SB 67-NURSING: LICENSURE; MULTISTATE COMPACT  1:33:18 PM CHAIR WILSON announced the consideration of SENATE BILL NO. 67 "An Act relating to the licensure of nursing professionals; relating to a multistate nurse licensure compact; and providing for an effective date." He noted the committee heard an overview of the bill and a sectional analysis and took public testimony at previous hearings. CHAIR WILSON recalled the committee began the amendment process on April 15. There was a motion pending to adopt Amendment 4 and an objection for the purpose of discussion. He asked Senator Begich to refresh the committee's memories about the amendment. 1:34:30 PM SENATOR BEGICH stated Amendment 4, under AS 08.68.330, adds the requirement that multistate licensed nurses successfully complete two hours of board approved Alaska Native cultures training. He noted that Alaska is unique, as twenty-one percent of its population is comprised of indigenous peoples. CHAIR WILSON remarked that the purpose of the meeting is to discuss whether the amendments will negatively impact the nursing compact. 1:35:40 PM SARA CHAMBERS, Director, Division of Corporations, Business and Professional Licensing, Department of Commerce, Community and Economic Development, Juneau, Alaska, stated a foundational concept of the Nurse Licensure Compact (NLC) is that states cannot impose additional preemployment restrictions on nurses. Amendment 4 would be a restriction and kill the bill. Previously, members inquired whether the training could be required after a nurse is hired. She suggested Ms. Fotsch speak to that consideration. 1:37:28 PM REBECCA Fotsch, Director, State Advocacy and Legislative Affairs, National Council of State Boards of Nursing, Chicago, Illinois, commented that she could check with the attorney for the Nurse Licensure Compact (NLC) to determine whether the amendment would be considered a material deviation from the agreement. The requirement is a problem because it would decrease efficiency and fluid mobility. Nurses would need to keep track of what each state requires. SENATOR REINBOLD commented that Amendment 4 is respectful to Alaska Natives and people living in remote areas, but she does not like to yield authority to a compact she has not seen. She asserted training could be accomplished during the nurse's flight to Alaska. She does not like the compact's lack of flexibility. She will vote for the amendment. 1:39:52 PM SENATOR BEGICH stated that a state cedes its ability to regulate nurses when it joins the compact. His goal is to protect the state's interest. The state will not be able to make changes unless every state in the compact accepts it. He is concerned that the state would be surrendering sovereignty and expressed a desire to have an attorney determine if Amendment 4 could be accepted by the compact. CHAIR WILSON noted nurses licensed in Alaska currently are not required to take a course in Alaska Native cultures. He asked Danette Schloeder to comment. 1:41:59 PM DANETTE SCHLOEDER, Chair, Alaska Board of Nursing, Anchorage, Alaska, replied correct; Amendment 4 would only apply to nurses working under a multistate license and not nurses who chose to have a single state license. She said the value of cultural education would benefit all healthcare providers, not just multistate licensed nurses. SENATOR HUGHES expressed disappointment that the department had not learned whether Amendment 4 would be a problem for the compact. Many nurses in her district want a multistate license. She agreed with Ms. Schloeder that cultural training for all healthcare providers would be ideal, but it is not in the committee's purview. She remarked that problems with SB 67 can be addressed in the next committee of referral. 1:44:04 PM CHAIR WILSON removed his objection; finding no further objection, Amendment 4 passed. He asked Ms. Chambers if she had any final comments. MS. CHAMBERS replied that there are misunderstandings about SB 67. She clarified that the entire compact is included in the bill. The bill document, SB 67, is the compact. She continued that it is not true that entering the compact causes the state to lose its ability to govern the practice of nursing. The Alaska Board of Nursing governs the practice and discipline of nursing in Alaska. The board can adopt regulations to respond to needs in the practice of nursing. Most of Alaska's nurses are from out of state. There are twenty thousand nurses in the state of Alaska. They are not all residents. Currently, the department does not require what the members are concerned about. The multistate license provides a faster way for nurses, who qualify at higher standards, to practice in Alaska. That is all it does; the rest of the jurisdiction stays with the Alaska Board of Nursing. She would like to alleviate concerns, misunderstands or questions the committee has. SB 67 gets highly qualified nurses to Alaska practicing under the jurisdiction of the Alaska Board of Nursing. 1:46:58 PM SENATOR BEGICH challenged the claim that most of Alaska's nurses are from outside the state and requested evidence. The committee was informed that the state cannot amend the compact without approval from all compact states. He contended that the compact would disallow any regulatory changes that materially impact the agreement and the legislature would not be able to amend statutes without approval. He asked Ms. Chambers to explain if he is wrong. SENATOR REINBOLD agreed that testimony was conflicting. She will vote no on SB 67 because it undermines legislative authority and decreases state sovereignty. The Alaska Alliance on Retired Americans, the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) and the Alaska Nurses Association provided solid reasons for voting no on SB 67. CHAIR WILSON solicited a motion to move the bill from committee. 1:49:41 PM SENATOR HUGHES moved to report SB 67, work order 32-GS1603\A as amended, from committee with individual recommendations and attached fiscal note(s). 1:49:50 PM SENATOR REINBOLD objected. 1:50:16 PM A roll call vote was taken. Senators Hughes and Wilson voted in favor of the motion to move SB 67 as amended from committee and Senators Costello, Reinbold, and Begich voted against it. Therefore, the motion failed 2:3. CHAIR WILSON announced that with a vote of 2 yeas and 3 nays, SB 67 failed to move from the Senate Health and Social Services Committee.