ALASKA STATE LEGISLATURE                                                                                  
          HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                         
                          May 8, 2024                                                                                           
                           3:45 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Jesse Sumner, Chair                                                                                              
Representative Justin Ruffridge, Vice Chair                                                                                     
Representative Stanley Wright                                                                                                   
Representative Mike Prax                                                                                                        
Representative Ashley Carrick                                                                                                   
Representative Dan Saddler                                                                                                      
Representative Zack Fields                                                                                                      
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE JOINT RESOLUTION NO. 27                                                                                                   
Supporting trade policies for the  United States that hold China,                                                               
Russia,  and other  countries accountable,  reward leadership  in                                                               
clean   production  standards,   reward  superior   environmental                                                               
performance,  support  economic   development,  and  support  the                                                               
rebuilding of supply chains in the United States.                                                                               
                                                                                                                                
     - MOVED HJR 27 OUT OF COMMITTEE                                                                                            
                                                                                                                                
SENATE BILL NO. 182                                                                                                             
"An  Act  extending   the  termination  date  of   the  Big  Game                                                               
Commercial Services Board; and providing for an effective date."                                                                
                                                                                                                                
     - MOVED SB 182 OUT OF COMMITTEE                                                                                            
                                                                                                                                
SENATE BILL NO. 239                                                                                                             
"An Act relating to the  Alaska Industrial Development and Export                                                               
Authority;   and  relating   to  workforce   housing  development                                                               
projects."                                                                                                                      
                                                                                                                                
     - MOVED HCS SB 239(L&C) OUT OF COMMITTEE                                                                                   
                                                                                                                                
SENATE BILL NO. 234                                                                                                             
"An Act  relating to the  Marijuana Control Board;  and providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
     - MOVED SB 234 OUT OF COMMITTEE                                                                                            
                                                                                                                                
CS FOR SENATE BILL NO. 115(HSS) AM                                                                                              
"An Act relating to physician assistants; relating to                                                                           
physicians; and relating to health care insurance policies."                                                                    
                                                                                                                                
     - MOVED HCS CSSB 115(L&C) OUT OF COMMITTEE                                                                                 
                                                                                                                                
HOUSE BILL NO. 336                                                                                                              
"An Act relating to athletic trainers; and providing for an                                                                     
effective date."                                                                                                                
                                                                                                                                
     - BILL HEARING RESCHEDULED TO 5/10/24                                                                                      
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HJR 27                                                                                                                  
SHORT TITLE: SUPPORTING CERTAIN US TRADE POLICIES                                                                               
SPONSOR(s): LABOR & COMMERCE                                                                                                    
                                                                                                                                
04/11/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
04/11/24       (H)       L&C, RES                                                                                               
04/15/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/15/24       (H)       Scheduled but Not Heard                                                                                
04/17/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/17/24       (H)       <Bill Hearing Rescheduled to 04/22/24>                                                                 
04/22/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/22/24       (H)       Scheduled but Not Heard                                                                                
04/24/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/24/24       (H)       Scheduled but Not Heard                                                                                
04/29/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/29/24       (H)       -- MEETING CANCELED --                                                                                 
05/01/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/01/24       (H)       Scheduled but Not Heard                                                                                
05/06/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/06/24       (H)       <Bill Hearing Rescheduled to 05/08/24>                                                                 
05/08/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: SB 182                                                                                                                  
SHORT TITLE: EXTEND BIG GAME COMM SERVICES BOARD                                                                                
SPONSOR(s): LABOR & COMMERCE                                                                                                    
                                                                                                                                
01/16/24       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/16/24       (S)       L&C, FIN                                                                                               
01/22/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
01/22/24       (S)       Heard & Held                                                                                           
01/22/24       (S)       MINUTE(L&C)                                                                                            
01/29/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
01/29/24       (S)       Moved SB 182 Out of Committee                                                                          
01/29/24       (S)       MINUTE(L&C)                                                                                            
01/31/24       (S)       L&C RPT 3DP 1AM                                                                                        
01/31/24       (S)       DP: BJORKMAN, DUNBAR, MERRICK                                                                          
01/31/24       (S)       AM: GRAY-JACKSON                                                                                       
04/09/24       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
04/09/24       (S)       Heard & Held                                                                                           
04/09/24       (S)       MINUTE(FIN)                                                                                            
04/22/24       (S)       FIN AT 1:30 PM SENATE FINANCE 532                                                                      
04/22/24       (S)       Moved SB 182 Out of Committee                                                                          
04/22/24       (S)       MINUTE(FIN)                                                                                            
04/24/24       (S)       FIN RPT 4DP                                                                                            
04/24/24       (S)       DP: OLSON, WILSON, KIEHL, MERRICK                                                                      
04/29/24       (S)       TRANSMITTED TO (H)                                                                                     
04/29/24       (S)       VERSION: SB 182                                                                                        
05/01/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
05/01/24       (H)       L&C, FIN                                                                                               
05/06/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/06/24       (H)       <Bill Hearing Rescheduled to 05/08/24>                                                                 
05/08/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: SB 239                                                                                                                  
SHORT TITLE: AIDEA WORKFORCE HOUSING DEVELOPMENT                                                                                
SPONSOR(s): DUNBAR                                                                                                              
                                                                                                                                
02/19/24       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/19/24       (S)       L&C, FIN                                                                                               
02/21/24       (S)       FIN REFERRAL REMOVED                                                                                   
03/27/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
03/27/24       (S)       Heard & Held                                                                                           
03/27/24       (S)       MINUTE(L&C)                                                                                            
04/12/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
04/12/24       (S)       Moved SB 239 Out of Committee                                                                          
04/12/24       (S)       MINUTE(L&C)                                                                                            
04/15/24       (S)       L&C RPT 2DP 2NR                                                                                        
04/15/24       (S)       NR: BJORKMAN, MERRICK                                                                                  
04/15/24       (S)       DP: GRAY-JACKSON, DUNBAR                                                                               
04/22/24       (S)       TRANSMITTED TO (H)                                                                                     
04/22/24       (S)       VERSION: SB 239                                                                                        
04/24/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
04/24/24       (H)       L&C                                                                                                    
04/29/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/29/24       (H)       -- MEETING CANCELED --                                                                                 
05/01/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/01/24       (H)       Heard & Held                                                                                           
05/01/24       (H)       MINUTE(L&C)                                                                                            
05/08/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: SB 234                                                                                                                  
SHORT TITLE: EXTEND MARIJUANA CONTROL BOARD                                                                                     
SPONSOR(s): LABOR & COMMERCE                                                                                                    
                                                                                                                                
02/15/24       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/15/24       (S)       L&C, FIN                                                                                               
03/08/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
03/08/24       (S)       Heard & Held                                                                                           
03/08/24       (S)       MINUTE(L&C)                                                                                            
03/13/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
03/13/24       (S)       Moved SB 234 Out of Committee                                                                          
03/13/24       (S)       MINUTE(L&C)                                                                                            
03/15/24       (S)       L&C RPT 3DP                                                                                            
03/15/24       (S)       DP: BJORKMAN, DUNBAR, GRAY-JACKSON                                                                     
04/03/24       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
04/03/24       (S)       Heard & Held                                                                                           
04/03/24       (S)       MINUTE(FIN)                                                                                            
04/04/24       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
04/04/24       (S)       Heard & Held                                                                                           
04/04/24       (S)       MINUTE(FIN)                                                                                            
04/22/24       (S)       FIN AT 1:30 PM SENATE FINANCE 532                                                                      
04/22/24       (S)       Moved SB 234 Out of Committee                                                                          
04/22/24       (S)       MINUTE(FIN)                                                                                            
04/24/24       (S)       FIN RPT 4DP                                                                                            
04/24/24       (S)       DP: OLSON, WILSON, KIEHL, MERRICK                                                                      
04/29/24       (S)       TRANSMITTED TO (H)                                                                                     
04/29/24       (S)       VERSION: SB 234                                                                                        
05/01/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
05/01/24       (H)       L&C, FIN                                                                                               
05/06/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/06/24       (H)       <Bill Hearing Rescheduled to 05/08/24>                                                                 
05/08/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: SB 115                                                                                                                  
SHORT TITLE: PHYSICIAN ASSISTANT SCOPE OF PRACTICE                                                                              
SPONSOR(s): TOBIN BY REQUEST                                                                                                    
                                                                                                                                
03/27/23       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/27/23       (S)       HSS, L&C                                                                                               
01/23/24       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
01/23/24       (S)       Heard & Held                                                                                           
01/23/24       (S)       MINUTE(HSS)                                                                                            
02/06/24       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
02/06/24       (S)       Heard & Held                                                                                           
02/06/24       (S)       MINUTE(HSS)                                                                                            
02/15/24       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
02/15/24       (S)       Moved CSSB 115(HSS) Out of Committee                                                                   
02/15/24       (S)       MINUTE(HSS)                                                                                            
02/19/24       (S)       HSS RPT CS 3DP 2AM   SAME TITLE                                                                        
02/19/24       (S)       DP: WILSON, KAUFMAN, DUNBAR                                                                            
02/19/24       (S)       AM: TOBIN, GIESSEL                                                                                     
02/28/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
02/28/24       (S)       Heard & Held                                                                                           
02/28/24       (S)       MINUTE(L&C)                                                                                            
04/05/24       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
04/05/24       (S)       Moved CSSB 115(HSS) Out of Committee                                                                   
04/05/24       (S)       MINUTE(L&C)                                                                                            
04/08/24       (S)       L&C RPT CS(HSS) 2DP 1NR 1AM                                                                            
04/08/24       (S)       AM: BJORKMAN                                                                                           
04/08/24       (S)       DP: DUNBAR, BISHOP                                                                                     
04/08/24       (S)       NR: MERRICK                                                                                            
04/24/24       (S)       TRANSMITTED TO (H)                                                                                     
04/24/24       (S)       VERSION: CSSB 115(HSS) AM                                                                              
04/26/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
04/26/24       (H)       HSS, L&C                                                                                               
05/02/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
05/02/24       (H)       Moved CSSB 115(HSS) AM Out of Committee                                                                
05/02/24       (H)       MINUTE(HSS)                                                                                            
05/03/24       (H)       HSS RPT 5NR 1AM                                                                                        
05/03/24       (H)       NR:    RUFFRIDGE,    MCCORMICK,    MINA,                                                               
                         SADDLER, PRAX                                                                                          
05/03/24       (H)       AM: SUMNER                                                                                             
05/06/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/06/24       (H)       Heard & Held                                                                                           
05/06/24       (H)       MINUTE(L&C)                                                                                            
05/08/24       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
TREVOR JEPSEN, Staff                                                                                                            
Representative Tom McKay                                                                                                        
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during the hearing on SB                                                              
239.                                                                                                                            
                                                                                                                                
BRANDON BREFCVYNSKI, Deputy Director                                                                                            
Alaska Industrial Development and Expert Authority                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered questions during the hearing on SB                                                              
239.                                                                                                                            
                                                                                                                                
JAMES HOLZENBERG, Staff                                                                                                         
Senator Forrest Dunbar                                                                                                          
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions  during the hearing on SB                                                             
239 on behalf of Senator Dunbar, prime sponsor.                                                                                 
                                                                                                                                
SENATOR JESSE BJORKMAN                                                                                                          
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, presented SB 182.                                                                      
                                                                                                                                
AARON BLOOMQUIST, Chair                                                                                                         
Big Game Commercial Services Board                                                                                              
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:   Gave invited  testimony during  the hearing                                                             
on SB 182.                                                                                                                      
                                                                                                                                
JOAN WILSON, Director                                                                                                           
Alcohol and Marijuana Control Office                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Gave invited  testimony during  the hearing                                                             
on SB 234.                                                                                                                      
                                                                                                                                
SENATOR L?KI TOBIN                                                                                                              
Alaska State Senator                                                                                                            
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime  sponsor, answered questions during                                                             
the hearing on SB 115.                                                                                                          
                                                                                                                                
JENNIFER FAYETTE, PA                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered questions  during the hearing on SB                                                             
115.                                                                                                                            
                                                                                                                                
KRISTIN MITCHELL, MD, President                                                                                                 
Alaska State Medical Association                                                                                                
Soldotna, Alaska                                                                                                                
POSITION STATEMENT:  Answered questions  during the hearing on SB                                                             
115.                                                                                                                            
                                                                                                                                
ROXANNE JONES, MD, Secretary of the Board                                                                                       
Alaska Academy of Family Physicians                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered questions  during the hearing on SB                                                             
115.                                                                                                                            
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:46:11 PM                                                                                                                    
                                                                                                                                
CHAIR JESSE SUMNER  called the House Labor  and Commerce Standing                                                             
Committee meeting  to order at  3:45 p.m.   Representatives Prax,                                                               
Carrick, Fields, Ruffridge,  and Sumner were present  at the call                                                               
to  order.   Representatives Wright  and Saddler  arrived as  the                                                               
meeting was in progress.                                                                                                        
                                                                                                                                
          HJR 27-SUPPORTING CERTAIN US TRADE POLICIES                                                                       
                                                                                                                                
3:47:08 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced that the  first order of business would be                                                               
HOUSE JOINT RESOLUTION NO. 27,  Supporting trade policies for the                                                               
United  States  that  hold China,  Russia,  and  other  countries                                                               
accountable,  reward leadership  in  clean production  standards,                                                               
reward  superior  environmental   performance,  support  economic                                                               
development, and support  the rebuilding of supply  chains in the                                                               
United States.                                                                                                                  
                                                                                                                                
3:47:18 PM                                                                                                                    
                                                                                                                                
The committee took at at-ease from 3:47 p.m. to 3:48 p.m.                                                                       
                                                                                                                                
3:48:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE moved to report  HJR 27 out of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.   There being objection,  HJR 27  was reported out  of the                                                               
House Labor and Commerce Standing Committee.                                                                                    
                                                                                                                                
           SB 182-EXTEND BIG GAME COMM SERVICES BOARD                                                                       
                                                                                                                                
3:49:04 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced  that the next order of  business would be                                                               
SENATE BILL  NO. 182, "An  Act extending the termination  date of                                                               
the  Big Game  Commercial Services  Board; and  providing for  an                                                               
effective date."                                                                                                                
                                                                                                                                
3:49:14 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 3:49 p.m.                                                                                 
                                                                                                                                
CHAIR SUMNER stated that the bill sponsor for SB 182 was                                                                        
currently unavailable; [therefore, the committee moved on to the                                                                
next order of business].                                                                                                        
                                                                                                                                
           SB 239-AIDEA WORKFORCE HOUSING DEVELOPMENT                                                                       
                                                                                                                                
3:49:36 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced  that the next order of  business would be                                                               
SENATE BILL  NO. 239, "An  Act relating to the  Alaska Industrial                                                               
Development  and  Export  Authority; and  relating  to  workforce                                                               
housing development projects."                                                                                                  
                                                                                                                                
3:49:53 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER moved to adopt Amendment 1 to SB 239, labeled 33-                                                                  
LS1072\S.6, Walsh, 5/6/24, which read:                                                                                          
                                                                                                                                
     Page 1, line 1, following "Authority;":                                                                                  
          Insert "relating to state loans for oil and gas                                                                     
     development  projects  in  the Cook  Inlet  sedimentary                                                                  
     basin;"                                                                                                                  
                                                                                                                                
     Page 1, following line 3:                                                                                                  
          Insert new bill sections to read:                                                                                     
        "* Section.  1. AS 42.05.141 is amended  by adding a                                                                
     new subsection to read:                                                                                                    
          (g)  The commission shall, as required under                                                                          
     AS 44.88.850(b), determine whether the  sale price in a                                                                    
     gas sales agreement for gas  produced through a project                                                                    
     partially or fully funded by  a loan under AS 44.88.850                                                                    
     constitutes  a just  and reasonable  immediate delivery                                                                    
     price for gas.                                                                                                             
        * Sec. 2. AS 44.25.020 is amended to read:                                                                            
          Sec. 44.25.020. Duties of department. The                                                                           
     Department of Revenue shall                                                                                              
               (1)  enforce the tax laws of the state;                                                                          
               (2)  collect, account for, have custody of,                                                                      
     invest, and manage all state  funds and all revenues of                                                                    
     the state  except revenues incidental  to a  program of                                                                    
     licensing and  regulation carried  on by  another state                                                                    
     department, funds  managed and  invested by  the Alaska                                                                    
     Retirement Management Board,  and as otherwise provided                                                                    
     by law;                                                                                                                    
               (3)  invest and manage the balance of the                                                                        
     power    development    fund   in    accordance    with                                                                    
     AS 44.83.386;                                                                                                              
               (4)  administer the surety bond program for                                                                      
     licensure as a fish processor or primary fish buyer;                                                                   
               (5)  provide reasonable assistance to the                                                                    
     Alaska  Industrial  Development  and  Export  Authority                                                                
     under AS 44.88.850(c).                                                                                                 
        * Sec.  3. AS 44.37.020 is  amended by adding  a new                                                                  
     subsection to read:                                                                                                        
          (d)  The Department of Natural Resources shall                                                                        
     provide reasonable assistance  to the Alaska Industrial                                                                    
     Development     and      Export     Authority     under                                                                    
     AS 44.88.850(c)."                                                                                                          
                                                                                                                                
     Page 1, line 4:                                                                                                            
          Delete "Section 1"                                                                                                  
          Insert "Sec. 4"                                                                                                     
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 5, following line 20:                                                                                                 
     Insert a new bill section to read:                                                                                         
        "*  Sec.  6.  AS 44.88  is  amended  by  adding  new                                                                
     sections to read:                                                                                                          
         Article 10A. Cook Inlet Reserve-Based Lending.                                                                       
          Sec. 44.88.850. Cook Inlet reserve-based lending                                                                    
     account.  (a)  The  Cook  Inlet  reserve-based  lending                                                                  
     account  is  established  in the  revolving  fund.  The                                                                    
     account consists of money or  assets deposited into the                                                                    
     account by  the authority and contributions  from other                                                                    
     sources.                                                                                                                   
          (b)  The authority may use money in the account                                                                       
     to make  one or  more reserve-based  loans to  fund oil                                                                    
     and  gas development  projects the  authority considers                                                                    
     necessary to  increase oil and gas  production from the                                                                    
     Cook Inlet  sedimentary basin. The authority  may, as a                                                                    
     term  of the  loan, accept  an ownership  share in  the                                                                    
     project funded  by the loan.  If the  authority accepts                                                                    
     an  ownership  share  as  a   term  of  the  loan,  the                                                                    
     ownership  share  must be  in  the  form of  a  carried                                                                    
     interest  that  does  not  obligate  the  authority  to                                                                    
     contribute  to the  development costs  of the  project.                                                                    
     The authority may make a loan under this section only                                                                      
               (1)  to a legal entity in compliance with                                                                        
     state and federal laws;                                                                                                    
               (2)  if the loan applicant provides a                                                                            
     written waiver  permitting the  authority to  access or                                                                    
     obtain  copies  of  the loan  applicant's  confidential                                                                    
     records  that are  in possession  of the  Department of                                                                    
     Natural  Resources   or  the  Department   of  Revenue;                                                                    
     information  provided  to   the  authority  under  this                                                                    
     section  shall be  kept confidential  by the  authority                                                                    
     unless disclosure  is authorized by the  loan applicant                                                                    
     or borrower;                                                                                                               
               (3)  if the authority obtains an independent                                                                     
     study  performed by  an  experienced, qualified  expert                                                                    
     that confirms  the valuation of  the loan  security and                                                                    
     the capacity  of the  loan to support  the oil  and gas                                                                    
     development  project  and  to  cause  or  increase  the                                                                    
     commercial  production  of oil  or  gas  from the  Cook                                                                    
     Inlet sedimentary basin;                                                                                                   
               (4)  if the Regulatory Commission of Alaska                                                                      
     determines, under AS 42.05.141(g),  that the sale price                                                                    
     in a  gas sales  agreement for  gas produced  through a                                                                    
     project partially or fully funded  by a loan under this                                                                    
     section  does   not  exceed   a  just   and  reasonable                                                                    
     immediate delivery price for gas;                                                                                          
               (5)  if the authority determines that the                                                                        
     sales price for oil and  gas produced through a project                                                                    
     partially or fully funded by  a loan under this section                                                                    
     is reasonable  and in the  best interests  of residents                                                                    
     of the state.                                                                                                              
          (c)  The authority may request assistance from                                                                        
     the Department  of Revenue under  AS 44.25.020(a)(5) or                                                                    
     the    Department    of   Natural    Resources    under                                                                    
     AS 44.37.020(d) to execute this section.                                                                                   
          (d)  The authority may accept an overriding                                                                           
     royalty interest in  a lease for which a  loan has been                                                                    
     extended under  (b) of  this section if,  as a  term of                                                                    
     the loan,  the overriding  royalty interest  is subject                                                                    
     to  prior   approval  by  the  Department   of  Natural                                                                    
     Resources. The  authority may only have  the overriding                                                                    
     royalty interest  transferred to  the authority  if the                                                                    
     borrower defaults.                                                                                                         
          Sec.   44.88.855.   Cook   Inlet   oil   and   gas                                                                  
     development projects;  report. (a) The  authority shall                                                                  
     evaluate   oil  and   gas   development  projects   the                                                                    
     authority   believes  have   reasonable  potential   to                                                                    
     increase  oil and  gas production  from the  Cook Inlet                                                                    
     sedimentary  basin.  Each  year,  the  authority  shall                                                                    
     prepare  a   report  related  to  those   oil  and  gas                                                                    
     development  projects and  shall, by  the first  day of                                                                    
     each regular  session of  the legislature,  deliver the                                                                    
     report to the  senate secretary and the  chief clerk of                                                                    
     the   house   of   representatives   and   notify   the                                                                    
     legislature  that  the  report  is  available.  At  the                                                                    
     request  of a  legislative committee,  a representative                                                                    
     of  the authority  shall appear  in  that committee  to                                                                    
     review  the report.  For each  oil and  gas development                                                                    
     project, the report must include                                                                                           
             (1)  a cost estimate for the project;                                                                              
               (2)   the potential recoverable gas  from the                                                                    
     project;                                                                                                                   
               (3)   the  projected rate  of return  for the                                                                    
     project;                                                                                                                   
               (4)   if the authority recommends  a reserve-                                                                    
     based  loan  for  the  project,  the  amount  of  funds                                                                    
     necessary  for deposit  into  the  Cook Inlet  reserve-                                                                    
     based  lending  account  to  provide  a  loan  for  the                                                                    
     project  and the  recommended source  of funds  for the                                                                    
     deposit.                                                                                                                   
          (b)             Notwithstanding      AS 44.88.215,                                                                    
     44.88.850(b)(2),  or   any  other  law,   a  borrower's                                                                    
     information shall  be subject  to the  public reporting                                                                    
     requirements  under   this  section.  Each   year,  the                                                                    
     authority shall prepare a report  related to Cook Inlet                                                                    
     reserve-based loans made  under AS 44.88.850 and shall,                                                                    
     by  the  first  day  of each  regular  session  of  the                                                                    
     legislature,   deliver  the   report   to  the   senate                                                                    
     secretary  and   the  chief  clerk  of   the  house  of                                                                    
     representatives  and notify  the  legislature that  the                                                                    
     report is  available. At the  request of  a legislative                                                                    
     committee,  a  representative  of the  authority  shall                                                                    
     appear  in that  committee  to review  the report.  The                                                                    
     report must                                                                                                                
               (1)   identify  each  entity borrowing  funds                                                                    
     under AS 44.88.850;                                                                                                        
               (2)    list  the   amount  borrowed  by  each                                                                    
     borrower and the date each loan was approved;                                                                              
               (3)   include a summary  of the terms  of the                                                                    
     lending agreement with each borrower;                                                                                      
               (4)  summarize each  project for which a loan                                                                    
     was made, including  the status of the  project and the                                                                    
     volume  of oil  and  gas produced  and  expected to  be                                                                    
     produced from the project;                                                                                                 
               (5)  list the status  of payments made on the                                                                    
     loan,  including whether  the loan  is or  ever was  in                                                                    
     default."                                                                                                                  
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 6, following line 24:                                                                                                 
     Insert a new bill section to read:                                                                                         
        "* Sec. 9. AS 44.88.900 is amended by adding new                                                                    
     paragraphs to read:                                                                                                        
               (20)  "oil and gas development project"                                                                          
      means a development project to produce proven oil or                                                                      
     gas reserves;                                                                                                              
     (21)   "reserve-based loan" means  a loan  made against                                                                    
     and  fully secured  by  an oil  and  gas field,  proven                                                                    
     undeveloped  or  developed  oil and  gas  reserves,  or                                                                    
     other assets of the entity receiving the loan."                                                                            
                                                                                                                                
REPRESENTATIVE RUFFRIDGE objected for the purpose of discussion.                                                                
                                                                                                                                
CHAIR  SUMNER   summarized  Amendment  1,  stating   that  it  is                                                               
essentially  the reserve-based  lending  language  that had  been                                                               
under discussion many times in other committees.                                                                                
                                                                                                                                
3:50:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CARRICK opined  that Amendment  1, in  substance,                                                               
seemed  like a  separate piece  of  legislation.   She noted  her                                                               
curiosity as to what other members of the committee thought.                                                                    
                                                                                                                                
3:51:18 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:51 p.m. to 3:52 p.m.                                                                       
                                                                                                                                
3:52:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  moved to  adopt Conceptual Amendment  1 to                                                               
Amendment 1  to change "may" to  "shall" on line 23,  page 2, and                                                               
asked Legislative Legal Services to  make conforming changes.  He                                                               
confirmed that he supported the underlying amendment.                                                                           
                                                                                                                                
3:53:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX  objected and expounded on  the proposed word                                                               
"shall".                                                                                                                        
                                                                                                                                
REPRESENTATIVE   FIELDS   gave   an  example   of   "Cook   Inlet                                                               
Investments" and the key being durability.                                                                                      
                                                                                                                                
3:54:07 PM                                                                                                                    
                                                                                                                                
TREVOR  JEPSEN, Staff,  Representative  Tom  McKay, Alaska  State                                                               
Legislature,  said the  thinking  behind "may"  was  to give  the                                                               
Alaska Industrial  Development and  Export Authority  (AIDEA) the                                                               
flexibility to take an ownership share but not require it.                                                                      
                                                                                                                                
3:54:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS asked  Chair  Sumner  what his  preference                                                               
was.                                                                                                                            
                                                                                                                                
3:55:02 PM                                                                                                                    
                                                                                                                                
BRANDON   BREFCVYNSKI,   Deputy   Director,   Alaska   Industrial                                                               
Development and  Expert Authority, remarked upon  the rigidity of                                                               
requiring AIDEA to  take an ownership stake.   Having "may" gives                                                               
more negotiating room  but "shall" limits the  ability to finance                                                               
a project, he explained.                                                                                                        
                                                                                                                                
3:56:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  PRAX spoke  against the  amendment and  said that                                                               
taking an  ownership share  equals accepting  a higher  degree of                                                               
risk.                                                                                                                           
                                                                                                                                
3:57:31 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER confirmed his opposition  [to Conceptual Amendment 1                                                               
to Amendment 1] and opined that it was too rigid.                                                                               
                                                                                                                                
3:57:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS [moved to  withdraw] Conceptual Amendment 1                                                               
to Amendment 1.  [There being no objection, it was so ordered.]                                                                 
                                                                                                                                
3:57:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE removed his  objection [to Amendment 1].                                                               
There being no further objection, Amendment 1 was adopted.                                                                      
                                                                                                                                
3:58:26 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER  moved to adopt Amendment  2 to SB 239,  as amended,                                                               
labeled 33-LS1072\S.2, Walsh, 5/7/24, which read:                                                                               
                                                                                                                                
     Page 1, line 1:                                                                                                            
          Delete "and"                                                                                                        
                                                                                                                                
     Page 1, line 2, following "projects":                                                                                    
          Insert "; and authorizing the Alaska Industrial                                                                 
     Development  and Export  Authority  to  issue bonds  to                                                                  
     finance  infrastructure  that supports  development  of                                                                  
     critical  mineral,  rare   earth  element,  and  energy                                                                  
     projects"                                                                                                                
                                                                                                                                
     Page 6, following line 24:                                                                                                 
          Insert a new bill section to read:                                                                                    
        "*  Sec.  5. The  uncodified  law  of the  State  of                                                                
     Alaska is amended by adding a new section to read:                                                                         
          LEGISLATIVE APPROVAL: STATEWIDE CRITICAL MINERAL,                                                                     
     RARE   EARTH   ELEMENT,   AND   ENERGY   INFRASTRUCTURE                                                                    
     PROJECTS.  (a) The  Alaska  Industrial Development  and                                                                    
     Export   Authority   may   issue   bonds   to   finance                                                                    
     infrastructure     and     construction    costs     of                                                                    
     infrastructure   that   support  the   development   of                                                                    
     critical  mineral,  rare   earth  element,  and  energy                                                                    
     projects located  in the  state. The  critical mineral,                                                                    
     rare earth  element, and energy  project infrastructure                                                                    
     shall  be  owned  and  operated  by  the  authority  or                                                                    
     financed under AS 44.88.172,  44.88.650 - 44.88.690, or                                                                    
     44.88.800  - 44.88.840.  The  principal  amount of  the                                                                    
     bonds provided  by the authority for  critical mineral,                                                                    
     rare earth element, and energy  projects may not exceed                                                                    
     $300,000,000  and  may  include the  costs  of  issuing                                                                    
     bonds  considered  reasonable  and appropriate  by  the                                                                    
     authority. The  bonds shall be repaid  from revenues of                                                                    
     the authority.                                                                                                             
          (b)  The Alaska Industrial Development and Export                                                                     
     Authority may issue  the bonds under this  section in a                                                                    
     single  issuance  or   in  several  issuances,  without                                                                    
     limitation  as to  the number  of issuances  or timing,                                                                    
     and  as  the  authority determines  best  furthers  the                                                                    
     purpose of  financing infrastructure that  supports the                                                                    
     development  of critical  mineral, rare  earth element,                                                                    
     and energy projects in the state.                                                                                          
          (c)  The bonds authorized by this section may not                                                                     
     be  considered in  calculating the  authority's bonding                                                                    
     limitation    for     a    12-month     period    under                                                                    
     AS 44.88.095(a).                                                                                                           
     (d)    This  section constitutes  legislative  approval                                                                    
     required by AS 44.88.095(g)."                                                                                              
                                                                                                                                
REPRESENTATIVE RUFFRIDGE objected.                                                                                              
                                                                                                                                
3:58:30 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:58 p.m. to 4:02 p.m.                                                                       
                                                                                                                                
4:02:15 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER [moved  to  withdraw]  Amendment 2  to  SB 239,  as                                                               
amended.  There being no objection, it was so ordered.                                                                          
                                                                                                                                
4:02:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  moved to adopt  Amendment 3 to SB  239, as                                                               
amended, labeled 33-LS1072\B.3, Walsh, 5/1/24, which read:                                                                      
                                                                                                                                
     Page 2, lines 13 - 14:                                                                                                     
        Delete "containing five or more dwelling units"                                                                     
                                                                                                                                
     Page 5, line 22:                                                                                                           
        Delete "containing five or more dwelling units"                                                                     
                                                                                                                                
     Page 6, lines 26 - 27:                                                                                                     
        Delete "containing five or more dwelling units"                                                                     
                                                                                                                                
     Page 6, line 29, through page 7, line 1:                                                                                   
          Delete "that costs the occupants less than 30                                                                         
     percent of the  income of a household  with 120 percent                                                                    
     of the area median family  income, as determined by the                                                                    
     United   States  Department   of   Housing  and   Urban                                                                    
     Development, for where the housing is constructed"                                                                         
     Insert "containing five or more dwelling units"                                                                            
                                                                                                                                
REPRESENTATIVE PRAX objected.                                                                                                   
                                                                                                                                
REPRESENTATIVE  FIELDS  said  that  he  developed  the  amendment                                                               
because of his concern with the language  on page 6, line 29.  He                                                               
stated  that if  the amendment  were adopted,  the program  would                                                               
support any multi-family workforce housing.                                                                                     
                                                                                                                                
4:03:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX  asked whether  there was a  legal definition                                                               
of "workforce housing".                                                                                                         
                                                                                                                                
REPRESENTATIVE  FIELDS  answered  that   he  was  broadening  the                                                               
definition to  not be confined  to low-income housing  because it                                                               
captured only one segment of the workforce.                                                                                     
                                                                                                                                
4:04:24 PM                                                                                                                    
                                                                                                                                
JAMES  HOLZENBERG, Staff,  Senator Forrest  Dunbar, Alaska  State                                                               
Legislature, on  behalf of  Senator Dunbar,  prime sponsor  of SB                                                               
239, explained  that the  definition was  intended to  narrow the                                                               
scope of  the bill.  He  added that the utility  of the amendment                                                               
could benefit the legislation overall.                                                                                          
                                                                                                                                
4:05:41 PM                                                                                                                    
                                                                                                                                
MR. BREFCEYNSKI stated that he had no concerns with Amendment 3.                                                                
                                                                                                                                
4:05:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX maintained his objection.                                                                                   
                                                                                                                                
4:06:22 PM                                                                                                                    
                                                                                                                                
A roll call  vote was taken.   Representatives Fields, Ruffridge,                                                               
Wright, Carrick, and  Sumner voted in favor of Amendment  3 to SB                                                               
239, as amended.  Representatives  Prax and Saddler voted against                                                               
it.  Therefore, Amendment 3 was adopted by a vote of 5-2.                                                                       
                                                                                                                                
4:07:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE moved to report  SB 239, as amended, out                                                               
of   committee   with    individual   recommendations   and   the                                                               
accompanying  fiscal notes.   There  being no  objection, HCS  SB                                                               
239(L&C)  was  reported  out  of the  House  Labor  and  Commerce                                                               
Standing Committee.                                                                                                             
                                                                                                                                
           SB 182-EXTEND BIG GAME COMM SERVICES BOARD                                                                       
                                                                                                                                
4:08:05 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced  that the next order of  business would be                                                               
SENATE BILL  NO. 182, "An  Act extending the termination  date of                                                               
the  Big Game  Commercial Services  Board; and  providing for  an                                                               
effective date."                                                                                                                
                                                                                                                                
4:08:25 PM                                                                                                                    
                                                                                                                                
SENATOR  JESSE  BJORKMAN,  Alaska  State  Legislature,  as  prime                                                               
sponsor, presented SB 182 and  reiterated the intent of the bill.                                                               
He  added that  it  reflected the  Big  Game Commercial  Services                                                               
Board's  efforts to  improve its  fiscal position.   He  said the                                                               
board had been  consistently working in the best  interest of the                                                               
public  and a  six-year extension  for the  termination date  had                                                               
been recommended.                                                                                                               
                                                                                                                                
CHAIR SUMNER welcomed invited testifiers.                                                                                       
                                                                                                                                
4:10:37 PM                                                                                                                    
                                                                                                                                
AARON  BLOOMQUIST, Chair,  Big  Game  Commercial Services  Board,                                                               
spoke to the commercial services  board and efforts around issues                                                               
individual licensees  and clients  have.   He confirmed  that the                                                               
budget  was in  good shape  and explained  investigative matters.                                                               
He further noted that the  department was understaffed, which can                                                               
create challenges,  but it continues  to do  its part.   He noted                                                               
that  in  the future,  the  board  would  bring requests  to  the                                                               
legislature surrounding survivorships,  emergency provisions, and                                                               
continuing education.                                                                                                           
                                                                                                                                
4:13:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER observed  that  the  audit indicated  the                                                               
extension was  a maximum  of eight years  and questioned  why the                                                               
request was for six.                                                                                                            
                                                                                                                                
SENATOR  BJORKMAN clarified  that  the bill  was  written for  an                                                               
eight-year extension  being that the board  had been successfully                                                               
fiscally responsible.                                                                                                           
                                                                                                                                
4:15:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE moved to report  SB 182 out of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There being no objection,  SB 182 was reported out of the                                                               
House Labor and Commerce Standing Committee.                                                                                    
                                                                                                                                
             SB 234-EXTEND MARIJUANA CONTROL BOARD                                                                          
                                                                                                                                
4:15:47 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced  that the next order of  business would be                                                               
SENATE BILL  NO. 234, "An  Act relating to the  Marijuana Control                                                               
Board; and providing for an effective date."                                                                                    
                                                                                                                                
4:16:04 PM                                                                                                                    
                                                                                                                                
SENATOR BJORKMAN,  as prime sponsor,  read the  sponsor statement                                                               
for  SB 234  [included in  the committee  packet], which  read as                                                               
follows [original punctuation provided]:                                                                                        
                                                                                                                                
     Senate Bill 234  proposes to extend the  sunset date of                                                                    
     the Marijuana Control Board (MCB) by three years.                                                                          
                                                                                                                                
     In October  of 2023, our Division  of Legislative Audit                                                                    
     completed a sunset  audit of the Board.  In this audit,                                                                    
     it was determined that overall,  the Board has operated                                                                    
     in the public's interest  by conducting its meetings in                                                                    
     accordance  with   state  law,  as  well   as  actively                                                                    
     amending regulations and  conducting investigation in a                                                                    
     timely manner.                                                                                                             
                                                                                                                                
     As you make an in-depth  review the audit, you will see                                                                    
     our auditor made  note of three issues  which should be                                                                    
     addressed by the Board and  the Legislature as it moves                                                                    
     forward.  First,   AMCO's  director   should  establish                                                                    
     procedures  to ensure  handler permit  documentation is                                                                    
     properly  maintained.  Secondly,  the  MCB  and  AMCO's                                                                    
     director  should continue  to implement  a new  license                                                                    
     and  enforcement   information  system.   Thirdly,  the                                                                    
     legislature   should   consider  requiring   regulation                                                                    
     changes  be  approved  by  the   majority  of  the  MCB                                                                    
     members.                                                                                                                   
                                                                                                                                
     Currently, the Board  will sunset on June  30, 2024. To                                                                    
     allow  the  Board to  continue  working  in the  public                                                                    
     interest,  SB 234  follows  the recommended  three-year                                                                    
     extension to June 30, 2027.  A three-year extension was                                                                    
     made in recognition that there  may soon be significant                                                                    
     changes to  the MCB  and to AMCO  duties. Additionally,                                                                    
     this would  align the next  MCB audit with that  of the                                                                    
     Alcoholic Beverage Control Board's next audit.                                                                             
                                                                                                                                
     I urge your support of this legislation.                                                                                   
                                                                                                                                
4:17:59 PM                                                                                                                    
                                                                                                                                
JOAN  WILSON, Director,  Alcohol  and  Marijuana Control  Office,                                                               
began her  testimony by relating  the numbers of  cultivators and                                                               
businesses  in Alaska  and that  without the  control board,  she                                                               
opined the  industry would cease  to exist.   She said  the board                                                               
would be addressing its license  fees, because the industry would                                                               
have  retained the  money borrowed  from the  general fund.   She                                                               
noted that there is an advantage  of aligning the sunset with the                                                               
Alcohol Beverage Control  Board (ABC).  She  explained that there                                                               
would still be a need to  regulate marijuana on a statewide basis                                                               
even with  the changes in  regulations.  She emphasized  that the                                                               
Alcohol  &  Marijuana  Control Office  (AMCO)  is  a  tight-knit,                                                               
hardworking office and it was a privilege to serve Alaska.                                                                      
                                                                                                                                
4:20:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER spoke  to the audit and  asked whether the                                                               
board had a role in enforcing collection of taxes.                                                                              
                                                                                                                                
MS. WILSON  replied no,  but that  the board  had the  ability to                                                               
revoke  licenses.   She  noted there  are  currently 300  defunct                                                               
licenses and the board is working hard to collect the money.                                                                    
                                                                                                                                
4:22:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK  asked how  many vacant staff  for license                                                               
processing  are at  AMCO.   She further  inquired about  how many                                                               
overall staff there were.                                                                                                       
                                                                                                                                
MS. WILSON  replied that AMCO  is recruiting for  three licensing                                                               
examiners and  one administrative assistant.   She added  that it                                                               
was  due to  the Title  4 rewrite.   In  response to  a follow-up                                                               
question, she replied that there are 24 positions at AMCO.                                                                      
                                                                                                                                
REPRESENTATIVE  CARRICK said  the  audit  related that  licensing                                                               
delays  served as  a  barrier  to the  marijuana  industry.   She                                                               
commented that if people cannot  enter legally, or in time, there                                                               
is a chance  of them entering the market illegally.   She offered                                                               
her belief that filling the  open positions is something that the                                                               
legislature should make a high priority.                                                                                        
                                                                                                                                
MS. WILSON related  that when she started two years  ago, it took                                                               
eight months  to get to queued  applications.  She said  AMCO re-                                                               
prioritizes as  much as it can  to serve applicants.   She stated                                                               
that the good news is that the queue has improved.                                                                              
                                                                                                                                
4:25:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE moved to report  SB 234 out of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There being no objection,  SB 234 was reported out of the                                                               
House Labor and Commerce Standing Committee.                                                                                    
                                                                                                                                
          SB 115-PHYSICIAN ASSISTANT SCOPE OF PRACTICE                                                                      
                                                                                                                                
4:26:05 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced  that the next order of  business would be                                                               
CS  FOR  SENATE  BILL  NO.  115(HSS)  AM,  "An  Act  relating  to                                                               
physician  assistants; relating  to physicians;  and relating  to                                                               
health care insurance policies."                                                                                                
                                                                                                                                
4:26:33 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:26 p.m. to 4:28 p.m.                                                                       
                                                                                                                                
4:28:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE confirmed he would not offer Amendment                                                                 
1.  He moved to adopt Amendment 2 to CSSB 115(HSS) AM, labeled                                                                  
33-LS0542\U.A.3, Gunther, 5/3/24, which read:                                                                                   
                                                                                                                                
     Page 3, line 7:                                                                                                            
         Delete "one or more collaborating physicians"                                                                          
          Insert "a collaborating physician"                                                                                    
                                                                                                                                
     Page 3, lines 7 - 8:                                                                                                       
          Delete "A collaborating physician or physicians"                                                                      
          Insert "The collaborating physician"                                                                                  
                                                                                                                                
     Page 3, lines 10 - 12:                                                                                                     
          Delete "one or more collaborating physicians who,                                                                     
        collectively, practice in each of the physician                                                                         
     assistant's practice areas"                                                                                                
          Insert "the collaborating physician"                                                                                  
                                                                                                                                
     Page 3, following line 13:                                                                                                 
     Insert new paragraphs to read:                                                                                             
               "(2)  be between a physician assistant and a                                                                     
      collaborating physician who practices in each of the                                                                      
     practice areas of the physician assistant;                                                                                 
               (3)  describe the practice areas of the                                                                          
     physician assistant and the collaborating physician;"                                                                      
                                                                                                                                
     Renumber the following paragraphs accordingly.                                                                             
                                                                                                                                
     Page 3, line 22, following "assistant;":                                                                                   
          Insert "and"                                                                                                          
                                                                                                                                
     Page 3, line 24:                                                                                                           
          Delete "; and"                                                                                                        
          Insert "."                                                                                                            
                                                                                                                                
     Page 3, lines 25 - 26:                                                                                                     
     Delete all material.                                                                                                       
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE RUFFRIDGE said that  Amendment 2 sought to clarify                                                               
that "collaborative physician"  in the bill should  be a singular                                                               
person,  whereas in  the underlying  bill  there is  a desire  to                                                               
clarify that there can be an alternate.                                                                                         
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
4:29:12 PM                                                                                                                    
                                                                                                                                
SENATOR L?KI TOBIN, Alaska State  Senator, as prime sponsor of SB                                                               
115,  said she  would  defer to  an expert  to  ensure there  was                                                               
accurate information given.                                                                                                     
                                                                                                                                
4:29:27 PM                                                                                                                    
                                                                                                                                
JENNIFER FAYETTE,  PA, offered  her belief that  it went  back to                                                               
statute  versus regulation  and opined  that it  was a  confusing                                                               
conversation in the bill.                                                                                                       
                                                                                                                                
REPRESENTATIVE FIELDS asked whether  limiting [the definition] to                                                               
one person  produced a problem  in, for example, a  tribal health                                                               
system where two collaborating physicians could be beneficial.                                                                  
                                                                                                                                
MS.  FAYETTE responded  that collaboration  and consultation  are                                                               
always available to  everyone.  She opined that  it is burdensome                                                               
to require more than one [collaborator].                                                                                        
                                                                                                                                
4:31:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT removed his objection.                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK objected.                                                                                                
                                                                                                                                
4:31:11 PM                                                                                                                    
                                                                                                                                
A  roll  call vote  was  taken.   Representatives  Fields,  Prax,                                                               
Ruffridge, Saddler,  and Wright  voted in  favor of  Amendment 2.                                                               
Representatives Carrick and Sumner  voted against it.  Therefore,                                                               
Amendment 2 was adopted by a vote of 5-2.                                                                                       
                                                                                                                                
4:31:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  moved  to   adopt  Amendment  3  to  CSSB                                                               
115(HSS)  AM,  as   amended,  labeled  33-LS0542\U.A.9,  Gunther,                                                               
5/6/24, which read:                                                                                                             
                                                                                                                                
     Page 3, line 4:                                                                                                            
          Delete "4,000"                                                                                                        
     Insert "10,000"                                                                                                            
                                                                                                                                
REPRESENTATIVE WRIGHT objected for purposes of discussion.                                                                      
                                                                                                                                
REPRESENTATIVE  FIELDS explained  that Amendment  3 would  change                                                               
the hours  prior to  independent practice  from 4,000  to 10,000.                                                               
He  offered his  belief  that 4,000  hours is  too  low, and  the                                                               
amendment is an attempt to strike a balance.                                                                                    
                                                                                                                                
4:32:29 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER sought  clarity if it would be 5  years of full-time                                                               
work.                                                                                                                           
                                                                                                                                
REPRESENTATIVE  FIELDS  replied  yes, assuming  one  works  2,000                                                               
hours a year  and he further noted that it  would differ based on                                                               
practice.                                                                                                                       
                                                                                                                                
4:33:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
SENATOR TOBIN added that the  amendment would require a physician                                                               
assistant  (PA) to  have additional  hours, and  if an  assistant                                                               
were   to  switch   specialties,   there   would  be   additional                                                               
requirements that  would equal that  of physicians.  She  gave an                                                               
example of Utah  and its specific provisions.  She  noted that in                                                               
Alaska,  there are  not enough  collaborating  physicians and  it                                                               
would make it more difficult on  the PA to find collaborators for                                                               
those five years.                                                                                                               
                                                                                                                                
4:34:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CARRICK noted  that  Amendment 1,  which was  not                                                               
offered, would have moved from 4,000 to 8,000 hours.                                                                            
                                                                                                                                
REPRESENTATIVE CARRICK  moved to adopt Conceptual  Amendment 1 to                                                               
Amendment 3, to change the hours to 8,000.                                                                                      
                                                                                                                                
REPRESENTATIVE RUFFRIDGE objected.                                                                                              
                                                                                                                                
REPRESENTATIVE  CARRICK said  that the  intent was  to provide  a                                                               
better balance between  the scope of the bill  and the underlying                                                               
amendment.                                                                                                                      
                                                                                                                                
4:35:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   FIELDS  offered   support  for   the  conceptual                                                               
amendment.                                                                                                                      
                                                                                                                                
4:35:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WRIGHT asked  Senator Tobin  whether 4,000  hours                                                               
was adequate and 8,000 was overkill.                                                                                            
                                                                                                                                
SENATOR TOBIN deferred to Ms. Fayette for further clarity.                                                                      
                                                                                                                                
4:36:35 PM                                                                                                                    
                                                                                                                                
MS.  FAYETTE said  that  the ongoing  misconception  is how  much                                                               
education one  receives and  noted that  the PA  program requires                                                               
2,000  hours to  be accepted  into medical  school.   She related                                                               
that the  average person has  6,000 hours  of patient care.   She                                                               
advised that PAs  are not trying to be doctors  but are seeking a                                                               
pathway that gets people to  provide better care and stay current                                                               
in what they do.                                                                                                                
                                                                                                                                
4:38:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS commented  that 8,000  hours was  the bare                                                               
minimum he could support.                                                                                                       
                                                                                                                                
4:38:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  stated that he  had never heard  of the                                                               
large number of  hours being completed prior to  going to school,                                                               
and asked, "The hours in what?"                                                                                                 
                                                                                                                                
MS. FAYETTE responded  that it had to be  repetitive patient care                                                               
and added  that many students  are emergency  medical technicians                                                               
(EMTs),  nursing students,  and medical  assistants.   She shared                                                               
that her program had a minimum of 2,500 hours.                                                                                  
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  shared an  anecdote of  his educational                                                               
background.   He asked, in  order to go  to PA school,  whether a                                                               
person  that  has completed  high  school  or undergrad  training                                                               
cannot apply.                                                                                                                   
                                                                                                                                
MS. FAYETTE  answered that they  probably would not  be accepted.                                                               
She clarified it must be paid  hours and one must have 2,000 paid                                                               
patient care.                                                                                                                   
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  asked whether  there was a  barrier put                                                               
in  place  by   the  schools  and  who   established  the  hourly                                                               
requirement in order to attend school.                                                                                          
                                                                                                                                
4:41:38 PM                                                                                                                    
                                                                                                                                
SENATOR  TOBIN   explained  that   each  program   had  different                                                               
prerequisite  requirements.    She  listed the  types  of  hourly                                                               
requirements and  that programs require  at least a  bare minimum                                                               
to  be accepted  into  these highly  competitive  programs.   She                                                               
reiterated that  it was not the  intent to have PAs  in line with                                                               
physicians.                                                                                                                     
                                                                                                                                
4:43:12 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER  asked how the  scope of practice would  differ from                                                               
that of a physician under the proposed legislation.                                                                             
                                                                                                                                
SENATOR  TOBIN pointed  to the  differences  on page  2, line  5,                                                               
which showed a list  of what PAs do, and for  example, PAs do not                                                               
operate under  regulation.  She mentioned  an inpatient procedure                                                               
such as stitches which may fall under an "operation."                                                                           
                                                                                                                                
4:44:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   WRIGHT  questioned   whether  2,000   hours  was                                                               
adequate for the  scope of work but observed that  4,000 had been                                                               
compromised on.                                                                                                                 
                                                                                                                                
4:44:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  provided his  rationale and  added that                                                               
he  thought 10,000  hours  made sense  but not  in  the way  that                                                               
Amendment  3  brought it  forward.    He  affirmed he  would  not                                                               
support the conceptual amendment or the underlying amendment.                                                                   
                                                                                                                                
4:46:10 PM                                                                                                                    
                                                                                                                                
A roll  call vote  was taken.   Representatives  Carrick, Fields,                                                               
and Sumner voted in favor  of Conceptual Amendment 1 to Amendment                                                               
3.   Representatives Wright, Ruffridge,  Saddler, and  Prax voted                                                               
against it.   Therefore, the Conceptual Amendment  1 to Amendment                                                               
3 failed to be adopted by a vote of 3-4.                                                                                        
                                                                                                                                
4:47:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK  noted her  appreciation for  PA testimony                                                               
stating 4,000 hours  as being adequate.  She  offered her support                                                               
for Amendment  3 being  that she was  not convinced  that without                                                               
the amendment some of the parity would be received.                                                                             
                                                                                                                                
4:48:22 PM                                                                                                                    
                                                                                                                                
SENATOR  TOBIN gave  a reminder  that every  PA program  required                                                               
2,000 hours and these additional  collaborative hours would be on                                                               
top of that.                                                                                                                    
                                                                                                                                
4:48:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  questioned whether there were  any doctors                                                               
online  to give  an  overview  of hours  in  school and  clinical                                                               
rotation.                                                                                                                       
                                                                                                                                
CHAIR  SUMNER confirmed  there was  not anyone  online or  in the                                                               
room.                                                                                                                           
                                                                                                                                
4:49:35 PM                                                                                                                    
                                                                                                                                
A roll call  vote was taken.  Representatives  Carrick and Fields                                                               
voted in favor of Amendment  3.  Representatives Saddler, Wright,                                                               
Prax,  Ruffridge,  and  Sumner  voted  against  it.    Therefore,                                                               
Amendment 3 failed to be adopted by a vote of 2-5.                                                                              
                                                                                                                                
4:50:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  moved  to   adopt  Amendment  4  to  CSSB                                                               
115(HSS)  AM,  as  amended,  labeled  33-LS0542\U.A.10,  Gunther,                                                               
5/6/24, which read:                                                                                                             
                                                                                                                                
     Page 1, line 11:                                                                                                           
          Delete "[AND]"                                                                                                        
          Insert "and"                                                                                                          
                                                                                                                                
     Page 1, line 12, through page 2, line 4:                                                                                   
          Delete "; and                                                                                                     
               (5)  hours of practice experience, if any,                                                                   
        that a physician assistant must complete under a                                                                    
     collaborative agreement to practice  in a practice area                                                                
     that  is  substantively  different than  the  physician                                                                
     assistant's previous practice areas;  the board may not                                                                
     require that  a physician assistant complete  more than                                                                
     4,000 hours  under this paragraph,  in addition  to the                                                                
     hours required  under (c) of this  section, to practice                                                                
     in  a   new  practice  area  without   a  collaborative                                                                
     agreement"                                                                                                             
                                                                                                                              
     Page 3, lines 3 - 5:                                                                                                       
          Delete "Unless additional hours are required by                                                                       
     the  board to  practice in  a new  practice area  under                                                                    
     (a)(5)  of this  section,  a  physician assistant  with                                                                    
     less than 4,000 hours of practice experience"                                                                              
          Insert "Except as provided in (d) of this                                                                             
     section, a physician assistant"                                                                                            
                                                                                                                                
     Page 3, following line 26:                                                                                                 
     Insert a new subsection to read:                                                                                           
          "(d)  A physician assistant with 4,000 or more                                                                        
     hours  of  practice  experience under  a  collaborative                                                                    
     agreement may  provide primary care  services permitted                                                                    
     under   (b)   of   this  section   without   having   a                                                                    
     collaborative agreement in place."                                                                                         
                                                                                                                                
     Reletter the following subsections accordingly.                                                                            
                                                                                                                                
REPRESENTATIVE RUFFRIDGE objected.                                                                                              
                                                                                                                                
REPRESENTATIVE  FIELDS  summarized   that  the  amendment  limits                                                               
independent practice of PAs to primary care.                                                                                    
                                                                                                                                
4:51:07 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
4:51:13 PM                                                                                                                    
                                                                                                                                
SENATOR  TOBIN   offered  her  belief   that  "carve   outs"  are                                                               
problematic.   She noted  that a  similar provision  was proposed                                                               
out of  state and  the reality  led to fewer  PA practices.   She                                                               
deferred to  Ms. Fayette  for further  reasoning on  the proposed                                                               
amendment.                                                                                                                      
                                                                                                                                
MS. FAYETTE reiterated  that the bill was put  forward for access                                                               
to care.   She noted that there are specialty  doctors lacking in                                                               
parts of  Alaska and gave personal  examples of the scope  of her                                                               
work in the  clinic.  She stressed the  importance of recognizing                                                               
the shortages but still being able to "answer the call."                                                                        
                                                                                                                                
4:54:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE appreciated the  testimony and asked Ms.                                                               
Fayette  if the  bill were  to  pass whether  she would  practice                                                               
independently or attempt to continue in a collaborative fashion.                                                                
                                                                                                                                
MS. FAYETTE  responded that  the bill wouldn't  change a  lot for                                                               
her regarding a "surgical assist."                                                                                              
                                                                                                                                
4:56:16 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
CHAIR  SUMNER  recessed the  House  Labor  and Commerce  Standing                                                               
Committee  meeting to  10 minutes  following  the adjournment  of                                                               
House floor session.   [The motion to adopt Amendment  4 was left                                                               
pending, with objection.]                                                                                                       
                                                                                                                                
7:13:15 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER  called  the  House  Labor  and  Commerce  Standing                                                               
Committee back to  order.  Present during the call  back to order                                                               
were  Representatives  Prax,   Carrick,  Fields,  Ruffridge,  and                                                               
Sumner.    Representatives  Saddler  and Wright  arrived  as  the                                                               
meeting was in progress.                                                                                                        
                                                                                                                                
          SB 115-PHYSICIAN ASSISTANT SCOPE OF PRACTICE                                                                      
                                                                                                                                
7:13:19 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced that the  final order of business would be                                                               
CS  FOR  SENATE  BILL  NO.  115(HSS)  AM,  "An  Act  relating  to                                                               
physician  assistants; relating  to physicians;  and relating  to                                                               
health care insurance policies."                                                                                                
                                                                                                                                
SENATOR  TOBIN noted  that  Ms. Fayette  wished  to continue  her                                                               
closing comments.                                                                                                               
                                                                                                                                
7:13:48 PM                                                                                                                    
                                                                                                                                
MS.  FAYETTE said  that when  a collaborator  is lost,  it causes                                                               
delayed care; therefore, access to care gets interrupted.                                                                       
                                                                                                                                
7:14:21 PM                                                                                                                    
                                                                                                                                
A  roll call  vote was  taken.   Representative  Fields voted  in                                                               
favor  of  Amendment  4.     Representatives  Ruffridge,  Wright,                                                               
Carrick,  Prax,   and  Sumner  voted  against   it.    Therefore,                                                               
Amendment 4 failed to be adopted by a vote of 1-5.                                                                              
                                                                                                                                
7:15:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  stated that he  will not move  Amendment 5                                                               
and moved to  adopt Amendment 6 to CSSB 115(HSS)  AM, as amended,                                                               
labeled  33-LS0542\U.A.14,  A.   Radford/Gunther,  5/6/24,  which                                                               
read:                                                                                                                           
                                                                                                                                
     Page 3, following line 29:                                                                                                 
          Insert a new subsection to read:                                                                                      
          "(e)  Before a physician assistant may provide                                                                        
     services  under this  section, the  physician assistant                                                                    
     must  inform  the patient  that  the  services will  be                                                                    
     performed  by a  physician assistant  and identify  any                                                                    
     physician who is present for the services."                                                                                
                                                                                                                                
     Reletter the following subsection accordingly.                                                                             
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE  FIELDS  explained  that  existing  law  does  not                                                               
require PAs  to identify  themselves as  such, and  the amendment                                                               
would require the PA to relate that they are a PA.                                                                              
                                                                                                                                
7:16:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
SENATOR  TOBIN  said   that  Ms.  Fayette  could   speak  to  the                                                               
regulation.                                                                                                                     
                                                                                                                                
7:16:24 PM                                                                                                                    
                                                                                                                                
MS. FAYETTE  said that  current regulations  require a  sign that                                                               
shows a  PA's credentials  and that their  education is  on file.                                                               
In addition, they  must wear a nametag or  clothing that presents                                                               
them as a PA.                                                                                                                   
                                                                                                                                
REPRESENTATIVE  WRIGHT asked  whether  a PA  greets  and tells  a                                                               
patient their name and title.                                                                                                   
                                                                                                                                
MS.  FAYETTE confirmed  that she  does  and added  that she  will                                                               
correct a patient if they think she is a physician.                                                                             
                                                                                                                                
7:17:08 PM                                                                                                                    
                                                                                                                                
SENATOR TOBIN  explained that  it is in  regulation that  all who                                                               
are not MDs  or physicians must identify themselves  as not being                                                               
a doctor.                                                                                                                       
                                                                                                                                
7:17:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CARRICK,  referencing  the  second  part  of  the                                                               
amendment,  asked  whether  PAs  currently  need  to  identify  a                                                               
physician who is present for the services.                                                                                      
                                                                                                                                
MS.  FAYETTE responded  that in  regulation, any  provider should                                                               
present themselves.                                                                                                             
                                                                                                                                
7:18:25 PM                                                                                                                    
                                                                                                                                
SENATOR TOBIN  noted that 12 percent  of collaborating physicians                                                               
have licenses outside the state.                                                                                                
                                                                                                                                
REPRESENTATIVE CARRICK  relayed her concern that  the second part                                                               
of Amendment 6 would be challenging  to put into place when there                                                               
is a lack of physicians.                                                                                                        
                                                                                                                                
7:19:40 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER advised members of a new invited testifier.                                                                        
                                                                                                                                
7:20:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  asked  the amendment  sponsor  if  the                                                               
intent of  the amendment  is to  allow a  PA to  perform services                                                               
only if a physician is present.                                                                                                 
                                                                                                                                
REPRESENTATIVE FIELDS  responded that was not  the intent because                                                               
remote collaborating physicians are necessary and helpful.                                                                      
                                                                                                                                
7:21:04 PM                                                                                                                    
                                                                                                                                
SENATOR  TOBIN  noted  that  regulation  provided  penalties  for                                                               
noncompliance of identification.                                                                                                
                                                                                                                                
CHAIR SUMNER commented  that if it was put  in statute, penalties                                                               
would still exist in regulation.                                                                                                
                                                                                                                                
SENATOR  TOBIN said  it was  a  concern in  that the  regulations                                                               
would need to  be re-written and there may be  confusion from the                                                               
medical board.                                                                                                                  
                                                                                                                                
7:22:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS clarified  it was not the  intent to change                                                               
more details in regulations.                                                                                                    
                                                                                                                                
7:22:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK  moved to adopt Conceptual  Amendment 1 to                                                               
Amendment 6 to  delete the following from line 5  [as numbered on                                                               
Amendment 6]:   "and  identify any physician  who is  present for                                                               
the services".  There being no objection, it was so ordered.                                                                    
                                                                                                                                
CHAIR  SUMNER   advised  that  Amendment  6,   as  amended,  with                                                               
objection, was before the committee.                                                                                            
                                                                                                                                
7:23:11 PM                                                                                                                    
                                                                                                                                
A roll call  vote was taken.   Representatives Fields, Ruffridge,                                                               
Saddler, Carrick,  and Sumner voted  in favor of Amendment  6, as                                                               
amended.    Representatives Prax  and  Wright  voted against  it.                                                               
Therefore, Amendment 6,  as amended, was adopted by a  vote of 5-                                                               
2.                                                                                                                              
                                                                                                                                
7:23:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  moved  to   adopt  Amendment  7  to  CSSB                                                               
115(HSS)  AM,  as  amended,  labeled  33-LS0542\U.A.19,  Gunther,                                                               
5/7/24, which read:                                                                                                             
                                                                                                                                
     Page 2, line 3:                                                                                                            
          Delete "(c)"                                                                                                      
          Insert "(d)"                                                                                                      
                                                                                                                                
     Page 2, line 31:                                                                                                           
          Delete "and"                                                                                                          
                                                                                                                                
     Page 2, following line 31:                                                                                                 
          Insert a new paragraph to read:                                                                                       
               "(13)  assist in the performance of an                                                                           
       operation performed by a physician, osteopath, or                                                                        
     podiatrist licensed under this chapter; and"                                                                               
                                                                                                                                
     Renumber the following paragraph accordingly.                                                                              
                                                                                                                                
     Page 3, following line 2:                                                                                                  
          Insert a new subsection to read:                                                                                      
          "(c)  A physician assistant may not perform an                                                                        
     operation."                                                                                                                
                                                                                                                                
     Reletter the following subsections accordingly.                                                                            
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE FIELDS summarized Amendment  7 and that the intent                                                               
was to offer better clarification for scopes of practice.                                                                       
                                                                                                                                
7:24:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  asked for definition  regarding assisting                                                               
in  the   performance  of  an  operation   versus  performing  an                                                               
operation.                                                                                                                      
                                                                                                                                
SENATOR TOBIN  noted that  the terms are  not defined  within the                                                               
amendment.   She referred to the  first part of the  amendment as                                                               
being  problematic,   being  it   may  create   difficulties  for                                                               
providers.   She  further noted  other difficulties  that may  be                                                               
created.                                                                                                                        
                                                                                                                                
7:26:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  requested a doctor online  who could speak                                                               
to Amendment 7.                                                                                                                 
                                                                                                                                
7:27:24 PM                                                                                                                    
                                                                                                                                
KRISTIN   MITCHELL,   MD,   President,   Alaska   State   Medical                                                               
Association,  after   noting  her  credentials,  said   that  the                                                               
definition of  "operation" could be broadly  determined and could                                                               
create complications.   She briefly explained  the definitions of                                                               
medical practitioners.                                                                                                          
                                                                                                                                
REPRESENTATIVE   FIELDS  asked   whether  the   committee  should                                                               
distinguish that  PAs should not  perform operations  or withdraw                                                               
Amendment 7.                                                                                                                    
                                                                                                                                
DR. MITCHELL  replied that she  was not an expert  in legislative                                                               
language but suggested  one possibility would be  to specify that                                                               
a PA would assist with but not perform a surgery.                                                                               
                                                                                                                                
7:29:10 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER asked  about the difference between a  surgery or an                                                               
operation and inquired what stitches would fall under.                                                                          
                                                                                                                                
DR. MITCHELL noted that there had  been an open debate about what                                                               
was  considered a  procedure or  minor  surgery, and  it was  not                                                               
entirely clear.   She gave an example that a  minor surgery could                                                               
include removing skin lesions.                                                                                                  
                                                                                                                                
7:30:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  [moved to  withdraw] Amendment 7.   [There                                                               
being no objection, Amendment 7 was withdrawn.]                                                                                 
                                                                                                                                
REPRESENTATIVE  FIELDS  moved  to   adopt  Amendment  8  to  CSSB                                                               
115(HSS)   AM,   as   amended,   labeled   33-LS0542\U.A.20,   A.                                                               
Radford/Gunther, 5/7/24, which read:                                                                                            
                                                                                                                                
     Page 1, line 11:                                                                                                           
          Delete "[AND]"                                                                                                        
          Insert "and"                                                                                                          
                                                                                                                                
     Page 1, line 12, through page 2, line 4:                                                                                   
          Delete "; and                                                                                                     
               (5)  hours of practice experience, if any,                                                                   
     that  a  physician  assistant  must  complete  under  a                                                                
     collaborative agreement to practice  in a practice area                                                                
     that  is  substantively  different than  the  physician                                                                
     assistant's previous practice areas;  the board may not                                                                
     require that  a physician assistant complete  more than                                                                
     4,000 hours  under this paragraph,  in addition  to the                                                                
     hours required  under (c) of this  section, to practice                                                                
     in  a   new  practice  area  without   a  collaborative                                                                
     agreement"                                                                                                             
                                                                                                                                
     Page 3, lines 3 - 5:                                                                                                       
          Delete "Unless additional hours are required by                                                                       
     the  board to  practice in  a new  practice area  under                                                                    
     (a)(5)  of this  section,  a  physician assistant  with                                                                    
     less than 4,000 hours of practice experience"                                                                              
          Insert "Except as provided under (f) of this                                                                          
     section, a physician assistant"                                                                                            
                                                                                                                                
     Page 3, following line 29:                                                                                                 
     Insert new subsections to read:                                                                                            
          "(e)  A collaborative agreement may designate one                                                                     
     or more alternate collaborating  physicians to whom the                                                                    
     responsibility  to  oversee   and  communicate  with  a                                                                    
     physician assistant  under the  collaborative agreement                                                                    
     may be assigned.                                                                                                           
          (f)  Upon termination of a collaborative                                                                              
     agreement,  a physician  assistant with  4,000 or  more                                                                    
     hours of  practice experience  may practice  within the                                                                    
     scope  of  services  authorized  under  the  terminated                                                                    
     collaborative   agreement   without   a   collaborating                                                                    
     physician for up to one year."                                                                                             
                                                                                                                                
     Reletter the following subsection accordingly.                                                                             
                                                                                                                                
     Page 3, line 31:                                                                                                           
          Delete "and a collaborating physician"                                                                                
     Insert ",  one or  more collaborating  physicians, and,                                                                    
     if  applicable,  one  or more  alternate  collaborating                                                                    
     physicians"                                                                                                                
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE  FIELDS summarized  the amendment  and highlighted                                                               
that it would  allow PAs to designate  an alternate collaborating                                                               
physician and, in the meantime, practice independently.                                                                         
                                                                                                                                
7:31:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER questioned  termination and whether either                                                               
could terminate at will.                                                                                                        
                                                                                                                                
REPRESENTATIVE FIELDS clarified that it  could be either, but was                                                               
not meant  to imply  a negative experience.   He  reiterated that                                                               
the intent is that the PA should be able to keep practicing.                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER asked for clarity about termination.                                                                     
                                                                                                                                
7:32:49 PM                                                                                                                    
                                                                                                                                
MS. FAYETTE  said she had  seen the language before  in emergency                                                               
stipulations but in statute she opined it is unfair.                                                                            
                                                                                                                                
SENATOR TOBIN  stated that she  opposed the amendment  because it                                                               
is  hard to  find collaborating  physicians currently,  and there                                                               
are  now 313  PAs  without  collaborating physicians;  therefore,                                                               
requiring  them   to  identify   an  alternative  is   an  overly                                                               
administrative burden and would not provide more access to care.                                                                
                                                                                                                                
7:33:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER expressed confusion over the consistency.                                                                
                                                                                                                                
[CHAIR SUMNER passed the gavel to Vice Chair Ruffridge.]                                                                        
                                                                                                                                
7:34:15 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 7:34 p.m. to 7:35 p.m.                                                                       
                                                                                                                                
7:35:17 PM                                                                                                                    
                                                                                                                                
VICE  CHAIR  RUFFRIDGE  asked  for   any  further  discussion  on                                                               
Amendment 8.                                                                                                                    
                                                                                                                                
7:35:31 PM                                                                                                                    
                                                                                                                                
A  roll call  vote was  taken.   Representative  Fields voted  in                                                               
favor  of Amendment  8.   Representatives Prax,  Saddler, Wright,                                                               
Carrick, and Ruffridge voted against  it.  Therefore, Amendment 8                                                               
failed to be adopted by a vote of 1-5.                                                                                          
                                                                                                                                
7:36:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  moved  to   adopt  Amendment  9  to  CSSB                                                               
115(HSS)   AM,   as   amended,   labeled   33-LS0542\U.A.21,   A.                                                               
Radford/Gunther, 5/7/24, which read:                                                                                            
                                                                                                                                
     Page 1, line 12:                                                                                                           
          Delete "and"                                                                                                      
                                                                                                                                
     Page 2, line 4, following "agreement":                                                                                 
          Insert "; and                                                                                                     
     (6)  range of different  activities similar to clinical                                                                
     rotations  a  physician  assistant  must  perform  when                                                                
     obtaining hours  of practice experience  required under                                                                
     (a)(5) or (c) of this section"                                                                                         
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE  FIELDS synopsized  that  the amendment  clarified                                                               
that  in  the  hours performed  under  collaborating  physicians,                                                               
there would be a range  of experience similar to medical doctors.                                                               
He added it would make sense to have a breadth of tasks.                                                                        
                                                                                                                                
REPRESENTATIVE WRIGHT  wished to  hear from  the bill  sponsor on                                                               
how the proposed amendment would affect the spirit of the bill.                                                                 
                                                                                                                                
7:37:22 PM                                                                                                                    
                                                                                                                                
SENATOR  TOBIN  referenced  a   document  members  received  that                                                               
provided  an overview  of requirements  for professions,  but she                                                               
clarified it failed to note that  PAs are required to complete 27                                                               
months of  continuous education.  She  noted further requirements                                                               
regarding   licensing  in   Alaska  and   that  it   is  not   an                                                               
apprenticeship program; PAs are not trying to be doctors.                                                                       
                                                                                                                                
REPRESENTATIVE  WRIGHT  added   that  he  admired  Representative                                                               
Fields' work  toward apprenticeships but  did not think  this was                                                               
the piece of legislation for that.                                                                                              
                                                                                                                                
7:39:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SADDLER   asked  about   definitions   regarding                                                               
clinical rotations and practice experience.                                                                                     
                                                                                                                                
MS. FAYETTE  said that clinical  rotations are  well established,                                                               
supervised, four-month rotations.                                                                                               
                                                                                                                                
7:40:28 PM                                                                                                                    
                                                                                                                                
VICE CHAIR RUFFRIDGE  inquired whether the rotations  are part of                                                               
the required 27 months.                                                                                                         
                                                                                                                                
MS. FAYETTE confirmed that was correct.                                                                                         
                                                                                                                                
7:40:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  inquired   further  about  the  clinical                                                               
rotation.                                                                                                                       
                                                                                                                                
MS.  FAYETTE explained  that you  observe what  is happening  and                                                               
perform  things, such  as exams,  under the  supervision of  your                                                               
supervising physician or PA.                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  asked whether it  was fair to say  that a                                                               
clinical rotation is a supervised training or apprenticeship.                                                                   
                                                                                                                                
MS. FAYETTE answered that it is about gaining experience.                                                                       
                                                                                                                                
7:42:19 PM                                                                                                                    
                                                                                                                                
VICE CHAIR  RUFFRIDGE asked Ms.  Fayette for accuracy that  in 27                                                               
months,  she performed  2,000 hours  of clinical  work, which  is                                                               
approximately  a  year  of training;  therefore,  that  meant  15                                                               
months was course work, and 12 months was clinical work.                                                                        
                                                                                                                                
MS. FAYETTE responded yes.                                                                                                      
                                                                                                                                
7:42:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER asked  about the  definition of  practice                                                               
experience.                                                                                                                     
                                                                                                                                
SENATOR  TOBIN opined  that  the amendment  tried  to mimic  what                                                               
happens while  a PA is in  a training program.   She restated the                                                               
percentage  of  collaborating  physicians  that do  not  live  in                                                               
Alaska and that  she was unsure how  supervised clinical rotation                                                               
would happen in this context.                                                                                                   
                                                                                                                                
7:44:18 PM                                                                                                                    
                                                                                                                                
[VICE CHAIR RUFFRIDGE passed the gavel back to Chair Sumner.]                                                                   
                                                                                                                                
7:44:40 PM                                                                                                                    
                                                                                                                                
DR. MITCHELL  offered her  understanding that  clinical rotations                                                               
would be for  medical students and there are  levels of training.                                                               
She shared her  experience and expectations and  expounded on the                                                               
levels  of responsibilities  one gains  through the  years.   She                                                               
concluded that she  could not draw a  reasonable parallel between                                                               
time  and  practice  experience   without  someone  with  whom  a                                                               
learning  individual  could   collaborate  closely,  among  other                                                               
factors.                                                                                                                        
                                                                                                                                
7:47:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX  asked Dr.  Mitchell whether  the requirement                                                               
was established in statute, regulation, or by the accreditor.                                                                   
                                                                                                                                
DR. MITCHELL deferred to Dr. Jones.                                                                                             
                                                                                                                                
7:48:31 PM                                                                                                                    
                                                                                                                                
ROXANNE  JONES, MD,  Secretary of  the Board,  Alaska Academy  of                                                               
Family  Physicians,  explained  that  it was  a  combination  and                                                               
briefly offered examples of residency timelines.                                                                                
                                                                                                                                
REPRESENTATIVE PRAX  pointed to the specific  requirements of the                                                               
residency  program   and  whether  it  was   established  by  the                                                               
accreditor as opposed to statue.  .                                                                                             
                                                                                                                                
DR. JONES confirmed that was correct.                                                                                           
                                                                                                                                
7:50:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  noted  that  Dr.  Mitchell  captured  the                                                               
intent  for  residency  in  reference   to  the  different  tasks                                                               
performed.                                                                                                                      
                                                                                                                                
7:51:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX  expressed his uncertainty  that establishing                                                               
this  in statute  would dictate  the  apprenticeship program  for                                                               
industries, as that is established by unions, not state statute.                                                                
                                                                                                                                
REPRESENTATIVE    FIELDS    clarified    what   he    meant    by                                                               
"apprenticeship,"  that there  are  standards  and benefits  from                                                               
learning on the job.                                                                                                            
                                                                                                                                
7:52:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  shared  his  concern  that  PAs  might                                                               
tailor themselves to be in  a particular practice areas based off                                                               
the collaboration  agreement they have.   According to  the bill,                                                               
he opined that the PA should be in primary care.                                                                                
                                                                                                                                
7:54:39 PM                                                                                                                    
                                                                                                                                
A roll  call vote  was taken.   Representatives  Carrick, Fields,                                                               
and Sumner voted in favor  of Amendment 9.  Representatives Prax,                                                               
Ruffridge,  Saddler, and  Wright  voted against  it.   Therefore,                                                               
Amendment 9 failed to be adopted by a vote of 3-4.                                                                              
                                                                                                                                
7:55:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS stated  he would  not offer  Amendments 10                                                               
and 11.                                                                                                                         
                                                                                                                                
7:55:34 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER moved to adopt Amendment  12 to CSSB 115(HSS) AM, as                                                               
amended, labeled  33-LS0542\U.A.17, Klein/Gunther,  5/7/24, which                                                               
read:                                                                                                                           
                                                                                                                                
     Page 1, line 1, following "physicians;":                                                                                 
          Insert "relating to a physician assistant                                                                           
     licensure  program  for  prison  inmates;  relating  to                                                                  
     parole eligibility;"                                                                                                     
                                                                                                                                
     Page 1, line 12:                                                                                                           
          Delete "and"                                                                                                      
                                                                                                                                
     Page 2, line 4, following "agreement":                                                                                 
          Insert "; and                                                                                                     
               (6)  criteria  for licensing  prison  inmates                                                                
     under  the program  established  by  the Department  of                                                                
     Corrections under AS 33.30.192"                                                                                        
                                                                                                                                
     Page 5, following line 23:                                                                                                 
          Insert new bill sections to read:                                                                                     
        "* Sec. 7. AS 33.16.090(a) is amended to read:                                                                      
          (a)  A prisoner sentenced to an active term of                                                                        
     imprisonment  of   at  least  181  days   may,  in  the                                                                    
     discretion of  the board, be released  on discretionary                                                                    
     parole if the prisoner                                                                                                     
               (1)  has served  the amount of time specified                                                                    
     under (b) of this section  or has completed the program                                                                
     under  AS 33.30.192  and  is licensed  as  a  physician                                                                
     assistant under AS 08.64.107, except that                                                                              
               (A)   a  prisoner  sentenced to  one or  more                                                                    
     mandatory  99-year terms  under AS 12.55.125(a)  or one                                                                    
     or  more definite  terms under  AS 12.55.125(l) is  not                                                                    
     eligible for consideration for discretionary parole;                                                                       
               (B)     a  prisoner   is  not   eligible  for                                                                    
     consideration   of   discretionary   parole   if   made                                                                    
     ineligible by order of a court under AS 12.55.115;                                                                         
               (C)       a    prisoner   imprisoned    under                                                                    
     AS 12.55.086 is  not eligible for  discretionary parole                                                                    
     unless  the actual  term of  imprisonment is  more than                                                                    
     one year;                                                                                                                  
               (D)    a  prisoner   sentenced  to  a  single                                                                    
     sentence within  or below a  presumptive range  set out                                                                    
     in AS 12.55.125(c),  (d)(2) -  (4), (e)(3) and  (4), or                                                                    
     (i) who has  not been allowed by  the three-judge panel                                                                    
     under AS 12.55.175  to be considered  for discretionary                                                                    
     parole  release is  not eligible  for consideration  of                                                                    
     discretionary parole;                                                                                                      
               (E)    a  prisoner   sentenced  to  a  single                                                                    
     sentence,   including   a  consecutive   or   partially                                                                    
     consecutive sentence,  that is not eligible  for a good                                                                    
     time  deduction under  AS 33.20.010(a)(3) and  that has                                                                    
     not  been  allowed  by   the  three-judge  panel  under                                                                    
     AS 12.55.175 to be  considered for discretionary parole                                                                    
     release   is   not   eligible  for   consideration   of                                                                    
     discretionary parole; or                                                                                                   
               (2)  is at least 60 years of age, has served                                                                     
     at least 10 years of a  sentence for one or more crimes                                                                    
     in a single judgment, and  has not been convicted of an                                                                    
     unclassified felony  or a sexual  felony as  defined in                                                                    
     AS 12.55.185.                                                                                                              
        *  Sec.  8. AS 33.30  is  amended  by adding  a  new                                                                  
     section to read:                                                                                                           
          Sec. 33.30.192. Physician assistant training                                                                        
     program.  The  department,  in  consultation  with  the                                                                  
     State  Medical Board,  shall establish  a program  that                                                                    
     allows  prison   inmates  to  pursue  licensure   as  a                                                                    
     physician assistant under AS 08.64.107."                                                                                   
                                                                                                                                
     Renumber the following bill section accordingly.                                                                           
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
CHAIR SUMNER  explained that there  was a provider  shortage, and                                                               
the amendment is one way to address that.                                                                                       
                                                                                                                                
7:56:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  commented that there was  also a shortage                                                               
of  peace  and  police  officers and  noted  the  possibility  to                                                               
entertain a conceptual amendment.                                                                                               
                                                                                                                                
7:56:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
SENATOR  TOBIN said  that  to  be accredited,  you  must have  an                                                               
established program in your facility, among other requirements.                                                                 
                                                                                                                                
7:58:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CARRICK  noted  a previous  robust  debate  about                                                               
allowing prisoners  tablets but  that she appreciated  the intent                                                               
of the amendment;  however, she was not sure the  body could make                                                               
a policy call of this magnitude.                                                                                                
                                                                                                                                
7:59:15 PM                                                                                                                    
                                                                                                                                
A roll  call vote  was taken.   Representatives  Fields, Carrick,                                                               
and  Sumner voted  in  favor of  Amendment  12.   Representatives                                                               
Wright,   Prax,  Ruffridge,   and  Saddler   voted  against   it.                                                               
Therefore, Amendment 12 failed to be adopted by a vote of 3-4.                                                                  
                                                                                                                                
7:59:54 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER stated he would not offer Amendment 13.                                                                            
                                                                                                                                
8:00:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE moved  to  adopt Amendment  14 to  CSSB                                                               
115(HSS)  AM,  as  amended,  labeled  33-LS0542\U.A.24,  Gunther,                                                               
5/8/24, which read:                                                                                                             
                                                                                                                                
     Page 2, line 27, following "number;":                                                                                      
          Insert "and"                                                                                                          
                                                                                                                                
     Page 2, line 31:                                                                                                           
          Delete "; and"                                                                                                        
          Insert "."                                                                                                            
                                                                                                                                
     Page 3, lines 1 - 2:                                                                                                       
     Delete all material.                                                                                                       
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE RUFFRIDGE said the intent  of the amendment was to                                                               
remove language that was "overly broad."                                                                                        
                                                                                                                                
8:01:06 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:01 p.m. to 8:03 p.m.                                                                       
                                                                                                                                
8:03:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
SENATOR TOBIN  explained "scope of  practice" and that  there are                                                               
regulations and oversights of the  PA profession.  She understood                                                               
the section  was broad,  but it  was a  "catch all"  section that                                                               
ensured that care could be provided.                                                                                            
                                                                                                                                
8:06:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  observed  that the  language  was  quite                                                               
broad and questioned who defined what was competent.                                                                            
                                                                                                                                
SENATOR TOBIN replied  that the scope of  practice was determined                                                               
by factors including policies and laws.                                                                                         
                                                                                                                                
8:08:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX opined  that there are two  entities who will                                                               
make the  determination: the judge  or the  lawyer.  He  added he                                                               
would be  happy to let them  make the decision as  they are "more                                                               
competent than we are."                                                                                                         
                                                                                                                                
MS. FAYETTE noted  the importance of the  specific definitions of                                                               
regulations.                                                                                                                    
                                                                                                                                
8:10:10 PM                                                                                                                    
                                                                                                                                
A roll call vote was  taken.  Representatives Saddler, Ruffridge,                                                               
Fields,   and   Sumner   voted  in   favor   of   Amendment   14.                                                               
Representatives  Carrick,  Prax,  and Wright  voted  against  it.                                                               
Therefore, Amendment 14 was adopted by a vote of 4-3.                                                                           
                                                                                                                                
8:10:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE moved  to  adopt Amendment  15 to  CSSB                                                               
115(HSS)  AM,  as  amended,  labeled  33-LS0542\U.A.25,  Gunther,                                                               
5/8/24, which read:                                                                                                             
                                                                                                                                
     Page 2, line 3, following "(c)":                                                                                       
          Insert "and (f)"                                                                                                  
                                                                                                                                
     Page 3, lines 3 - 4:                                                                                                       
          Delete "by the board to practice in a new                                                                             
     practice area under (a)(5)"                                                                                                
          Insert "under (a)(5) or (f)"                                                                                          
                                                                                                                                
     Page 3, line 24:                                                                                                           
          Delete "and"                                                                                                          
                                                                                                                                
     Page 3, line 26, following "areas":                                                                                        
          Insert "; and                                                                                                         
               (8)  designate a collaborating physician as                                                                      
     the primary collaborating physician"                                                                                       
                                                                                                                                
     Page 3, line 27, following "or":                                                                                           
          Insert "primary"                                                                                                      
                                                                                                                                
     Page 3, following line 29:                                                                                                 
          Insert new subsections to read:                                                                                       
          "(e)  A physician assistant and primary                                                                               
     collaborating physician  shall maintain  a record  on a                                                                    
     form provided by the department  of the number of hours                                                                    
     of  practice  experience   obtained  by  the  physician                                                                    
     assistant. The form must include the                                                                                       
               (1)  area of practice specialty of the                                                                           
     collaborating physician; and                                                                                               
               (2)  hours completed by practice type.                                                                           
          (f)  Upon the physician assistant's completion of                                                                     
     4,000  hours of  practice experience,  additional hours                                                                    
     required under  (a)(5) of  this section,  or additional                                                                    
     hours  required  under  this  subsection,  the  primary                                                                    
     collaborating   physician  shall   attest  on   a  form                                                                    
     provided   by  the   department   that  the   physician                                                                    
     assistant    is   competent    to   practice    without                                                                    
     supervision.  If  the primary  collaborating  physician                                                                    
     determines   that  the   physician  assistant   is  not                                                                    
     competent  to practice  without supervision,  the board                                                                    
     shall  require that  the  physician assistant  practice                                                                    
     under a  collaborative agreement for  additional hours,                                                                    
     as determined by the board.                                                                                                
          (g)  A physician assistant is entitled to a                                                                           
     hearing   conducted   by   the  board   to   appeal   a                                                                    
     determination  by  a  primary  collaborating  physician                                                                    
     that  the  physician  assistant  is  not  competent  to                                                                    
     practice without  supervision. The  physician assistant                                                                    
     may appeal an adverse decision  of the board to a court                                                                    
     of  competent  jurisdiction.  The board  or  court  may                                                                    
     reverse    the   primary    collaborating   physician's                                                                    
     determination  that  the  physician  assistant  is  not                                                                    
     competent to practice without  supervision if the board                                                                    
     or   court  finds   that   the  primary   collaborating                                                                    
     physician's determination was  arbitrary and capricious                                                                    
     or without just cause.                                                                                                     
          (h)  The board shall randomly audit three percent                                                                     
     of  the   physician  assistants  licensed   under  this                                                                    
     section   to   assess    each   physician   assistant's                                                                    
     compliance with the requirements of this chapter."                                                                         
                                                                                                                                
     Reletter the following subsection accordingly.                                                                             
                                                                                                                                
     Page 3, line 31:                                                                                                           
          Delete "a collaborating physician"                                                                                    
     Insert "one or more collaborating physicians"                                                                              
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE noted  the  amendment  was lengthy  and                                                               
summarized that the intent of  the amendment was to establish how                                                               
and what the hours accomplish.                                                                                                  
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
8:13:48 PM                                                                                                                    
                                                                                                                                
SENATOR  TOBIN  confirmed  that she  worked  with  the  amendment                                                               
sponsor and there would be no additional fiscal impact.                                                                         
                                                                                                                                
8:14:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SADDLER   offered   an   assumption   that   the                                                               
collaborating  physician was  the employing  physician. He  noted                                                               
concern about the  added responsibility on a  physician who would                                                               
be  made  to determine  who  is  competent,  and  that it  was  a                                                               
liability question.                                                                                                             
                                                                                                                                
DR.  MITCHELL commented  that  the  amendment provided  sidebars,                                                               
extra supervision,  and assurance  that if there  was independent                                                               
practice,  the physician  could evaluate  the PA's  abilities and                                                               
attest to them.                                                                                                                 
                                                                                                                                
REPRESENTATIVE  SADDLER asked  whether physicians  pass judgement                                                               
on their PAs currently.                                                                                                         
                                                                                                                                
DR. MITCHELL said  she did not employ PAs, but  she would presume                                                               
from  her  colleagues that  if  they  did  not  feel the  PA  was                                                               
providing  adequate care,  they  would request  that person  find                                                               
other employment.                                                                                                               
                                                                                                                                
8:18:11 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER commented that if a  PA was not working "shoulder to                                                               
shoulder"  with a  physician, that  relationship would  have less                                                               
value.                                                                                                                          
                                                                                                                                
DR. MITCHELL  opined that  the amendment  increases the  value of                                                               
the  agreement  because  it  makes  the  PA  supervisor  be  more                                                               
attentive  to  the  skills  and  experience of  the  PA  in  that                                                               
environment.                                                                                                                    
                                                                                                                                
8:19:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT removed his objection.                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX objected.                                                                                                   
                                                                                                                                
8:19:55 PM                                                                                                                    
                                                                                                                                
A roll call vote was  taken.  Representatives Ruffridge, Saddler,                                                               
Wright, Carrick, Fields,  and Sumner voted in  favor of Amendment                                                               
15.  Representative Prax voted  against it.  Therefore, Amendment                                                               
15 failed to be adopted by a vote of 6-1.                                                                                       
                                                                                                                                
8:20:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE stated he would not offer Amendment 16.                                                                
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE moved  to  adopt Amendment  17 to  CSSB                                                               
115(HSS)  AM,  as  amended,  labeled  33-LS0542\U.A.27,  Gunther,                                                               
5/8/24, which read:                                                                                                             
                                                                                                                                
     Page 2, line 2:                                                                                                            
          Delete "4,000"                                                                                                    
     Insert "6,000"                                                                                                         
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE RUFFRIDGE summarized the  amendment how it related                                                               
to amounts of hours without a collaborative agreement.                                                                          
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
8:23:06 PM                                                                                                                    
                                                                                                                                
SENATOR  TOBIN asked,  "Do  we  have the  right  skills sets  and                                                               
knowledge to determine what is  the appropriate number of hours?"                                                               
She spoke  to other  states that are  untethered, and  she opined                                                               
that to  remain competitive, 4,000  worked was a good  pathway to                                                               
independence.                                                                                                                   
                                                                                                                                
8:23:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SADDLER   asked    the   amendment   maker   for                                                               
clarification  that if  a PA  were to  switch areas  of practice,                                                               
they must have 6,000 additional hours.                                                                                          
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  explained  that  6,000  would  be  the                                                               
initial  number  of hours,  and  should  the PA  change  practice                                                               
areas, they would need to  go back into a collaborative agreement                                                               
for an additional 4,000 hours.                                                                                                  
                                                                                                                                
8:25:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE offered a conceptual amendment to                                                                      
Amendment 17 that it would read: "page 3, line 4".                                                                              
                                                                                                                                
8:25:46 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:25 p.m. to 8:27 p.m.                                                                       
                                                                                                                                
8:27:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER announced there being no objection,                                                                       
Conceptual Amendment 1 to Amendment 17 was adopted.`                                                                            
                                                                                                                                
8:28:23 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:28 p.m. to 8:29 p.m.                                                                       
                                                                                                                                
8:29:20 PM                                                                                                                    
                                                                                                                                
A roll call  vote was taken.   Representatives Fields, Ruffridge,                                                               
Saddler, Wright, Carrick, and Sumner  voted in favor of Amendment                                                               
17,  as   amended.    Representative   Prax  voted   against  it.                                                               
Therefore, Amendment 17, as amended, was  adopted by a vote of 6-                                                               
1.                                                                                                                              
                                                                                                                                
8:29:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX moved to adopt Amendment 18 to CSSB 115(HSS)                                                                
AM, as amended, labeled 33-LS0542\U.A.29, Gunther, 5/8/24, which                                                                
read:                                                                                                                           
                                                                                                                                
     Page 1, line 1:                                                                                                            
          Delete "and"                                                                                                        
                                                                                                                                
     Page 1, line 2, following "policies":                                                                                    
          Insert "; relating to internship and residency                                                                      
     requirements to practice medicine and osteopathy; and                                                                    
    relating   to   physician   and   osteopath   specialty                                                                   
     designations"                                                                                                            
                                                                                                                                
     Page 4, following line 13:                                                                                                 
     Insert a new bill section to read:                                                                                         
       "* Sec. 4. AS 08.64.272 is amended by adding a new                                                                   
     subsection to read:                                                                                                        
          (d)  The board shall adopt regulations allowing a                                                                     
     physician or osteopath licensed  under this chapter who                                                                    
     has   completed  a   residency  or   internship  in   a                                                                    
     particular   practice  area   to   receive  a   license                                                                    
     endorsement designating  the physician or  osteopath as                                                                    
     specializing in that practice area."                                                                                       
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 5, following line 31:                                                                                                 
     Insert a new bill section to read:                                                                                         
      "*   Sec.   9.   AS 08.64.200(a)(2),   08.64.205(2),                                                                  
     08.64.225(a)(2)(A), and 08.64.225(c) are repealed."                                                                        
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE  PRAX explained  that the  amendment would  remove                                                               
the  medical  residency  requirements  for  medical  doctors  and                                                               
doctors  of   [osteopathic  medicine].     He  further   noted  a                                                               
transitional  component,  which  would allow  physicians  in  the                                                               
middle of a residency program to complete it.                                                                                   
                                                                                                                                
8:30:32 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER  asked  Representative  Prax whether  he  would  be                                                               
incentivized to  complete a residency program  if the requirement                                                               
went away.                                                                                                                      
                                                                                                                                
REPRESENTATIVE PRAX said, "It would be up to them."                                                                             
                                                                                                                                
8:30:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  said he opposed the  amendment to maintain                                                               
public faith.                                                                                                                   
                                                                                                                                
8:30:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK requested to hear from the bill sponsor.                                                                 
                                                                                                                                
8:31:03 PM                                                                                                                    
                                                                                                                                
SENATOR TOBIN said she did not have a comment.                                                                                  
                                                                                                                                
8:31:18 PM                                                                                                                    
                                                                                                                                
A  roll call  vote was  taken.   Representatives Prax  and Wright                                                               
voted  in  favor  of  Amendment   18.    Representatives  Fields,                                                               
Ruffridge,  Saddler,  Carrick,  and   Sumner  voted  against  it.                                                               
Therefore, Amendment 18 failed to be adopted by a vote of 2-5.                                                                  
                                                                                                                                
8:31:50 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER moved to adopt Amendment  16 to CSSB 115(HSS) AM, as                                                               
amended, labeled 33-LS0542\U.A.26, Gunther, 5/8/24, which read:                                                                 
                                                                                                                                
     Page 5, lines 13 - 23:                                                                                                     
          Delete all material.                                                                                                  
                                                                                                                                
     Renumber the following bill section accordingly.                                                                           
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
CHAIR  SUMNER explained  that amendment  untethers  PAs that  are                                                               
providing  services in  correctional facilities,  and the  intent                                                               
would be  that they  have a  place to get  their hours  without a                                                               
collaborative agreement.                                                                                                        
                                                                                                                                
8:32:42 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:32 p.m. to 8:33 p.m.                                                                       
                                                                                                                                
8:33:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
SENATOR  TOBIN thanked  the amendment  maker  for thinking  about                                                               
prisoners,  and offered  her belief  they should  have access  to                                                               
adequate  care,  but  that the  amendment  created  a  two-tiered                                                               
system.                                                                                                                         
                                                                                                                                
8:34:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  commented that he  was not sure  the bill                                                               
would prohibit a PA from  working in a correctional facility, and                                                               
was not sure it was necessary  unless there was an assumption the                                                               
PA  would  not  have  to go  through  the  initial  collaborative                                                               
agreement.                                                                                                                      
                                                                                                                                
8:35:18 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER  said the intent  of the  amendment was to  create a                                                               
"fast track" for work without a collaborative agreement.                                                                        
                                                                                                                                
REPRESENTATIVE  SADDLER followed  up about  concerns with  a two-                                                               
tiered system and that it could expose the state to litigation.                                                                 
                                                                                                                                
CHAIR SUMNER stated, "You need providers to provide care."                                                                      
                                                                                                                                
8:35:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX  opined that  if prisoners were  polled, they                                                               
would welcome this service.                                                                                                     
                                                                                                                                
8:36:13 PM                                                                                                                    
                                                                                                                                
A roll  call vote was  taken.  Representatives Fields,  Prax, and                                                               
Ruffridge  voted  in  favor of  Amendment  16.    Representatives                                                               
Carrick,   Saddler,  Wright,   and  Sumner   voted  against   it.                                                               
Therefore, Amendment 16 failed to be adopted by a vote of 3-4.                                                                  
                                                                                                                                
8:37:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  moved  to adopt  Conceptual  Amendment                                                               
[19] to  CSSB 115(HSS)  AM, as  amended, on page  2, line  10, to                                                               
delete "perform" and "interpret".                                                                                               
                                                                                                                                
CHAIR SUMNER  objected being it  was past the  amendment deadline                                                               
[and Conceptual Amendment 16 had  not been previously submitted].                                                               
He then said it would "have to be the absolute last one."                                                                       
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE expressed  concern  about the  language                                                               
offered  previously about  a broad  interpretation on  performing                                                               
diagnostics.   He  expounded on  training  and interpretation  of                                                               
types of diagnostics.                                                                                                           
                                                                                                                                
8:39:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT requested to hear from the bill sponsor.                                                                  
                                                                                                                                
MS. FAYETTE commented  that the point of the bill  is to increase                                                               
access to care  and in rural areas,  a PA may be  the only person                                                               
who can provide it.  She opined  that it could put burdens on the                                                               
things PAs can do.                                                                                                              
                                                                                                                                
8:40:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK  opposed the  amendment.  She  said having                                                               
to see  a physician  to get a  result read would  be a  hurdle to                                                               
many  Alaskans.     She  reiterated   that  the  intent   of  the                                                               
legislation is  about untethering  PAs, not about  limiting their                                                               
scope of practice.                                                                                                              
                                                                                                                                
REPRESENTATIVE RUFFRIDGE responded that there  is a process for a                                                               
Clinical  Laboratory Improvement  Amendment (CLIA)  waiver, which                                                               
provides  "up  or  down"  diagnoses  without  the  very  specific                                                               
language.                                                                                                                       
                                                                                                                                
8:42:09 PM                                                                                                                    
                                                                                                                                
DR. MITCHELL shared her interpretations  and said that she agreed                                                               
with   Representative   Ruffridge   about  the   performance   of                                                               
diagnostic procedures.                                                                                                          
                                                                                                                                
8:44:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  noted  that  part of  the  challenge  is                                                               
requiring  the  legislature  to  make  judgements  about  who  is                                                               
qualified to perform what kind of medical services.                                                                             
                                                                                                                                
8:45:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK asked Dr.  Mitchell whether removal of the                                                               
words "perform" and  "interpret" in the section would  limit a PA                                                               
to conduct certain tests.                                                                                                       
                                                                                                                                
DR. MITCHELL deferred to Dr. Jones.                                                                                             
                                                                                                                                
8:46:14 PM                                                                                                                    
                                                                                                                                
DR. JONES  replied yes,  the PA  could still do  tests such  as a                                                               
urine analysis  through a CLIA  waived test that provides  a yes,                                                               
no, or algorithmic answer.   Striking the words would not prevent                                                               
this interpretation, she confirmed.                                                                                             
                                                                                                                                
REPRESENTATIVE CARRICK asked whether  a CLIA waiver was something                                                               
that  a PA  could get  a  blanket waiver  for or  whether it  was                                                               
limited to specific situations.                                                                                                 
                                                                                                                                
DR.  JONES responded  that a  CLIA waiver  is based  on a  clinic                                                               
obtaining a  specific test type  for any patient and  is assigned                                                               
to the clinic.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  CARRICK sought  clarity  about a  PA obtaining  a                                                               
CLIA waiver.                                                                                                                    
                                                                                                                                
DR. JONES  said she did  not know what the  baseline requirements                                                               
would be  for a CLIA  waiver status for a  lab, as it  required a                                                               
medical doctor to sign off.                                                                                                     
                                                                                                                                
8:48:30 PM                                                                                                                    
                                                                                                                                
CHAIR   SUMNER   asked    Representative   Ruffridge   for   more                                                               
clarification on the words that would be removed.                                                                               
                                                                                                                                
8:49:01 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:49 p.m. to 8:51 p.m.                                                                       
                                                                                                                                
8:51:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   RUFFRIDGE   [moved   to   withdraw]   Conceptual                                                               
Amendment [19].  [There being  no objection, Conceptual Amendment                                                               
19 was withdrawn.]                                                                                                              
                                                                                                                                
8:51:11 PM                                                                                                                    
                                                                                                                                
CHAIR  SUMNER  moved to  adopt  Conceptual  Amendment 4  to  CSSB                                                               
115(HSS)  AM,  as   amended,  on  page  2,   line  11,  following                                                               
"procedures", to  insert "in  compliance with  regulation adopted                                                               
under AS08.64.106".                                                                                                             
                                                                                                                                
REPRESENTATIVE WRIGHT objected.                                                                                                 
                                                                                                                                
8:52:06 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:52 p.m. to 8:53 p.m.                                                                       
                                                                                                                                
8:53:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WRIGHT removed his objection.                                                                                    
                                                                                                                                
8:53:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER objected and  commented that something was                                                               
already in regulation.                                                                                                          
                                                                                                                                
SENATOR TOBIN said  that the amendment would  add new subsections                                                               
to Alaska Statute  and added clarity to the phrase  that would be                                                               
inserted.                                                                                                                       
                                                                                                                                
REPRESENTATIVE  SADDLER removed  his objection.   There  being no                                                               
further objection, Conceptual Amendment [19] was adopted.                                                                       
                                                                                                                                
8:55:13 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 8:55 p.m. to 8:56 p.m.                                                                       
                                                                                                                                
8:56:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE moved  to report  CSSB 115(HSS)  AM, as                                                               
amended,  out of  committee with  individual recommendations  and                                                               
the accompanying fiscal notes.                                                                                                  
                                                                                                                                
REPRESENTATIVE CARRICK  objected for  the purpose  of discussion.                                                               
She thanked  the PA and  MDs that  provided testimony as  well as                                                               
the bill  sponsor.  She shared  her thoughts that it  was hard to                                                               
amend substantive  bills this late  in the session.   She removed                                                               
her objection.                                                                                                                  
                                                                                                                                
8:57:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER objected.                                                                                                
                                                                                                                                
8:58:26 PM                                                                                                                    
                                                                                                                                
A roll  call vote was  taken.  Representatives   Wright, Carrick,                                                               
Prax,  Ruffridge, and  Sumner voted  in  favor of  the motion  to                                                               
report  CSSB  115(HSS) AM,  as  amended,  out of  committee  with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
Representative  Saddler voted  against it.   Therefore,  HCS CSSB                                                               
115(L&C)  was  reported  out  of the  House  Labor  and  Commerce                                                               
Standing Committee by a vote of 5-1.                                                                                            
                                                                                                                                
8:58:38 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Labor and  Commerce Standing Committee  meeting was  adjourned at                                                               
8:59 p.m.