HB 149-NURSING: LICENSURE; MULTISTATE COMPACT  3:42:50 PM CHAIR SUMNER announced that the next order of business would be HOUSE BILL NO. 149, "An Act relating to the licensure of nursing professionals; relating to a multistate nurse licensure compact; and providing for an effective date." 3:43:32 PM REPRESENTATIVE PRAX, as prime sponsor, introduced HB 149. He stated that the Nurse Licensure Compact (NLC) would reduce the amount of time it takes for a nurse to become licensed in the state of Alaska. He suggested that this would reduce the number of vacancies in nursing positions. 3:47:56 PM RILEY NYE, Staff, Representative Mike Prax, Alaska State Legislature, on behalf of Representative Prax, prime sponsor, co-presented a PowerPoint, titled "House Bill 149: Nurse Licensure Compact" [hard copy included in the committee packet.] He reiterated that the proposed legislation would reduce the amount of time for a nurse to become licensed in the state of Alaska; thus, reducing the number of vacancies in nursing positions. He continued that it currently takes a minimum of two or three months for a nurse to become licensed in Alaska. He voiced that the Alaska Board of Nursing has made all the changes legally possible to streamline the process without harming public safety. The Alaska Hospital and Healthcare Association (AHHA) reported there were approximately 1,500 nursing vacancies in Alaska by the end of 2022. 3:52:30 PM REPRESENTATIVE FIELDS questioned the effect of increasing the number of employees in the Department of Commerce, Community, and Economic Development (DCCED) and whether this would speed up the process. 3:53:02 PM SYLVAN ROBB, Director, Division of Corporations, Business and Professional Licensing, Department of Commerce, Community, and Economic Development, answered that the division, per the governor's budget, will be adding 12 more employees, and several of these positions would be added to the nursing team; however, this would affect the cost of licensure. She explained that one of the biggest challenges facing the nursing team is the volume of nursing licensure applications. In response to a follow-up question concerning increasing the number of the nursing team, she answered that there are currently 10 employees on this team, which is the most of any licensure team. 3:54:52 PM MR. NYE remained on slide 2 and stated that projections show that the number of nursing vacancies in Alaska will grow to approximately 5,000 by the year 2030. Of the seven states studied, Alaska is projected to have the worst nursing shortage by this time. 3:55:51 PM MR. NYE, in response to Representative Saddler, expressed uncertainty about the number of nurses leaving the state. MS. ROBB added that the division does not track the places of employment for nurses. 3:57:15 PM REPRESENTATIVE FIELDS commented on a study which showed a lack of evidence concerning NLC reducing nursing shortages, and he asked whether there are methodological issues with the study. MS. ROBB answered that the division has received letters of support from several states indicating that implementing NLC has been successful. She added that she is unaware of the study cited by Representative Fields. 3:59:26 PM REPRESENTATIVE CARRICK, referencing a survey from the Alaska Board of Nursing, pointed out that 56 percent of the respondents were Alaska resident nurses. She questioned who these other nonresident nurses were in the survey. MS. ROBB answered that the survey was sent to any nurse with an Alaska license. She discussed the statistics in the survey [which are addressed in slide 8 and slide 9 of the presentation]. She stated that 89 percent of those who reside in Alaska are supportive of the compact. She explained that nonresident nurses are included in the study because nurses are required to hold a license in each state they practice in, including telehealth and teaching. In response to a follow-up question, she said that residency is not a requirement to practice in Alaska. REPRESENTATIVE CARRICK asked how a compact would increase opportunities to come practice in Alaska. MS. ROBB answered that the proposed legislation would eliminate the need for a separate license when nurses come from out of state to practice in Alaska; therefore, it would reduce the amount of time before the nurse could start working. 4:05:24 PM REPRESENTATIVE SADDLER asked whether two or three months is an excessive amount of time to receive an occupational license. MS. ROBB answered that the amount of time required to gain a license varies by profession. She added that two or three months feels like a long time for individuals waiting to work and earn wages and for medical facilities that need more nurses. 4:08:37 PM REPRESENTATIVE RUFFRIDGE asked whether a nurse can hold an NLC license and an Alaskan license simultaneously. MS. ROBB answered yes. She added that many nurses who live in compact states have a compact license and an Alaskan license. MR. NYE added that nurses who move to Alaska would lose their ability to hold an NLC license because Alaska is not an NLC member. REPRESENTATIVE RUFFRIDGE expressed the understanding that when a nurse moves to Alaska and acquires a license, if this nurse had an NLC license, it would be lost. MS. ROBB answered that holding an NLC license requires a nurse to be a resident of a member state; however, a nurse living in a member state who has an NLC license can acquire an Alaskan license to practice in Alaska. 4:13:05 PM MR. NYE continued to slide 3, explaining that nurses with an NLC license can practice in all participating states without the need to acquire the state's specific licenses. He maintained that adopting the proposed legislation would allow Alaskan healthcare facilities to fill more nursing vacancies; thus, the burden on nurses who already practice in Alaska would be reduced. He added that being an NLC member state would still allow the state to retain authority and enforcement abilities for issues regarding nursing. 4:17:08 PM MR. NYE moved to slide 4 and gave examples of the benefits of NLC for Alaska. He explained that the Alaska Board of Nursing would still retain authority and jurisdiction for the practice of nursing in the state. He said that Alaska would become a more friendly environment for nurses and eliminate the costly and time-consuming process of acquiring additional licenses. 4:19:56 PM MS. ROBB, co-presenting the PowerPoint presentation, continued to slide 5 and gave additional facts about NLC. She reiterated that Alaska would not lose sovereignty. She expressed the opinion that NLC's requirements are stringent and passing NLC would not have a negative impact on public health and safety. She remarked that Alaska currently does not track licensed nurses; therefore, there should be no concerns regarding the inability to track nurses practicing under NLC. She expressed the opinion that NLC in Alaska would result in quicker processing for licensure applications, which could result in lower licensing fees in the future. 4:27:17 PM MS. ROBB displayed a chart on slide 6 which compared the current state qualifications, per statute, for nurse licensure with the NLC qualifications. She expressed the opinion that the requirements set forth by the compact would not create safety concerns because there is the same level of required qualifications. 4:29:34 PM MS. ROBB moved to slide 7 and slide 8, pointing out that other NLC member states describe membership as an essential tool for retention and recruitment. She said that 39 states have enacted NLC, with an additional 9 states having pending legislation. 4:32:28 PM MS. ROBB continued to slide 8 and slide 9 which displayed the supporters of NLC in the state, including the Alaska Board of Nursing. She pointed out the results from the survey sent by the Alaska Board of Nursing to approximately 16,000 licensed nurses in Alaska. Of these, 3,573 responses were received, with 3,259 nurses, or 92 percent, in favor of joining NLC. For nurses with a primary residence in Alaska, 89 percent were in favor. She displayed a list of over 75 organizations which have also expressed support for Alaska becoming a member of NLC. CHAIR SUMNER noted that the presentation would be continued during a future hearing. [HB 149 was held over.]