ALASKA STATE LEGISLATURE  HOUSE LABOR AND COMMERCE STANDING COMMITTEE  February 19, 2020 3:19 p.m. MEMBERS PRESENT Representative Ivy Spohnholz, Chair Representative Louise Stutes Representative Zack Fields Representative Sara Hannan Representative Andi Story Representative Mel Gillis Representative Sara Rasmussen MEMBERS ABSENT  All members present COMMITTEE CALENDAR  HOUSE BILL NO. 91 "An Act relating to the practice of naturopathy; relating to the licensure of naturopaths; relating to the Department of Commerce, Community, and Economic Development; and providing for an effective date." - HEARD & HELD CS FOR SENATE BILL NO. 106(L&C) "An Act relating to renewal of insurance coverage for homeowners and renters; and providing for an effective date." - MOVED CSSB 106(L&C) OUT OF COMMITTEE HOUSE BILL NO. 113 "An Act relating to employment preferences for spouses and children of veterans, disabled veterans, former prisoners of war, members of the national guard, and deceased service members." - HEARD & HELD PREVIOUS COMMITTEE ACTION  BILL: HB 91 SHORT TITLE: NATUROPATHS: LICENSING; PRACTICE SPONSOR(s): REPRESENTATIVE(s) JOHNSTON 03/13/19 (H) READ THE FIRST TIME - REFERRALS 03/13/19 (H) L&C, FIN 04/03/19 (H) L&C AT 3:15 PM BARNES 124 04/03/19 (H) Heard & Held 04/03/19 (H) MINUTE(L&C) 04/08/19 (H) L&C AT 3:15 PM BARNES 124 04/08/19 (H) Heard & Held 04/08/19 (H) MINUTE(L&C) 05/03/19 (H) L&C AT 3:15 PM BARNES 124 05/03/19 (H) Heard & Held 05/03/19 (H) MINUTE(L&C) 02/12/20 (H) L&C AT 3:15 PM BARNES 124 02/12/20 (H) Heard & Held 02/12/20 (H) MINUTE(L&C) 02/19/20 (H) L&C AT 3:15 PM BARNES 124 BILL: SB 106 SHORT TITLE: HOMEOWNER/RENTER INSURANCE RENEWAL SPONSOR(s): SENATOR(s) BEGICH 04/10/19 (S) READ THE FIRST TIME - REFERRALS 04/10/19 (S) L&C 05/07/19 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) 05/07/19 (S) Heard & Held 05/07/19 (S) MINUTE(L&C) 05/09/19 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) 05/09/19 (S) Heard & Held 05/09/19 (S) MINUTE(L&C) 05/10/19 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) 05/10/19 (S) Moved CSSB 106(L&C) Out of Committee 05/10/19 (S) MINUTE(L&C) 05/11/19 (S) L&C RPT CS 4DP SAME TITLE 05/11/19 (S) DP: REINBOLD, BIRCH, COSTELLO, GRAY- JACKSON 05/14/19 (S) TRANSMITTED TO (H) 05/14/19 (S) VERSION: CSSB 106(L&C) 05/15/19 (H) READ THE FIRST TIME - REFERRALS 05/15/19 (H) L&C 02/12/20 (H) L&C AT 3:15 PM BARNES 124 02/12/20 (H) Heard & Held 02/12/20 (H) MINUTE(L&C) 02/19/20 (H) L&C AT 3:15 PM BARNES 124 BILL: HB 113 SHORT TITLE: MILITARY FAMILY EMPLOYMENT PREFERENCE SPONSOR(s): REPRESENTATIVE(s) JACKSON 03/27/19 (H) READ THE FIRST TIME - REFERRALS 03/27/19 (H) MLV, L&C 04/16/19 (H) MLV AT 1:00 PM GRUENBERG 120 04/16/19 (H) Heard & Held 04/16/19 (H) MINUTE(MLV) 04/18/19 (H) MLV AT 1:00 PM GRUENBERG 120 04/18/19 (H) -- MEETING CANCELED -- 04/23/19 (H) MLV AT 1:00 PM GRUENBERG 120 04/23/19 (H) Moved CSHB 113(MLV) Out of Committee 04/23/19 (H) MINUTE(MLV) 04/24/19 (H) MLV RPT CS(MLV) NT 5DP 1NR 04/24/19 (H) DP: KOPP, JACKSON, TARR, TUCK, LEDOUX 04/24/19 (H) NR: THOMPSON 05/06/19 (H) L&C AT 3:15 PM BARNES 124 05/06/19 (H) -- MEETING CANCELED -- 05/10/19 (H) L&C AT 3:15 PM BARNES 124 05/10/19 (H) Heard & Held 05/10/19 (H) MINUTE(L&C) 02/19/20 (H) L&C AT 3:15 PM BARNES 124 WITNESS REGISTER ERIN SHINE, Staff Representative Jennifer Johnston Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Explained the changes in the committee substitute (CS) for HB 91, Version K, on behalf of Representative Johnston, prime sponsor. SUZETTE MAILLOUX Alaska Association of Naturopathic Physicians Fairbanks, Alaska POSITION STATEMENT: Testified during the hearing on HB 91 and answered questions from the committee. SENATOR TOM BEGICH Alaska State Legislature Juneau, Alaska POSITION STATEMENT: As prime sponsor, presented SB 106 and answered questions. LORI WING-HEIER, Director Division of Insurance Department of Commerce, Community & Economic Development Juneau, Alaska POSITION STATEMENT: Testified during the hearing on SB 106. REPRESENTATIVE SHARON JACKSON Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Introduced HB 113 as prime sponsor. ELIJAH VERHAGEN, Staff Representative Sharon Jackson Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented a PowerPoint presentation, entitled "House Bill 113," and provided a sectional analysis of HB 113 on behalf of Representative Jackson, prime sponsor. VERDIE BOWEN, Director of Veterans Affairs Office of Veterans Affairs Department of Military & Veterans' Affairs Anchorage, Alaska POSITION STATEMENT: Answered questions during the hearing on HB 113. MEGAN JAMES Alaska Coalition for Veterans & Military Families Anchorage, Alaska POSITION STATEMENT: Testified during the hearing on HB 113. ACTION NARRATIVE 3:19:08 PM CHAIR IVY SPOHNHOLZ called the House Labor and Commerce Standing Committee meeting to order at 3:19 p.m. Representatives Stutes, Fields, Hannan, Story, Gillis, and Spohnholz were present at the call to order. Representative Rasmussen arrived as the meeting was in progress. HB 91-NATUROPATHS: LICENSING; PRACTICE  3:20:02 PM CHAIR SPOHNHOLZ announced that the first order of business would be HOUSE BILL NO. 91, "An Act relating to the practice of naturopathy; relating to the licensure of naturopaths; relating to the Department of Commerce, Community, and Economic Development; and providing for an effective date." 3:20:19 PM REPRESENTATIVE STUTES moved to adopt the proposed committee substitute (CS) for HB 91, labeled 31-LS0608\K, Fisher, 2/8/20, as the working draft. 3:20:38 PM CHAIR SPOHNHOLZ objected for the purpose of discussion. 3:20:46 PM ERIN SHINE, Staff, Representative Jennifer Johnston, Alaska State Legislature, on behalf of Representative Johnston, prime sponsor, explained the changes to HB 91 proposed under Version K, which replaces Version M. She paraphrased from a document provided in the committee packet, entitled "House Bill 91 ver. K Explanation of Changes," which read as follows [original punctuation provided]: Section 2 Adds a five-person Naturopathy Advisory Board for the purpose of making recommendations on adoption of regulations and other department matters relating to naturopaths Sections 3-7, 10-15, 18 Adds and amends sections to provide the Department of Commerce, Community and Economic Development's Division of Corporations, Business and Professional Licensing appropriate powers and oversight of naturopathic doctors for licensing, investigations, and disciplinary actions Section 8 Adds a provision that requires naturopathic doctors to pass the Naturopathic Physicians Licensing Examination pharmacology portion to be able to prescribe allowed medications Section 10 Amends to increase the public health duties to report for naturopathic doctors to mirror the requirements for other health care providers Section 14 Adds requirement for the department to report actions on naturopathic licensees to the National Practitioner Data Bank Section 15 Adds title protection for naturopath Section 22 Updates the effective date to January 1, 2021 3:23:54 PM The committee took a brief at-ease. 3:23:59 PM REPRESENTATIVE STORY asked if Version K narrows the scope of prescriptive ability for naturopathic doctors (NDs). MS. SHINE offered her belief that it does not. She said they envisioned the same prohibitions in Version K as in the previous CS, which prohibits naturopaths from prescribing controlled substances and chemotherapeutic agents. 3:25:19 PM REPRESENTATIVE STORY, referring to Section 8 of Version K, said the addition of a provision that requires naturopathic doctors to pass an exam seems to narrow their scope of practice further. MS. SHINE noted that their prescriptive abilities remain the same; however, naturopathic doctors would have to pass the pharmacology portion of the Naturopathic Physicians Licensing Examination to be able to prescribe in Alaska. 3:25:54 PM REPRESENTATIVE STUTES directed attention to the fiscal note [identifier: HB091-DCCED-CBPL-01-16-20] and asked how it's $0 when there's an advisory board. MS. SHINE offered her understanding that the previous CS had $4,200 appropriated for adopting regulations. She explained that if Version K were to move from committee, the division director would probably update the fiscal note to reflect the costs. She noted that this wouldn't be spent from general funds because the licensing professions bear their own costs in their licensing fees. 3:26:55 PM CHAIR SPOHNHOLZ removed her objection. There being no further objection, Version K was adopted as the working draft. 3:27:55 PM SUZETTE MAILLOUX, Alaska Association of Naturopathic Physicians, provided a brief personal background. She said Alaska is missing out on many qualified, capable [naturopathic] doctors who don't want to accept the state's limited scope of practice. She pointed out that naturopaths are trained as primary care physicians and offered her belief that the limited scope of practice is a waste of their training. She reflected on her personal experience with the inability to prescribe to her patients, which forces them to see other providers - costing them more time and money. She said the reality of medicine is that prescriptions and minor office procedures are often necessary. She touted the safety record that NDs have in both Alaska and in states that allow for a full scope of practice. She reiterated that they are fully trained as physicians and want to stay in Alaska to provide safe and effective care. To conclude, she addressed opposing testimony consisting of malpractice claims that she said are unsubstantiated and were never reported to the state. 3:31:38 PM REPRESENTATIVE STORY questioned whether Ms. Mailloux took pharmacology classes that would allow her to prescribe. MS. MAILLOUX answered yes, adding that she received her training in Oregon where, had she stayed and pursued licensure, she would have the full scope of practice of a primary care physician. She further noted that the addition of Section 8 in the current CS would ensure that naturopathic doctors stay up to date with current pharmacological knowledge and training. 3:32:53 PM REPRESENTATIVE STUTES asked if there are residencies involved in a naturopath's education. MS. MAILLOUX replied that residencies are not required for naturopathic doctors, they are optional. She noted that there are not enough residency positions for NDs in the U.S., as they do not practice hospital-based medicine. 3:33:47 PM REPRESENTATIVE FIELDS sought to clarify which surgeries naturopaths would be allowed do under HB 91. He directed attention to Section 8, paragraph (3), which read as follows: perform procedures in the office using operative, electrical, or other methods, including the use of antiseptics and local anesthetics, for the surgical repair and care of superficial lacerations, abrasions, and lesions and the removal of foreign bodies located in the superficial tissues of the human body; the procedures may not include general or spinal anesthetics, major surgery, surgery of the body cavities, plastic surgery, surgery involving the eyes, or surgery involving tendons, ligaments, nerves, or blood vessels; and 3:34:27 PM MS. MAILLOUX, in response to Representative Fields, listed small biopsies, mole removals, stitches of minor cuts, and IUD [intrauterine device] placement and removal. 3:35:01 PM REPRESENTATIVE FIELDS asked how naturopaths and medical doctors differ in the dermatological training they receive. MS. MAILLOUX said it's similar; however, they differ in the variety of treatments offered, as well as the philosophy of medicine. Regarding the basic science, pathology, or assessing for illness - both are "on par." 3:35:57 PM CHAIR SPOHNHOLZ announced that HB 91 was held over. SB 106-HOMEOWNER/RENTER INSURANCE RENEWAL  3:36:15 PM CHAIR SPOHNHOLZ announced that the next order of business would be CS FOR SENATE BILL NO. 106(L&C), "An Act relating to renewal of insurance coverage for homeowners and renters; and providing for an effective date." 3:36:33 PM SENATOR TOM BEGICH, Alaska State Legislature, as prime sponsor, highlighted the basic elements of SB 106. Basically, he said, it eliminates a loophole that causes the loss of insurance if someone makes a claim against a criminal action that might have occurred in his or her home. SB 106 would offer a three-year grace period in which a claim could be made without penalization. He stated it's a bill to keep a victim from being revictimized. He proceeded to follow up on unanswered questions from the bill's previous hearing. First, he said, there are at least 10 states that may have similar kinds of legislation. Second, he confirmed that personal insurance covers homeowners and renter's insurance. He directed attention to AS 21.36.460 (i)(7)(B). 3:39:22 PM CHAIR SPOHNHOLZ opened public testimony. After ascertaining that no one wished to testify, she closed public testimony. 3:40:18 PM REPRESENTATIVE HANNAN asked to hear from Lori Wing-Heier. 3:40:48 PM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community & Economic Development, explained that this has been an issue, particularly in the Anchorage and Matanuska- Susitna area, where people are losing their insurance after making a claim. She said after working with the insurers and the bill sponsor, the Division of Insurance doesn't see any problems with SB 106. She added that the division thinks it strengthens consumer protections in the event they are victimized by a crime. 3:41:37 PM REPRESENTATIVE RASMUSSEN thanked the bill sponsor for bringing this piece of legislation forward, adding that she will happily support moving SB 106 out of committee and on the House floor. 3:41:57 PM REPRESENTATIVE STUTES moved to report SB 106 out of committee with individual recommendations and the accompanying fiscal notes. Without objection, CSSB 106(L&C) was moved from the House Labor and Commerce Standing Committee. 3:42:19 PM The committee took an at-ease from 3:42 to 3:46 p.m. HB 113-MILITARY FAMILY EMPLOYMENT PREFERENCE  3:46:11 PM CHAIR SPOHNHOLZ announced that the final order of business would be HOUSE BILL NO. 113, "An Act relating to employment preferences for spouses and children of veterans, disabled veterans, former prisoners of war, members of the national guard, and deceased service members." 3:46:32 PM REPRESENTATIVE SHARON JACKSON, Alaska State Legislature, as prime sponsor, introduced HB 113. She paraphrased from the sponsor statement provided in the committee packet, which read in its entirety as follows [original punctuation provided]: The purpose of House Bill 113 is to extend current hiring preferences to military spouses and dependent children in the State of Alaska and the private sector. Military families fall into two categories: Blue Star or Gold Star Families. Blue Star families are military spouses and dependents of active service members and veterans. Gold Star families are spouses and children of a deceased service members who died while in active duty. A recent report from the Department of Defense found that a quarter of military spouses are unemployed or underemployed. There are several efforts being done in all 50 states, but Alaska is one of the few states that do not extend employment preferences to military spouses. There are roughly 151,881 military spouses and dependents in Alaska according to the Alaska Department of Military & Veteran Affairs. This is a small but significant way to honor our service members and their families, who are making a sacrifice to serve their country, yet often fall between the cracks while doing so. 3:49:43 PM ELIJAH VERHAGEN, Staff, Representative Sharon Jackson, Alaska State Legislature, provided a PowerPoint presentation, entitled "House Bill 113," on behalf of Representative Jackson, prime sponsor. He directed attention to slide 3, titled, "What," which read as follows [original punctuation provided]: HB113 Will extend current state hiring preferences to military spouses and dependents. It will also extend liability protections to the private sector to include spouses and dependents. 3:50:58 PM REPRESENTATIVE HANNAN asked what it means to "extend liability protections to the private sector." MR. VERHAGEN directed attention to page 2, line 12, of HB 113, and said, "this is legally putting in statute that in the private sector, an employer may hire a military spouse solely because they are a military spouse. Whereas currently, that is not in statute." He asked if that answered Representative Hannan's question. 3:52:25 PM REPRESENTATIVE HANNAN said not quite. CHAIR SPOHNHOLZ pointed out that the slide says, "extend liability protections," and asked what that means. 3:52:38 PM MS. VERHAGEN said "currently, if someone were to choose to hire - because it's not in statute - a military spouse instead of someone else who's equally qualified, I believe that they would be able to be sued and this is giving them - they are free from this liability because now it's written in statute that they may give a hiring preference to military spouse." 3:53:08 PM REPRESENTATIVE HANNAN contended that a private sector business employer can hire who they want. She said, for example, coastguard kids are frequently the first round of hires for seasonal businesses because of their accountability to military structure, adding that she never perceived there was any legal liability associated with that. 3:54:22 PM REPRESENTATIVE JACKSON stated that, "private businesses are private - we are not here to tell them what they can or can't do, but this will be extended to them to at least give a military spouse the interview." CHAIR SPOHNHOLZ said perhaps the language in the presentation is confusing. 3:56:38 PM MR. VERHAGEN resumed his presentation on slide 4 and explained that military spouses are among the highest unemployed and underemployed group in the United States, despite their education or experience. He cited a poll of over 4,000 military spouses that found 40 percent have a college degree. Additionally, upwards of 60 percent have "some college" experience compared to 29 percent of spouses in the civilian sector. He further noted that 9 out of 10 military spouses are women. Mr. Verhagen went on to paraphrase slide 5, titled "Top 3 Challenges," which read as follows [original punctuation provided]: ? Unemployment The number of unemployed military spouses averages at more than 40%. ? Underemployment Low pay. Research shows that military spouses with a college degree earn 40% less than their counterparts. A study from Syracuse University found that 90% of female spouses of active- duty members reported they were underemployed ? Frequent moves Spouses and dependents move constantly, resulting in employment gaps, lack of networking 3:59:00 PM REPRESENTATIVE RASMUSSEN sought to clarify whether 29 percent of civilian spouses have a degree or 29 percent of civilian spouses have a degree and are currently unemployed. 3:59:19 PM MR. VERHAGEN clarified that "29.9" percent have a college degree. REPRESENTATIVE RASMUSSEN asked for the source of that data. MR. VERHAGEN directed attention to Figure 1 on page 2 of a document provided in the committee packet, entitled "Military Spouses in the Labor Market." 4:00:15 PM CHAIR SPOHNHOLZ noted that it's an uncomfortable statistic because it's not clear who the civilian, noninstitutionalized population is. 4:00:55 PM MR. VERHAGEN responded by reading the following paragraph from the document [original punctuation provided]: According to the ACS survey, working age military spouses are predominantly female (92 percent), and they are young. Although the average American adult of working age is 41 years old, working age military spouses are 33 years old, on average. 2 Military spouses are also more educated than other civilian, non-institutionalized Americans of working age, suggesting that losing their contributions to the labor market is particularly detrimental for the American economy (Figure 1). While approximately 30 percent of the U.S. working age population has a college degree, approximately 40 percent of military spouses in this age range do. CHAIR SPOHNHOLZ clarified that "this is the civilian, noninstitutionalized population of United States workers." MR. VERHAGEN answered yes. 4:02:10 PM MR. VERHAGEN concluded his presentation on slide 6, reporting that 24 states have instituted a hiring preference for military spouses. He turned attention to the sectional analysis, which read as follows [original punctuation provided]: Section 1. AS 18.80.200(c)  This section does not prohibit a private employer from having hiring preferences for persons described in Section 2 of this bill. Section 2. AS 23.88.010  This section repeals and reenacts the current statute by adding definitions removed from Section 1 for clarity. This section does not prohibit a private employer from having hiring preferences to active- military, veterans and families. This section adds language to include spouses and dependent children of deceased service members to the list. Section 3. AS 39.25.150(19)  This section amends the State Personnel Act to reference definitions as stated in Section 4 for consistency. Section 4. AS 39.25.159(a)  This section amends the employment preference for veterans or former prisoners of war by adding new language to include families of an active-duty service member, veteran, or former prisoner of war. This section clarifies the type of preference given the hiring process and whether the applicant is disabled or not. Subsection (B) is removed for consistency Section 5. AS 39.25.159(d)  This section clarifies that a person may receive an employment preference under only one of the categories described in sections 3 and 4. A person may use the preference without limitation when being considered for a position for which persons who are not currently state employees are being considered. If the recruitment for a position is limited to state employees, preference under (a) or (c) of this section may not be counted. This section adds language to include spouses or dependent children for consistency with other sections. Section 6 AS 39.25.159 (e)  This section clarifies that this bill does not involve interpreting amendments of a collective bargaining agreement and makes a reference to subsection (a) of Section 4. Section 7 AS 39.25.159(f)  This section defines a dependent child. Section 8 AS 39.25.159(c)  This section removes language that has been included in Section 4 of this bill. 4:05:25 PM REPRESENTATIVE HANNAN asked if the hiring preference for either the spouse or the dependent child has a time limit. REPRESENTATIVE JACKSON said the limit for the dependent child is age 19 or age 23 if he or she is attending college. REPRESENTATIVE HANNAN asked if there is a time limit for the spouse. REPRESENTATIVE JACKSON replied the spouse receives the benefit until he or she remarries. REPRESENTATIVE HANNAN questioned whether it could be a lifetime benefit. REPRESENTATIVE JACKSON said yes, for the working years of the spouse's life. 4:07:02 PM REPRESENTATIVE STORY asked if there is information on how the program is working in the 24 states that provide veterans' preferences to spouses. 4:10:15 PM VERDIE BOWEN, Director of Veterans Affairs, Office of Veterans Affairs, Department of Military & Veterans' Affairs, stated that in Maryland, [military] spouses and children have been able to gain employment much faster now that the benefits have been implemented. 4:11:04 PM CHAIR SPOHNHOLZ asked if there are any states that have limited the length of the benefit for widows. 4:11:48 PM MR. BOWEN answered no, adding that most states do not sunset the gold star clause. Under the gold star clause, DIC [Dependency and Indemnity Compensation] payments are provided until the spouse remarries. He noted that most states use that as their reference point. He reiterated that if the spouse remarries, he or she loses access to the gold star benefit. 4:12:35 PM CHAIR SPOHNHOLZ asked if Mr. Bowen would like to provide any additional testimony. 4:12:41 PM MR. BOWEN said he would like to see this bill passed because it does "several things" for family members. He noted that Alaska has over 43,000 active-duty National Guard Reserve Component family members within the state that are supporting 22,000 active duty members. He stated that the primary way to reduce stress is to help them gain access to gainful employment, which will help reduce other factors that could happen within their housing units. 4:15:35 PM REPRESENTATIVE HANNAN questioned whether a family whose member dies by suicide is still considered a gold star family. 4:16:15 PM MR. BOWEN replied that gold star is usually provided to people that die in a combat zone. He said if an individual took his or her life in a combat zone or was injured in a combat zone then the gold star identification would not apply. 4:16:39 PM REPRESENTATIVE HANNAN asked if there's a limit on the life insurance policy that's paid to a family if the death is caused by suicide. MR. BOWEN answered no. He explained that the exact amount of the life insurance is paid to the family regardless of whether the death was caused by suicide. 4:19:11 PM MEGAN JAMES, Alaska Coalition for Veterans & Military Families, stated that many military spouses and dependent children come to the Alaska Coalition for Veterans & Military Families for assistance in looking for professions. She added that they work longest with the military spouses because of their varied working backgrounds due to continued sacrifice of their own career for that of the service members. She noted that varied work histories and gaps in employment don't look like the best hires on paper to some employers. She said HB 113 would essentially even the playing field for military spouses and gold star families. Furthermore, she pointed out that if military families are gainfully employed and spouses are happily working at the duty location, the service members are more likely to be mission ready, to reenlist, and their home is likelier to be resilient and thriving without the worry of financial implications that come from having a spouse without work while they're gone. She shared a personal anecdote of her own experience with this matter. She noted that this bill is not offering the promise of a job, but it allows them to have a better chance against other qualified candidates as they are going through the employment process. 4:22:05 PM CHAIR SPOHNHOLZ announced that HB 113 was held over. 4:23:34 PM ADJOURNMENT  There being no further business before the committee, the House Labor and Commerce Standing Committee meeting was adjourned at [4:23] p.m.