HB 293-GENETIC COUNSELOR: LICENSING; ADVISORY COUNCIL.  4:19:18 PM CO-CHAIR HALL announced that the only order of business would be HOUSE BILL NO. 293, "An Act relating to the practice of genetic counseling; relating to the licensure of genetic counselors; establishing the Genetic Counseling Advisory Council; relating to the duties of the State Medical Board; relating to telehealth by licensed genetic counselors; relating to medical malpractice liability of licensed genetic counselors; relating to immunity from civil liability for a licensed genetic counselor providing free health care services; and prohibiting unfair discrimination under group health insurance against genetic counselors." CO-CHAIR HALL announced that the committee would hear invited testimony on HB 293. 4:19:53 PM PAM VENTGEN, Executive Director, Alaska State Medical Association (ASMA), gave invited testimony in support of HB 293. She said ASMA represents both physicians and physician assistants in Alaska. She said that the association supports HB 293 as beneficial to all Alaskans who use genetic counseling services. She said that this is a critical service that needs to be provided by people with credentials and licensing is the best way to establish this. She said that the proposed legislation also would allow billing for services to insurance companies. MS. VENTGEN explained that currently, genetic counselors work primarily in cancer care centers and conduct natal and prenatal counseling as well. She said that it is most appropriate to include licensing of genetic counselors under ASMA, since the association works closely with physicians. She said that in the past, the licensed paramedics before they were moved over to the Department of Health. She reasoned that it would not be unusual for the board to license a subgroup of professionals. She asked for support for HB 293. 4:21:34 PM REPRESENTATIVE COULOMBE asked Ms. Ventgen whether ASMA had any concerns regarding the scope of practice proposed under HB 293. MS. VENTGEN responded that ASMA had no concerns regarding the scope of practice. She added that the scope of practice for pharmacists is well defined in their standards of practice and they work closely with physicians. 4:23:08 PM REPRESENTATIVE CARRICK said that she has concerns about creating a board for a profession that has so few people practicing in Alaska. She asked for the Division of Corporations, Business, and Professional Licensing perspective given previous work with boards. 4:24:03 PM SYLVAN ROBB, Director, Division of Corporations, Business, and Professional Licensing; Department of Commerce, Community & Economic Development, responded that currently there are 21 regulatory boards within the division. She noted the current bill proposes an advisory board and currently the division does not have any professions that have an advisory board. She noted that the regulatory authority would rest with ASMA as the bill is currently structured. She said that the smallest group of professionals with a board is the Board of Certified Direct Entry Midwives, and there were about 38 licenses within this profession. She noted that having a regulatory board for this small group of professionals has proven somewhat challenging. She reiterated that HB 293 proposes an advisory board, and some of the conflict-of-interest issues would not exist to the same degree as a regulatory board. REPRESENTATIVE CARRICK asked the bill sponsor whether the board proposed under HB 293 would approve licensure. 4:25:43 PM CO-CHAIR FIELDS directed Representative Carrick's question to his staff. 4:25:57 PM EVAN ANDERSON, Staff, Representative Zack Fields, Alaska State Legislature, on behalf of Representative Fields, prime sponsor of HB 293, responded that there are two different terms: the advisory council and the board. He noted that under the proposed bill, all licensing goes through ASMA, but the advisory council is tasked with helping sort through the material pertaining to licenses. He said that given a discussion with a previous testifier, they mentioned that the advisory council would help sift through applications and support the licensing process. 4:26:37 REPRESENTATIVE CARRICK asked Ms. Ventgen whether ASMA had the capacity to accommodate the influx of licenses. MS. VENTGEN responded that she expects that a lot of this work will be delegated by the guidance of the advisory council. She said that currently, the licensing examiner and executive administrator for ASMA processes these licenses, unless there are any red flags on the application. She did not expect that this would be a significant increase in workload. 4:28:03 PM REPRESENTATIVE COULOMBE asked Ms. Robb about the fiscal note and whether the operating expenditures match the designated general fund (DGF) source, and she assumed that there would be a fee for licenses. She asked for clarification on the funding mechanisms. MS. ROBB responded that this is correct and fees charged for licenses generate revenue. REPRESENTATIVE COULOMBE asked why there was so much money designated for travel and whether the intent is for the advisory board members to travel to meet all in one place. She noted that there was $37,000 designated for travel purposes. MS. ROBB responded that currently Administrative Order 358 remains in effect, which imposes a travel freeze. She noted that the boards have not been meeting in person. She noted that if the order is rescinded, then the board would require authority to spend receipts pertaining to travel. REPRESENTATIVE COULOMBE asked whether the authority would be for the division to spend up to $37,000 on travel. MS. ROBB responded that this is correct and if no travel occurred then no expenses would be used on travel. REPRESENTATIVE COULOMBE asked whether the travel funds could be used in a different manner. MS. ROBB responded that there is no tracking by program, but expenses are tracked closely to ensure licensees are paying only for the cost associated with their own program. 4:30:30 PM CO-CHAIR FIELDS asked Ms. Robb whether deleting the authority to travel would be sufficient to make the fiscal note zero. He asked if there were ways to make the fiscal note fully DGF or zero in the interest of maximizing the likelihood of getting licensure established. MS. ROBB responded that the entire fiscal note is DGF and there was no unrestricted general fund (UGF) involvement. CO-CHAIR FIELDS asked whether eliminating travel authority would result in a zero fiscal note. MS. ROBB responded that there would be expenses outside the scope of travel. Furthermore, the division would need to pay for public notice of meetings. 4:31:45 PM REPRESENTATIVE COULOMBE said that there is an expectation of $62,000 in receipts and it seems like an expensive license for seven people. She asked for clarification and whether there was an expectation that many out-of-state people would get licenses. 4:32:06 PM CO-CHAIR FIELDS responded that given previous testimony, there was an expectation that there may be dozens or even hundreds of people who may get licensure. 4:32:36 PM CO-CHAIR HALL opened public testimony on HB 293. After ascertaining that nobody wished to testify, she closed public testimony. CO-CHAIR HALL announced that HB 293 was held over.