115(HSS)  would                                                               
redefine the term  "attending physician," which she  opined was a                                                               
mistake.     She  reiterated  that   the  Alaska   State  Medical                                                               
Association was  in opposition to  the bill as written  but would                                                               
be  willing   to  work  with   PA  colleagues  to   craft  better                                                               
regulations and submit improved legislation to the committee.                                                                   
                                                                                                                                
8:16:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  referenced  Title  8  and  the  scope  of                                                               
practice for MDs in statute versus regulation.                                                                                  
                                                                                                                                
DR. MITCHELL replied  that she was not an expert  on the scope of                                                               
practice for MDs  and would defer the inquiry to  someone who had                                                               
access to statute.                                                                                                              
                                                                                                                                
REPRESENTATIVE  FIELDS asked  whether there  was anything  in the                                                               
legislation  that would  list PAs  performing anything  different                                                               
from MDs.                                                                                                                       
                                                                                                                                
DR. MITCHELL questioned the  language, "provide consultation upon                                                               
request", noting that  typically it is a request  by someone with                                                               
a higher level of specialty  training.  She speculated on further                                                               
verbiage that she found might be problematic.                                                                                   
                                                                                                                                
REPRESENTATIVE  FIELDS noted  his  discomfort  in supporting  the                                                               
bill   in  reference   to   whether  what   MDs   do  should   be                                                               
differentiated.  He sought guidance  on how the scope of practice                                                               
for PAs could be narrowed to  provide primary care, as he was not                                                               
persuaded of that yet.                                                                                                          
                                                                                                                                
DR. MITCHELL responded  that she had asked for  numbers about how                                                               
the PA  workforce is  distributed in Alaska  but could  not speak                                                               
knowledgably since she  had not seen the numbers yet.   She spoke                                                               
to  other  health  systems  being  led  by  higher-level  trained                                                               
physicians.                                                                                                                     
                                                                                                                                
8:23:20 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:23 p.m. to 8:26 p.m.                                                                       
                                                                                                                                
8:26:06 PM                                                                                                                    
                                                                                                                                
ROXANNE  JONES, MD,  Secretary of  the Board,  Alaska Academy  of                                                               
Family  Physicians, testified  in  opposition  to CSSB  115(HSS).                                                               
She   provided  her   professional   background,  including   her                                                               
experience serving  as a collaborating  physician to PAs  in many                                                               
states, and  shared her  first-hand experience  around PAs.   She                                                               
urged members  to take more time  on the bill and  opined that PA                                                               
collaborative agreements need  to be fixed, as it  should be used                                                               
as a tool for PA practices.   She added that the curricula in the                                                               
PA programs do  not prepare PAs to practice  without a supervisor                                                               
or collaborator.   She noted  that liability speaks loudly.   She                                                               
urged the committee to not pass CSSB 115(HSS).                                                                                  
                                                                                                                                
8:31:45 PM                                                                                                                    
                                                                                                                                
MS. FAYETTE spoke to medicine  definitions in statute.  She noted                                                               
the importance of putting the PA  profession in statute, as it is                                                               
currently only  in regulation.   Additionally,  she said  she has                                                               
been engaging  in this process  for PAs,  and that she  had given                                                               
multiple presentations to the State Medical Board on the topic.                                                                 
                                                                                                                                
8:34:36 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER opened public testimony on SB 115.                                                                                 
                                                                                                                                
8:35:21 PM                                                                                                                    
                                                                                                                                
CANDACE  HICKEL,   Physician  Assistant,  shared   her  extensive                                                               
background in  the PA  profession and  opined that  PA regulation                                                               
laws  are antiquated,  and she  provided  a brief  history.   She                                                               
highlighted  the importance  of  PAs in  Alaska  and related  the                                                               
training  requirements for  PAs.   She  said  that she  continued                                                               
close  collaboration  with  surgeons  by the  design  of  a  PA's                                                               
practice  and policies  already in  place at  the hospital.   She                                                               
said people are  asking for quality care and opined  that PAs are                                                               
the  solution.   She urged  support  for CSSB  115(HSS) from  the                                                               
legislature.                                                                                                                    
                                                                                                                                
8:39:03 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 8:39 p.m.                                                                                 
                                                                                                                                
8:39:19 PM                                                                                                                    
                                                                                                                                
KARI  BERNARD, Physician  Assistant, testified  in support  of SB
115 and provided  a research report and summary  to the committee                                                               
[included in  the committee  packet].  She  related that  she had                                                               
been  a  PA  for  20  years  and  provided  a  brief  educational                                                               
background.    She listed  studies  regarding  PA provided  care,                                                               
which included costs.   She said studies do not  support that PAs                                                               
are driving up the cost of  care.  She further summarized studies                                                               
of PAs following the same  guidelines as physicians.  She offered                                                               
to be available to answer more specific questions.                                                                              
                                                                                                                                
8:42:42 PM                                                                                                                    
                                                                                                                                
BETSY DOUDS-PACVAN, PA, President,  Alaska Academy of Physician's                                                               
Assistants,  as   a  PA,  provided  her   background  working  in                                                               
outpatient addiction treatment and  behavioral health.  She noted                                                               
that Alaska  is experiencing a  shortage of  healthcare providers                                                               
and CSSB 115(HSS) would allow PAs  the ability to practice to the                                                               
full  extent  of their  rigorous  training  and education.    She                                                               
opined that CSSB 115(HSS) is a  tool that would allow PAs to join                                                               
the workforce more easily while continuing to be regulated.                                                                     
                                                                                                                                
8:45:53 PM                                                                                                                    
                                                                                                                                
KATHERINE VAN  ATTA, PA,  testified in  support of  CSSB 115(HSS)                                                               
and  shared her  educational  and professional  background.   She                                                               
noted  that  collaborative  plans  are not  required  to  perform                                                               
effective  consulting.   She  said  CSSB  115(HSS) would  support                                                               
giving healthcare  providers to  the rural and  underserved areas                                                               
of  the state  that really  need PAs.   She  touched on  proposed                                                               
regulations and offered  her belief that a  different approach is                                                               
needed and that SB 115 could alleviate many issues.                                                                             
                                                                                                                                
8:48:38 PM                                                                                                                    
                                                                                                                                
DANIEL  REYNOLDS, DO,  shared his  work and  military experiences                                                               
and  noted the  extensive time  he spent  working with  PAs.   He                                                               
opined that  CSSB 115(HSS)  supported the  change that  is needed                                                               
because of  the training and skill  level PAs currently get.   He                                                               
said if  there was  a problem  with care  that is  delivered, PAs                                                               
would not be  practicing.  He stressed that the  care PAs deliver                                                               
is excellent  and at a high  level and he reiterated  his support                                                               
for the proposed legislation.                                                                                                   
                                                                                                                                
8:51:24 PM                                                                                                                    
                                                                                                                                
CHRISTI FROILAND, PA, provided her  background in dermatology and                                                               
highlighted  that  she is  a  specialist  to whom  other  offices                                                               
refer.   She spoke to  collaboration and  that it is  "built into                                                               
the DNA"  of a PA.   She further noted her  teaching experiences.                                                               
She opined that CSSB 115(HSS)  is not about independent practice;                                                               
it  is about  giving a  PA the  ability to  practice to  the full                                                               
extent of their training and to not be tied to one physician.                                                                   
                                                                                                                                
8:53:48 PM                                                                                                                    
                                                                                                                                
ETHAN MCWILLIAMS, CEO, Wilderness  Medical Staffing, testified in                                                               
support  of CSSB  115(HSS).   He  provided  his professional  and                                                               
personal background.   He said  it is hard to  find collaborating                                                               
physicians with  the time  needed for paperwork.   He  touched on                                                               
liability and insurance,  and noted other states in  which he had                                                               
worked.  He added that his  broker or carrier had never expressed                                                               
any  concern  about the  insurability  of  PAs in  those  states;                                                               
therefore, he did not understand why Alaska would be different.                                                                 
                                                                                                                                
8:56:57 PM                                                                                                                    
                                                                                                                                
MOLLY  SOUTHWORTH, MD,  Internist  and Endocrinologist,  American                                                               
College of  Physicians, Alaska  Chapter, testified  in opposition                                                               
to CSSB 115(HSS) because of  patient safety concerns and the need                                                               
to build stronger teams.  She  stressed that PAs are a vital part                                                               
of the  system but are  not trained with independent  practice in                                                               
mind.   She opined that  the bill is a  threat to Alaskans.   She                                                               
suggested that  CSSB 115(HSS) not  be passed in its  current form                                                               
and that  a stronger  bill be crafted  that focused  on improving                                                               
team collaboration.                                                                                                             
                                                                                                                                
8:59:25 PM                                                                                                                    
                                                                                                                                
JOHNNA KOHL, MD,  testified against CSSB 115(HSS)  in its current                                                               
form and explained  that two years of clinical  practice does not                                                               
constitute an experienced assistant.   She gave examples of real-                                                               
life situations in family medicine  that, for example, there is a                                                               
difference in training between a  PA and nurse practitioner.  She                                                               
urged members to  continue to work on the bill  and not pass CSSB
115(HSS), as written.                                                                                                           
                                                                                                                                
9:01:53 PM                                                                                                                    
                                                                                                                                
MEGHAN HALL,  PA, testified  in support in  CSSB 115(HSS)  in its                                                               
current form  because the amendments  have been made and  many of                                                               
the concerns have  been voiced.  She offered her  belief that the                                                               
bill would keep  PAs relevant, recognize them as  full members of                                                               
the health care team, and protect patient safety.                                                                               
                                                                                                                                
9:03:15 PM                                                                                                                    
                                                                                                                                
MURRAY BUTTNER,  MD, testified in  support of CSSB 115(HSS).   He                                                               
spoke to his  work and board experience, as well  as working with                                                               
PAs.  He added that he  had been a collaborating physician for 10                                                               
to 15 PAs  in his 27 years  in the profession.  He  went over the                                                               
outdated regulatory  framework for  PAs but  not for  other areas                                                               
such as for nurse practitioners.   He offered his belief that the                                                               
bill  currently  written  seemed  reasonable  and  he  hoped  the                                                               
committee would see a way to move it.                                                                                           
                                                                                                                                
9:06:20 PM                                                                                                                    
                                                                                                                                
MARGARET  CARLSON, MD,  Family Medicine  Physician, testified  in                                                               
opposition   to  CSSB   115(HSS)   and   gave  her   professional                                                               
background.    She  said  that   she  has  been  a  collaborative                                                               
physician for  PAs her whole  career and respects  them; however,                                                               
there is a  difference in training that comes  down to experience                                                               
and  leadership.   She  related examples  of  patients not  being                                                               
satisfied with their care and the  wait times.  She asked whether                                                               
access to care  is more important than the quality  of care.  She                                                               
encouraged the committee to reconsider the bill.                                                                                
                                                                                                                                
9:09:27 PM                                                                                                                    
                                                                                                                                
CAMILLA SULAK,  MD, Board Member,  American College  of Emergency                                                               
Physicians,  Alaska  Chapter,  testified in  opposition  to  CSSB
115(HSS).  She  said a concern is safety and  opined that PAs are                                                               
more likely to  over-prescribe opiates.  She  related that health                                                               
care costs  are already high  and must not be  increased; neither                                                               
should the wait  times for care.   Access to care is  an issue as                                                               
well, she  said, and  many other states  have voted  against this                                                               
type of legislation.                                                                                                            
                                                                                                                                
9:12:30 PM                                                                                                                    
                                                                                                                                
KATHRYNE  MITCHELL,  representing  self, testified  against  CSSB
115(HSS)   and  opposed   the   4,000-hour   requirement.     She                                                               
highlighted  the differences  in  the  education of  a  PA and  a                                                               
medical  doctor.   She asked  why Alaskans  would want  to go  to                                                               
medical school when they can go practice with fewer hours.                                                                      
                                                                                                                                
9:15:17 PM                                                                                                                    
                                                                                                                                
DANA KERR,  MD, testified  against CSSB  115(HSS) and  the 4,000-                                                               
hour requirement.   She  opined that there  needed to  be minimum                                                               
testing.   She stressed that  she valued PAs  both professionally                                                               
and personally.   She relayed a personal  anecdote regarding PAs'                                                               
knowledge, and  the lack thereof.   She  said there needed  to be                                                               
better standards.                                                                                                               
                                                                                                                                
REPRESENTATIVE FIELDS asked whether, if  the state were to create                                                               
standards and diversity of training, there  be a model to look to                                                               
for PAs.                                                                                                                        
                                                                                                                                
MS. KERR  replied that she was  not aware of current  tests as PA                                                               
training has not been for  independent practice.  She agreed that                                                               
it should be explored.                                                                                                          
                                                                                                                                
9:19:00 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER, after  ascertaining no one else  wished to testify,                                                               
closed public testimony.                                                                                                        
                                                                                                                                
9:19:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS asked  about  standards of  apprenticeship                                                               
testing.                                                                                                                        
                                                                                                                                
MS.  HICKEL  replied  that  there  are  post-graduate  fellowship                                                               
trainings.  She  highlighted that the purpose of the  bill was to                                                               
improve access to quality care in Alaska.                                                                                       
                                                                                                                                
9:20:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE inquired about  current PA licensing and                                                               
collaboration.   He said he  heard that there are  1,000 licensed                                                               
PAs in  the state  and asked  whether there was  a record  of the                                                               
collaborative physicians that reside in the state.                                                                              
                                                                                                                                
9:21:47 PM                                                                                                                    
                                                                                                                                
GLENN  SAVIERS,   Deputy  Director,  Division   of  Corporations,                                                               
Business,  &  Professional  Licensing,  Department  of  Commerce,                                                               
Community    &    Economic   Development    (DCCED),    addressed                                                               
Representative  Ruffridge and  said  it would  not  be an  easily                                                               
pulled record; it would take some time.                                                                                         
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  asked whether  an MD outside  the state                                                               
could sign a collaborative agreement.                                                                                           
                                                                                                                                
MS.  SAVIERS  offered  to  follow   up  regarding  out  of  state                                                               
collaborating physicians.                                                                                                       
                                                                                                                                
9:24:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked  whether there was a  way to regulate                                                               
collaborative  fees  or whether  there  were  options other  than                                                               
collaborative fees.                                                                                                             
                                                                                                                                
MS.  HICKEL  answered that  that  had  been considered  the  past                                                               
several years  but culminated  in the bill  in its  present form,                                                               
which she supported.                                                                                                            
                                                                                                                                
9:25:30 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced that CSSB 115(HSS) was held over.                                                                        
                                                                                                                                
9:25:39 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Labor  & Commerce  Standing Committee  meeting  was adjourned  at                                                               
9:26.                                                                                                                           

Document Name Date/Time Subjects
SB182 Sponsor Statement Ver A 1.17.24.pdf HL&C 5/6/2024 3:15:00 PM
SB 182
SB 182 DCCED-CBPL-01-18-24.pdf HL&C 5/6/2024 3:15:00 PM
SB 182
SB 182 Supporting Document Legislative Audit 062223.pdf HL&C 5/6/2024 3:15:00 PM
SB 182
SB 182 Letters of Support as of 042924.pdf HL&C 5/6/2024 3:15:00 PM
SB 182
SB234 Sponsor Statement.pdf HL&C 5/6/2024 3:15:00 PM
SB 234
SB234 Fiscal Note-DCCED-AMCO 03.01.24.pdf HL&C 5/6/2024 3:15:00 PM
SB 234
SB234 Supporting Documents-Legislative Audit 10.30.23.pdf HL&C 5/6/2024 3:15:00 PM
SB 234
SB234 ver A.pdf HL&C 5/6/2024 3:15:00 PM
SB 234
HJR27 Supporting Document_New Trade Regime Can Counter Chinese Supply Chain.pdf HL&C 5/6/2024 3:15:00 PM
HJR 27
HJR27 Supporting Document_Greenhouse Gas Lifecycle Assessment.pdf HL&C 5/6/2024 3:15:00 PM
HJR 27
HJR27 Sponsor Statement.pdf HL&C 5/6/2024 3:15:00 PM
HJR 27
SB0115-1-2-021924-CED-N.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB 115 Bill Overview 5.5.2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB115 Research Summary of Research on the Safety Effectiveness and Affordability of PA-Delivered Care 5.2.2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB115 Excerpt from AAPA Guide to PA Regulations and Compliance 5.5.2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB115 Explanation of Changes Version B to U 5.5.2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB115 Sectional Analysis Version U.A 45.5.2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB115 Sponsor Statement 5.5.2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB115 Summary of Additional Supporting Documents 5.5.2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
HJR27-LEG-SESS-05-06-24.pdf HL&C 5/6/2024 3:15:00 PM
HJR 27
SB115 opposition AEMA.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB115HLandC050624WrittenTestimony.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
alaska-primary-care-physicians-to-nurse-practitioners-2022.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
scope-education-and-training-PA-0923.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB89 Opposition.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
Letter Rep Summer_2024_MAR_08.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
SB 89 AK_Testimony_Oppose_SB89_Vape Tax_Senate Finance PDF.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
SB 89 testimony opposed.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
SB 89 Support Letter AK Native Health Board 2.28.24.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
SB 29 Research - Quit Using Nicotine - ANTHC.pdf HL&C 5/6/2024 3:15:00 PM
SB 29
SB 89 Support Letter AK Childrens Trust 3.1.24.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
SB 89 Bill Text version Y.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
SB 89 - Comparison of version of R and Y.pdf HL&C 5/6/2024 3:15:00 PM
SB 89
DCCED-CBPL Follow Up to HL&C re SB 115 5.7.24.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
SB 115.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
L & C Written Testimony by Southworth 050424.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
Addendum to Southworth Testimony w Examples 050424.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
ASPS Comments - Scope PA - AK House Labor & Commerce Chairs - 5-3-2024.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
32 Letters of Opposition SB115.pdf HL&C 5/6/2024 3:15:00 PM
SB 115
McWilliams - Testimony in Support of SB115 (signed).pdf HL&C 5/6/2024 3:15:00 PM
SB 115