Legislature(2023 - 2024)BELTZ 105 (TSBldg)
02/10/2023 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| Workforce Overview from the Division of Corporations, Business and Professional Licensing Perspective | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
February 10, 2023
1:32 p.m.
MEMBERS PRESENT
Senator Jesse Bjorkman, Chair
Senator Click Bishop, Vice Chair
Senator Elvi Gray-Jackson
Senator Forrest Dunbar
Senator Kelly Merrick (via teleconference)
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
PRESENTATION(S): WORKFORCE OVERVIEW FROM THE DIVISION OF
CORPORATIONS~ BUSINESS AND PROFESSIONAL LICENSING PERSPECTIVE
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
SYLVAN ROBB, Director
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Juneau, Alaska
POSITION STATEMENT: Delivered a workforce overview from the
perspective of the Division of Corporations, Business and
Professional Licensing.
GLENN SAVIERS, Deputy Director
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Juneau, Alaska
POSITION STATEMENT: Participated in the workforce overview from
the perspective of the Division of Corporations, Business and
Professional Licensing.
ACTION NARRATIVE
1:32:28 PM
CHAIR JESSE BJORKMAN called the Senate Labor and Commerce
Standing Committee meeting to order at 1:32 p.m. Present at the
call to order were Senators Merrick (via teleconference),
Dunbar, Bishop, Gray-Jackson, and Chair Bjorkman.
^Workforce Overview from the Division of Corporations, Business
and Professional Licensing Perspective
WORKFORCE OVERVIEW FROM THE DIVISION OF CORPORATIONS, BUSINESS
AND PROFESSIONAL LICENSING PERSPECTIVE
1:33:09 PM
CHAIR BJORKMAN announced the committee would hear a workforce
overview from the Division of Corporations, Business and
Professional Licensing perspective.
1:34:03 PM
SYLVAN ROBB, Director, Division of Corporations, Business and
Professional Licensing (CBPL), Department of Commerce, Community
and Economic Development, Juneau, Alaska, introduced herself.
MS. ROBB began the presentation on slide 2, and reviewed the
following:
CORPORATIONS
• Maintains a registry of corporations doing business
in Alaska
• Assists corporations with registrations
• Registers trademarks
• Maintains corporate reporting records
BUSINESS LICENSING
• Answers questions about applications
• Registers business licenses
• Grants endorsements to sell nicotine products
1:36:26 PM
PROFESSIONAL LICENSING
• Licenses qualified professionals under 45 programs
per AS 08
• Provides administrative support for 21 professional
licensing board
INVESTIGATIONS
• Enforce licensing statutes and regulations
• Investigate public complaints regarding violations
of licensing law
• Assist boards, commissions, and the division
director when considering license discipline
ADMINISTRATIVE SUPPORT
• Provide front-line customer service
• Support division's clerical and fiscal functions
1:39:51 PM
MS. ROBB turned to the bar graph on slide 3 to discuss increased
workload volume in CBPL from FY2019 - FY2022. The division
experienced substantial growth in the number of registered
corporations and licenses issued. The division had a 21 percent
increase in registered corporations since FY19, bringing the
total number of registered corporations to 92,000. Business
licenses and endorsements increased by 36 percent. Alaska is
just shy of having 100,000 licensed businesses. There has been a
24 percent increase in professional licensing since FY19,
bringing the total number of professional licenses in the state
to over 104,000. The number of professional licenses issued grew
64 percent in the last ten years. None of these numbers include
the number of applications submitted, processed, and later
abandoned or withdrawn before a license was issued. CBPL is a
volume business, and the increase in volume comes with more
concurrent phone calls, faxes, and emails. The volume is
intensified because the world operates in an age where people
expect quick responses. The increased workload in these sections
affected the investigations and administrative teams. She
mentioned that the division did not charge for business licenses
during the pandemic; however, the fee was reinstated on February
1, 2023.
MS. ROBB said that the remainder of the presentation focuses on
professional licensing since that is the committee's main
interest.
1:42:08 PM
MS. ROBB turned to slide 4 to give a Professional Licensing
Overview:
PROFESSIONAL LICENSING PROGRAM REGULATION
• 21 programs are regulated by licensing boards; these 21
programs offer 180 different license types
• 24 programs are regulated by the division; these 24
programs offer 81 different license types
• 261 license, permit, certification, and endorsement types
within the 45 programs
• Over 400 pathways to initial licensure within the 45
programs
MS. ROBB said a pathway is how a person qualifies for a license.
For example, a person can qualify by having been a petitioner in
another state, already having had a license. She described the
dentist program. The dental program can license a dentist by:
- examination level III - a dentist who has never been licensed
- examination level II - a dentist who has been licensed between
90 days and 5 years
- by credential - a license who has been licensed elsewhere over
5 years
1:43:42 PM
MR. ROBB said the dental hygienist license is obtained through
those same three pathways. Dentists may obtain a permit to
administer moderate or minimal sedation, a permit to administer
deep sedation or general anesthesia, and both types of permits
are obtainable through multiple pathways. Dental hygienists may
obtain a certificate to administer local anesthetic agents, a
certificate to provide nitric oxide, endorsements to perform
restorative functions, and two are obtainable through multiple
pathways. The Board of Dental Examiners does not regulate dental
assistants, but if the dental assistant performs coronal
polishing or restorative functions, they must obtain a
certificate from the dental board. There is also a temporary
dentist permit, a courtesy dentist license, a courtesy dental
hygienist license, a military temporary courtesy license for
both dentists and hygienists, and collaborative agreements
between dentists and dental hygienists. CBPL will have specialty
dentist licenses and advanced dental hygienist permits soon. All
of these items require separate allocations. This program
example illustrates a great deal is contained within each of the
45 programs. Furthermore, the Board of Dental Examiners approves
many course types, coronal polishing courses, continuing
education courses for dental licenses, continuing education
courses for moderate sedation permits, and so on. She said each
has its individual requirements, pathways, approval applications
and requires different supporting documents. She said staff
requires significant knowledge for one program, many licenses
and permit types, and many applications and forms.
• Each program has its own statutes and regulations, and
therefore has its own processes and requirements
• Each program may differ slightly on its requirements for
licensure compared to its counterparts in other states due
to statutes or regulations adopted by the Alaska
Legislature and Alaska board or the department (as
applicable)
MR. ROBB said that staff requires a good knowledge of statutes
and regulations. Some of the programs have regulations that
exceed 50 pages. There is a lot to know.
1:45:52 PM
STAFFING
• Most of our programs are handled by one staff member, who
not only handles all licensing duties but also in some
cases staffs a board
• Many staff members take on more than one program usually
one boarded program and then one or more smaller,
department-regulated program
• Programs with significantly larger license numbers such as
nursing, construction contractors, pharmacy, and medical
are staffed by bare bone teams (i.e., as few staff members
as needed to get the job done to keep program costs down
per AS 08.01.065)
1:47:25 PM
SENATOR BISHOP asked what solutions she has to reduce the 2.5-
month license processing time.
MS. ROBB replied the best solution is the nurse licensure
compact. An upcoming slide describes the remedy for long
processing times.
SENATOR BISHOP asked about other solutions for getting it done.
MS. ROBB replied the biggest challenge is a lack of staff and an
extremely high turnover rate. She said that staff turnover slows
processing speed down because of the breadth of knowledge
required to do the job, which she just described, and the
learning curve. In addition to the institutional knowledge lost
as employees leave, there are also efficiencies with staff who
have processed a license application 50 times as opposed to one
time.
SENATOR BISHOP asked what exit surveys show, and he sought
confirmation that positions processing Board of Nursing license
applications are a range 14.
MS. ROBB answered that the occupational license examiner
positions are a range 14.
1:49:35 PM
SENATOR DUNBAR dovetailed off Senator Bishop. He asked whether
the department considered increasing the range and what the
process is to do so.
MS. ROBB replied that ideas to improve compensation are
addressed later in the presentation. Under consideration is
reclassifying the position, the method used to change ranges.
The department is working with the classification unit in the
Division of Personnel and Labor Relations, Department of
Administration (DOA), to ensure the position aligns with the
merit system for State of Alaska employees. The department is
considering a broader class study to create better pathways.
This will encourage upwardly mobile employees with more
knowledge to stay in the division for advancement opportunities.
1:51:01 PM
SENATOR GRAY-JACKSON asked what the salary is for a range 14.
MS. ROBB responded that she did not have that information but
would follow up with the committee.
MS. ROBB noted that the division is receipt supported, including
the cost of processing documents and applications, answering
calls and emails, staffing board meetings, and investigating
complaints. Per statute, the fees are set based on the cost of
running each licensing programs.
1:52:10 PM
MS. ROBB turned to slide 5 to discuss board-regulated programs;
the total number of boards is 21 and the total number of seats
is 121. She thanked all the Alaskans who serve on these boards;
it is a big commitment. Boards are required to meet four times
per year, but some boards meet weekly to get their work done.
She discussed the separation of work between the board and the
division; each board is structured slightly differently. She
said that, in general, boards set regulations governing the
practice of the profession and the required continuing
education. Boards sometimes approve each new licensee, review
issues requiring discipline, and impose sanctions. Some boards
review and approve continuing education courses. She described
how the division serves board-regulated programs; the division's
duties include noticing public meetings, arranging space and
travel for meetings, distributing board materials, taking
minutes and recording meetings and ensuring minutes are posted
for public access, acting as an advisor to the board, and
obtaining, reviewing, and processing completed applicant
packets. The board gives each packet the final review. The
division investigates complaints and reports of misconduct for
individuals operating without a license and forwards
substantiated complaints to the board for sanction. The division
maintains forms and regulations, keeping the website up-to-date.
CBPL collects fees and reviews expenses to set fees, processes
renewal applications, creates new forms and processes as
regulations and statutes change and new license types are
created. The division assists prospective and current applicants
and licensees with questions.
1:54:50 PM
MS. ROBB said the simplest way to differentiate the work between
boards and the division is that boards regulate their respective
professions, and the division handles the day-to-day
administrative functions.
1:55:09 PM
MS. ROBB advised that a range 14 earns just under $50,000
annually.
MS. ROBB noted each program includes a number of different
license types within each profession, and these numbers do not
include military, temporary, and courtesy licenses. Slide 5
reads:
21 Programs Regulated by Boards
• Board of Registration for Architects, Engineers, and Land
Surveyors (22 license types)
• Board of Barbers and Hairdressers (22 license types)
• Big Game Commercial Services Board (6 license types)
• Board of Chiropractic Examiners (4 license types)
• Board of Dental Examiners (15 license types)
• Board of Marine Pilots (3 license types)
• State Medical Board (11 license types)
• Board of Marital and Family Therapy (4 license types)
• Board of Massage Therapists (3 license types)
• Board of Certified Direct-Entry Midwives (4 license
types)
• Board of Nursing (8 license types)
• Board of Examiners in Optometry (2 license types)
• Board of Professional Counselors (3 license types)
• Board of Pharmacy (18 license types)
• Board of Physical Therapy and Occupational Therapy (12
license types)
• Board of Psychologist and Psychological Associate
Examiners (4 license types)
• Board of Public Accountancy (8 license types)
• Board of Certified Real Estate Appraisers (10 license
types)
• Real Estate Commission (10 license types)
• Board of Social Work Examiners (6 license types)
• Board of Veterinary Examiners (5 license types)
1:57:18 PM
MS. ROBB displayed a list showing 24 programs the division
regulates. She noted that the number of license types does not
include military, temporary, or courtesy licenses. She pointed
out that the Prescription Drug Monitoring Program (PDMP) falls
under the Board of Pharmacy's purview but is listed under
division-regulated programs, the reason being PDMP requires its
own staff, independent from that of the Board of Pharmacy, and
it requires a hands-on approach that volunteer board members
cannot provide. PDMP interfaces with six regulatory boards. She
noted that the Telemedicine Business Registry is a registry for
businesses that provides telehealth services in Alaska; the
business must be registered whether located in or out of state.
24 Programs Regulated by Division
• Acupuncture (2 license types)
• Animal Euthanasia Permits (2 license types)
• Athletic Training (2 license types)
• Audiology (2 license types)
• Behavior Analysts (4 license types)
• Collection Agencies (6 license types)
• Concert Promoters (2 license types)
• Construction Contractors and Residential
Endorsements (6 license types)
• Dietitians (2license types)
• Dispensing Opticians (4 license types)
• Electrical Administrators (2 license types)
• Geologists (2 license types)
• Guardians and Conservators (10 license types)
• Hearing Aid Dealers (2 license types)
• Home Inspectors (6 license types)
• Mechanical Administrators (2 license types)
• Morticians (12 license types)
• Naturopaths (2 license types)
• Nursing Home Administrators (3 license types)
• Nutritionists (2 license types)
• Pawnbrokers (2 license types)
• Prescription Drug Monitoring Program (N/A)
• Speech-Language Pathology (4 license types)
• Telemedicine Business Registry (N/A)
• Underground Storage Tank Workers (2 license types)
1:58:23 PM
SENATOR DUNBAR asked how many professional boards are outside
the division's purview. He provided the example of the Police
Standards Council.
MS. ROBB said in terms of occupational licensing, that is
correct and a good point. CBPL does not license everything; it
does not license officers, teachers, or attorneys for example.
Those are housed elsewhere. CBPL licensure programs are listed
above.
1:59:30 PM
MS. ROBB advanced to slide 7 to advise the committee on the
division's struggle to keep up with its volume of work. She
reiterated that the division's primary challenges are a lack of
staff and staff turnover. The high staff turnover rate, with its
corresponding loss of institutional knowledge, has been a huge
loss. She reviewed slide 7:
CBPL Staffing Issues
Increases in Corporations and Licenses
• 20.6% increase in registered corporations since
FY19
• 35.5% increase in business licenses &
endorsements since FY19
• 23.6% increase in professional licenses since
FY19
Staff Numbers
• 103 division positions (6 non-permanent) as of
the end of FY19
• 115 division positions (13 non-permanent) as of
the end of FY22
• 110 division positions (7 non-permanent) as of
end of CY22 (6.8% increase since FY19)
Issues
• PCNs have not kept up with increased volume
MS. ROBB said the volume increase equates to 61,000 additional
corporate registrations, business licenses or endorsements, or
professional licenses since FY19.
• Around a 35% vacancy rate in professional
licensing staff during COVID
• That decreased to 20% at the end of FY22, and is
now down to 14%
• Current division-wide vacancy rate is 12%
• Around a 55% turnover rate in the professional
licensing staff during COVID
• 40% turnover rate in FY22.
2:02:34 PM
SENATOR BISHOP asked whether the division does exit surveys and
whether there is a trend. He wondered whether the employees who
stayed were interviewed and, if so, how many have a defined
benefit plan.
MS. ROBB said the State of Alaska does voluntary exit surveys.
She said that in her one month on the job, she had yet to have a
chance to review the exit surveys. She thanked Senator Bishop
for the suggestion.
2:03:30 PM
GLENN SAVIERS, Deputy Director, Division of Corporations,
Business and Professional Licensing (CBPL), Department of
Commerce, Community and Economic Development (DCCED), Juneau,
Alaska, said she would follow up with specifics to those
questions.
SENATOR BISHOP expressed curiosity to know why staff chose to
stay.
MS. ROBB said that is a great suggestion.
2:04:35 PM
MS. ROBB advanced to slide 8 to discuss the division's staff
numbers, job titles, and ranges:
CBPL PROFESSIONAL LICENSING STAFF
Job Title Range PCNs
Occupational License Examiner 14 30
Executive Administrator Varies 8
Administrative Assistant 1 12 4
Program Coordinator 2 18 3
Records and Licensing Supervisor 16 3
Program Coordinator 1 16 2
Project Assistant 14 2
Nurse Consultant 1 24 1
MS. ROBB said this chart does not reflect the administrative
support team that handles mail, phone calls, faxes, and emails.
MS. ROBB compared two charts on slide 9, occupational licensing
examiner vacancies against the CBPL as a whole. The occupational
examiner job class is critical within the division. It has 36
employees and is the largest job class in the division. The
occupational examiner group dropped to a 36.7 percent vacancy
rate in 2021. Both the corporations, business, and professional
licensing and occupational licensing charts show a trend toward
standard vacancy rates.
2:06:13 PM
MS. ROBB advanced to slide 10 to discuss division efforts and
successes:
Success Stories and Ongoing Efforts by CBPL
• All renewal applications are available online now
MS. ROBB reported that applicants started 46 percent of all
initial application events online. The Board of Nursing has its
initial applications available online and licenses 28,000
individuals, the biggest licensing pool. One hundred percent of
renewal applications are available online.
• Made additional services available online
• Updates and enhancements to internal licensing
database
2:08:58 PM
• Reclassifying positions to better support
applicants, licensees, staff, and boards
• Commissioner's Office created a board advisor to
assist with:
• Training and advising boards about their roles
and duties; and
• Training and advising staff that work with boards
about their roles and responsibilities
• Management stepped up and filled staffing gaps to
get licenses issued
• Reviewing options to improve how exams are offered
• Amending regulations under the division's authority
• Pushing boards to amend regulations that are hard to
understand or create overly burdensome requirements
2:11:19 PM
SENATOR DUNBAR asked about the length of time positions stayed
vacant, on average. He expressed his belief that the legislature
passed recruitment incentives last year and wondered if those
were vetoed. He asked for more information about what happened
with that legislation.
MS. ROBB said it is difficult to give an average vacancy rate,
but some positions have been vacant for over a year. It depends
on the type of position. She requested specific parameters so
that she could collect that information. As to recruitment
incentives, there were no division recruitment incentives last
year.
SENATOR DUNBAR redirected the inquiry to the chair for future
exploration. He wondered whether the body had funded retirement
incentives and why they were vetoed.
MS. ROBB described division improvements pertaining to the last
three bullets on slide 10.
2:15:45 PM
MS. SAVIERS supplemented the response to Senator Bishop's
question. The Board of Nursing and the State Medical Board
amended their regulations last year, so a temporary permit was
an automatic part of obtaining a permanent license. Once the
applicant submits the necessary pieces, the division will issue
a temporary license while it finalizes the permanent one. This
regulation change streamlined processing by reducing the number
of applications for temporary licensure and getting healthcare
workers into the workplace faster.
CHAIR BJORKMAN sought confirmation that the state has nurse
licensure reciprocity for temporary nursing permits.
MS. SAVIERS replied that it is not that simple. The state still
requires a handful of documents before issuing a temporary
license. She offered to follow up with the documents needed for
the temporary permit versus the permanent license.
CHAIR BJORKMAN said that would be helpful. He said if the goal
is a nursing compact, the temporary permit is a good stop-gap
measure until the goal can be achieved.
CHAIR BJORKMAN wondered about the onboarding process for
examiners, asking specifically about changes to the process over
the past ten years and training for entry-level, range 14
positions.
2:18:51 PM
MS. SAVIERS responded that she was not involved with training
until last year. It is in transition. The division utilizes
feedback from trainee examiners to discover what works. The
division relies on AspireAlaska, which provides EXCEL, ADOBE,
and Outlook training. The operations manager offers guidance on
organizing the work desk and interpreting statutes and
regulations. Management is creating checklists for new examiners
to use as verification tools. The division takes the "I do it,
we do it, you do it" approach, meaning the trainee shadows the
supervisor, then they do it together, and finally, the trainee
does it under supervision. The plan is to have more training
sessions; the division will fly in licensing examiners for a
week or two for in-person training.
CHAIR BJORKMAN asked whether the shifts in training are more
online or in-person.
2:21:14 PM
MR. SAVIERS replied that training sessions are shifting towards
online using Teams. Sessions are recorded so everyone can access
them. Because of the vacancy rate, the division expanded
recruitment to include Juneau, Anchorage, and occasionally
Fairbanks. In-person training sessions depend on the location of
supervisors and trainees. The division still does more one-on-
one training but is shifting to online.
CHAIR BJORKMAN said it would be interesting to see the reception
trainees give online training and its effectiveness with quality
of service and turning licenses around. He said that his
experience with online learning in his profession has not been
great.
MS. SAVIERS clarified that the online portion is used for
general training, like how to use the database. More one-on-one
training is done for processing applications.
2:23:35 PM
MS. ROBB read slide 11 to discuss the biggest question CBPL
receives from the legislature:
What More Can We Do? Compacts!
Interstate Licensing Compacts
• Contracts between two or more states
• State-based approach to multi-state licensure that
uses a vehicle for interstate collaboration
• Most powerful, durable, and adaptive tools for
ensuring cooperative action among states
• Reciprocal professional licensing practices between
states while ensuring the quality and safety of
services and safeguarding state sovereignty
• Compacts are not a takeover of state licensing, but
rather a way to preserve state control over
professional licensure:
• State licensure processes remain in place
• Licensees voluntarily become part of a compact
• State practice acts are not impacted; compacts
don't mean delegating scope of practice
• Compacts are not owned or controlled by any
organization
• Compacts allow for:
• Significant improvements in the time it takes to
get licensed professionals into vacant Alaska
positions
• Freedom of movement across states
• To date, over 40 states and territories have adopted
occupational compacts
2:27:07 PM
SENATOR DUNBAR sought clarification on state sovereignty. He
expressed his understanding that adopting the compact meant it
would be codified into state law. He sought confirmation that
Alaska would be dropped from the compact if the state modified
it.
MS. ROBB replied yes, that is correct. The legislature must
adopt the compact language without change. This prevents states
from raising or lowering compact standards. A state would remove
itself from the compact by modifying it. She said if the compact
moved in a direction the state was not comfortable with, the
state could drop out.
SENATOR DUNBAR recalled that she mentioned licensure fees fund
the division. He wondered if CBPL would lose revenue if out-of-
state compact-licensed nurses, who paid their license fees
elsewhere, practiced in Alaska. He asked if there is a mechanism
to compensate CBPL for a loss of revenue and if the division is
concerned.
MS. ROBB replied that the professional license fees are based on
the cost of processing the license. The division would only
incur work costs once the applicant renewed; at that time, the
state would charge a renewal fee.
2:29:23 PM
SENATOR DUNBAR followed up, stating the division has other
functions like disciplinary functions and staffing boards. He
asked whether licensure fees cover the costs of those periphery
functions, and if so, it seems the division would be reducing
its revenue but not as quickly reducing its workload.
MS. ROBB replied that the department fully vetted the nurse
licensure compact from every angle. She explained if the nursing
compact passed, the division would offer applicants the option
of an Alaska nursing license or a compact nursing license. Each
license is distinctly different with its individual fees,
qualifying criteria, and investigation procedures.
SENATOR DUNBAR followed up, asking who investigates compact
nurses.
MS. ROBB replied state investigators conduct investigations for
violations that occur in Alaska.
SENATOR DUNBAR sought clarification that compact nurses would
pay a fee.
MS. ROBB answered that is correct. Compact nurses have their own
compact license fee. She likened it to the Division of Motor
Vehicles (DMV), which issues Alaska driver's and Real ID
licenses; each has an individual fee. The same is true with
nursing licenses. The Alaska-only nursing license has a fee
separate and different from the compact nurse. Each nurse
category has its unique fees that cover its particular and
individual investigations.
2:31:43 PM
MS. SAVIERS added that CBPL questioned the national organization
that connects nurse licensure compact states. The division asked
about the percentage of compact licensed nurses involved with an
investigation and corresponding license fee increases. She
reported that of the 39 nurse licensure compact states, there
had been zero investigations. She explained that compact license
standards are higher than most states nationwide. Applicants
cannot have felonies, nursing practice-related misdemeanors, or
any disciplinary actions on their license. Compact licensees
have squeaky-clean records. She reiterated the earlier point
that the multi-state nurse licensure compact is written under a
different statutory chapter than the single state Alaska nurse
license, ensuring operation costs for each program remain
separate.
2:33:52 PM
MS. ROBB showed the states nationwide that participate in any of
the six occupational licensure compacts listed on slide 12:
- Advanced Practice Nursing (APRN) Compact
- Physical Therapy (PT) Compact
- Psychology Interjurisdictional Compact (PsyPact)
- Nurse Licensure Compact (NLC)
- Interstate Medical Licensure Compact (IMLC)
- Emergency Medical Technician Compact (REPLICA)
She indicated that over 40 states and territories have adopted
compacts. Alaska is one of nine states that has not adopted an
occupational licensing compact. Alaska participates in 28
compacts, but none relating to occupational licensing. It is
especially difficult for the division to get qualified
professionals who want to work in Alaska temporarily or
permanently; compacts would improve the situation without
compromising quality of service, safety, or state sovereignty.
She said the division supports compacts in general but
acknowledged that not all licensing compacts are equal.
2:36:19 PM
MS. ROBB advanced to slide 13 to discuss the nurse licensure
compact:
Enhanced Nurse Licensure Compact (eNLC)
• NLC license standards are higher than Alaska's nurse
license standards
MS. ROBB said Alaska-qualified nurses would choose between a
single-state license to practice only in Alaska or a multi-state
one. She reiterated that the multi-state license standards are
higher than the single-state Alaska license. There is no risk to
standards of care or public safety. The financial pools are
maintained separately.
• 39 U.S. states and territories have joined the NLC:
Another 7 have legislation pending to join
• Alaska is projected to have 5,000 RN vacancies by 2030.
We only produce ~324 RN graduates per year
• Retains State Sovereignty: Alaska Board of Nursing
retains the right to govern nursing practice in Alaska
and revoke practice privileges in the state, regardless
of the type of license held
• Fills nursing vacancies quicker: Skip the in-state
licensure process; facilities still perform background
checks
• Alaska nurse licensing staff is the biggest team: More
than double the size of any other licensing team in the
division, they work lots of overtime, and they still have
23-month processing times
• No other option! The Alaska Board of Nursing has
streamlined licensure requirements and processes as much
as possible without reducing public safety. At this
point, the NLC is the only immediate solution to Alaska's
nursing shortage
2:40:14 PM
SENATOR DUNBAR commented that the legislature wants to increase
the number of nurses in Alaska. He noted that she said nursing
students have indicated they will leave the state to obtain a
multi-state nurse license. He asked whether she has statistical
evidence that eNLC participating states retain a larger number
of their in-state nurses.
MS. ROBB replied that she has no statistical evidence, but 39
states have already joined, and seven more are considering it.
She said that Alaska is one of the last holdouts, and it is
concerning that the ease of working in a multi-license state
could affect the state's ability to attract nurses. She
clarified that joining the eNLC does not guarantee attracting
nurses; however, joining the compact makes practicing in Alaska
an easier choice for nurses.
SENATOR DUNBAR asked to see data from analogous, rural states to
compare the before and after numbers of those states that joined
the compact.
MS. ROBB replied that she would provide that information to the
committee.
2:42:28 PM
MS. ROBB noted that the Alaska Board of Nursing initially did
not support the compact. It was not until 2018, after
introducing an enhanced, higher standard, that the Board of
Nursing supported the compact. She pointed out the division
ensured there were no compact standards preventing currently
licensed nurses from continuing to practice in Alaska.
2:43:47 PM
SENATOR GRAY-JACKSON recalled several years ago, the Board of
Nursing opposed the nurse licensure compact.
MS. ROBB commented that the Board of Nursing supports the
compact now that it is enhanced.
SENATOR GRAY-JACKSON asked when the Board of Nursing changed its
support for the compact.
MS. ROBB replied after the compact was enhanced in 2018.
2:44:43 PM
MS. SAVIERS clarified that the Alaska Nurses Association opposes
the nurse licensure compact.
MS. ROBB said that elected officials from each member state
decided upon the compact enhancements, and each member state's
legislature had to adopt the changes and include them in
statute. States that did not adopt the changes were removed from
the compact. She emphasized that the compact does not have a
grandfather clause. She explained that a state failing to adopt
changes would not be grandfathered in as a member state because
of previous membership. States must adopt compact changes to
retain their membership. New Jersey was the only state that did
not adopt the enhancement changes, and it exited the compact.
Later, however, New Jersey adopted the changes and rejoined the
compact. States have the option to exit the compact by repealing
the compact statutes, and in so doing, Alaska would return to
single-state nurse licensure.
MS. ROBB stated that the Alaska Nurses Association is the only
health organization in the state that opposes joining eNLC. Over
75 Alaska organizations support it, including all hospitals,
healthcare facilities, and the Advanced Practice Registered
Nurse (APRN) Alliance. She said the division met with the Alaska
Hospital and Healthcare Association (AHHA) and the Alaska Nurses
Association (AaNA) to explore alternative options. Since AaNA
did not support eNLC, it was set aside, and other ideas were
encouraged. She said the group was unable to come up with
solutions that streamlined and accelerated processing time. She
said that brought the division back around to the Enhanced Nurse
Licensure Compact. She recapped the division's hurdles, the
benefits of adopting eNLC, and the Board of Nursing's support
for the compact.
2:50:12 PM
CHAIR BJORKMAN stated two facts. Alaska has a nursing shortage,
and the demand for nurse licensure has skyrocketed. He said
those facts are incompatible. He asked why Alaska has a nursing
shortage when applications are abundant.
MS. ROBB replied that the division does not track where
licensees work or if they are working. She said that she could
not speculate on an answer.
CHAIR BJORKMAN remarked on the surge in nurse license
applications and its effects on production. He explored whether
the root cause of the rising workload has to do with the way the
health industry operates. He wondered whether market forces
within the industry that necessitate the need for traveling
nurses create higher demand for licensure nationwide. He
considered whether the industry should take steps or whether the
legislature should encourage the industry to address the
problem's root cause. He explained that his district's local
hospital employs over 20 traveling nurses. Seven additional
positions were open to traveling nurses at that time. The
hospital offered these nurses upwards of $150 per hour,
substantially more than a range 14 licensing examiner earns. He
wondered whether the root cause of CBPL's issue is that people
making $150 per hour only need to work a little.
2:53:31 PM
MS. ROBB commented that misinformation is circulating about the
nursing compact, which has created some opposition. She asked
that legislators consider the compact with an open mind and
contact the division when they hear something concerning or have
questions. She said neither the division, the Alaska Board of
Nursing, nor the administration would support anything adversely
affected Alaska's nurses, Alaskans, or state sovereignty.
MS. ROBB said that joining the nurse licensure compact is more
than a licensing issue; it is a healthcare issue that licensing
plays a part in supporting. The state has watched hospice
clinics close, seen understaffed hospitals and nurses working
two and three consecutive shifts, causing early burnout. The
compact is not a fix-all, but it will accelerate licensing and
make it easier for nurses to work in Alaska.
2:55:11 PM
SENATOR GRAY-JACKSON wondered what the Alaska Board of Nursing's
concerns are about joining the compact. She asked whether the
division had discussed those concerns with the board.
MS. ROBB clarified that the Alaska Board of Nursing supports
joining the compact. However, it is confusing that the Alaska
Nurses Association opposes it, especially since a 2019 survey of
nurses strongly supported the nurse licensure compact.
2:56:32 PM
MS. SAVIERS added that she could not speak for AaNA, especially
since the division has differing opinions, and it would be a
disservice to talk for the association. She said the
administration surveyed over 16,000 Alaska licensed nurses at
the end of 2019. Of the 3,527 nurses that responded, 92 percent
favored the compact, 3 percent opposed it, and 4 percent had no
opinion. The survey asked whether the nurses were union members
during their nursing appointment, and of those that were, 87
percent wanted to join the compact, 8 percent did not want to
join, and 6 percent had no opinion either way. The data shows
that nurses want this, not just the board, the hospitals, and
the administration. The division has kept its door open to the
association for continued clarification and conversation.
2:57:53 PM
SENATOR DUNBAR suggested that sunset language might be
preferable to repeal language to exit the compact. He asked
about the appropriate length of time for a sunset date.
MS. ROBB replied this is a great suggestion. The division would
need at least two years to assess the compact.
SENATOR DUNBAR said if the legislature were to draft a bill,
that information would be helpful.
3:00:07 PM
MS. ROBB advanced to slide 14 to explore what else could be
done.
What Else Can We Do (Besides Compacts)?
• Clean up statutes: See Governor Dunleavy's Professional
Licensing Reform introduced in the 31st Legislative
Session as a great example (HB 216 / SB 157)
• Allow for Universal Temporary Licensure: While this will
result in more applications for staff to process and
potentially longer licensing times, it will at least
allow people to get to work in Alaska quicker while
awaiting their permanent licenses
• Involve the division:
• When introducing new licensing program, loop the
division in early. Decide if needs a regulatory board,
advisory board, or no board at all
• When working on licensing legislation, use the
division to vet prior to introduction
• Help us promote recruitments through your newsletters to
constituents
• Suggest ideas!
3:03:06 PM
SENATOR GRAY-JACKSON thanked the presenters.
CHAIR BJORKMAN asked whether universal temporary licensure
requires a statute change.
MS. ROBB replied that it would require a statute change.
CHAIR BJORKMAN pointed out that the division's workload
increased 64 percent, but the division only added seven long-
term non-permanent positions. That is a tremendous workload
increase, especially considering the recent and current vacancy
factors in the division. He recognized the division for their
work. He thanked those that stuck around and stuck it out. The
committee looks forward to supporting CBPL. He said that AaNA
has expressed there are other things that the board and the
division can do besides compacting. He encouraged the division
to meet with AaNA and configure a mutual agreement about what
those issues are and what has been tried; this will better
inform legislators in making decisions about compacting going
forward.
3:05:44 PM
There being no further business to come before the committee,
Chair Bjorkman adjourned the Senate Labor and Commerce Standing
Committee meeting at 3:05 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 02.10.23 DCCED CBPL Presentation.pdf |
SL&C 2/10/2023 1:30:00 PM |
CBPL Presentation to SL&C |