ALASKA STATE LEGISLATURE  HOUSE LABOR AND COMMERCE STANDING COMMITTEE  February 11, 2026 4:27 p.m. MEMBERS PRESENT Representative Zack Fields, Co-Chair Representative Carolyn Hall, Co-Chair Representative Ashley Carrick Representative Robyn Niayuq Frier Representative Dan Saddler Representative Julie Coulombe Representative David Nelson MEMBERS ABSENT  All members present OTHER LEGISLATORS PRESENT  Representative Justin Ruffridge COMMITTEE CALENDAR  HOUSE BILL NO. 210 "An Act relating to occupational disability benefits for peace officers and firefighters; and providing for an effective date." - MOVED HB 210 OUT OF COMMITTEE HOUSE BILL NO. 195 "An Act relating to the prescription and administration of drugs and devices by pharmacists; relating to reciprocity for pharmacists; and providing for an effective date." - HEARD & HELD HOUSE BILL NO. 293 "An Act relating to the practice of genetic counseling; relating to the licensure of genetic counselors; establishing the Genetic Counseling Advisory Council; relating to the duties of the State Medical Board; relating to telehealth by licensed genetic counselors; relating to medical malpractice liability of licensed genetic counselors; relating to immunity from civil liability for a licensed genetic counselor providing free health care services; and prohibiting unfair discrimination under group health insurance against genetic counselors." - SCHEDULED BUT NOT HEAR PREVIOUS COMMITTEE ACTION  BILL: HB 210 SHORT TITLE: PEACE OFFICERS/FIREFIGHTERS: DISABILITY SPONSOR(s): REPRESENTATIVE(s) KOPP 04/30/25 (H) READ THE FIRST TIME - REFERRALS 04/30/25 (H) L&C, FIN 05/16/25 (H) L&C AT 3:15 PM BARNES 124 05/16/25 (H) 02/02/26 (H) L&C AT 3:15 PM BARNES 124 02/02/26 (H) Heard & Held 02/02/26 (H) MINUTE(L&C) 02/09/26 (H) L&C AT 3:15 PM BARNES 124 02/09/26 (H) 02/11/26 (H) L&C AT 3:15 PM BARNES 124 BILL: HB 195 SHORT TITLE: PHARMACIST PRESCRIPTION AUTHORITY SPONSOR(s): REPRESENTATIVE(s) MINA 04/15/25 (H) READ THE FIRST TIME - REFERRALS 04/15/25 (H) HSS, FIN 04/29/25 (H) HSS AT 3:15 PM DAVIS 106 04/29/25 (H) Heard & Held 04/29/25 (H) MINUTE(HSS) 05/01/25 (H) HSS AT 3:15 PM DAVIS 106 05/01/25 (H) Moved HB 195 Out of Committee 05/01/25 (H) MINUTE(HSS) 05/02/25 (H) HSS RPT 6DP 1NR 05/02/25 (H) DP: PRAX, GRAY, SCHWANKE, RUFFRIDGE, MEARS, MINA 05/02/25 (H) NR: FIELDS 05/02/25 (H) L&C REFERRAL ADDED AFTER HSS 05/14/25 (H) L&C AT 3:15 PM BARNES 124 05/14/25 (H) 05/15/25 (H) L&C AT 9:00 AM BARNES 124 05/15/25 (H) Heard & Held 05/15/25 (H) MINUTE(L&C) 05/16/25 (H) L&C AT 3:15 PM BARNES 124 05/16/25 (H) 02/11/26 (H) L&C AT 3:15 PM BARNES 124 WITNESS REGISTER JUSTIN MACK Alaska Professional Firefighters Anchorage, Alaska POSITION STATEMENT: Testified in support of HB 210. MICHAEL O'CONNER, representing self Flagstaff, Arizona POSITION STATEMENT: Testified in support of HB 210. ROBERT TEELING, representing self Bullhead City, Arizona POSITION STATEMENT: Testified in support of HB 210. SCOTT LANIER, representing self Bullhead City, Arizona POSITION STATEMENT: Testified discussing experience getting disability benefits. DOUGLAS SCHRAGE, Fire Chief Anchorage Fire Deptartment. Anchorage, Alaska POSITION STATEMENT: Testified in support of HB 210. BOB WILLIAMS Alaska Retirement Management Board Juneau, Alaska POSITION STATEMENT: Provided testimony regarding retirement structuring pertaining to HB 210. REPRESENTATIVE GENEVIEVE MINA Alaska State Legislature Juneau, Alaska POSITION STATEMENT: As prime sponsor, reintroduced HB 195. KATY GIORGIO, Staff Representative Genevieve Mina Alaska State Legislature Juneau, Alaska POSITION STATEMENT: On behalf of prime sponsor, Representative Genevieve Mina, introduced the Committee Substitute (CS) to HB 195. BRANDY SEIGNEMARTIN, PharmD Anchorage, Alaska POSITION STATEMENT: Gave invited testimony in support of HB 195. ASHLEY SCHABER, PharmD, Director of Pharmacy Alaska Native Medical Center Member Alaska Board of Pharmacy Anchorage, Alaska POSITION STATEMENT: On behalf of the Alaska Board of Pharmacy, gave invited testimony in support of HB 195. ACTION NARRATIVE 4:27:04 PM CO-CHAIR ZACK FIELDS called the House Labor and Commerce Standing Committee meeting to order at 4:27 p.m. Representatives Nelson, Coulombe, Frier, Fields, and Hall were present at the call to order. Representatives Saddler and Carrick arrived as the meeting was in progress. HB 210-PEACE OFFICERS/FIREFIGHTERS: DISABILITY  4:27:27 PM CO-CHAIR FIELDS announced that the first order of business would be HOUSE BILL NO. 210, "An Act relating to occupational disability benefits for peace officers and firefighters; and providing for an effective date." 4:28:02 PM CO-CHAIR FIELDS opened public testimony on HB 210. 4:28:18 PM JUSTIN MACK, Alaska Professional Firefighters, testified in support of HB 210. He noted that Alaska Professional Firefighters represents over five hundred professional fire and emergency medical service (EMS) workers across the state. He said that the proposed bill would recognize the challenging work that Alaska's public safety members are asked to do. He said that as a 15-year firefighter with the Anchorage Fire Department and as president of the Anchorage Firefighters Union, he has seen several members undergo career ending injuries, both physical and mental health related. He noted that firefighters are asked to respond to dangerous and unstable conditions, often with limited information. He noted that while they are trained for these emergencies, it is understood that there may be injuries. He noted that firefighters work long hours and there is a rising distress call volume. He said that this proposed bill would be a much-needed fix. 4:29:56 PM CO-CHAIR FIELDS, after ascertaining there was no one else who wished to testify, closed public testimony on HB 210. 4:30:02 PM REPRESENTATIVE SADDLER moved to adopt Amendment 1 to HB 210, labeled 34-LS0938\A.1, Wayne, 2/2/26, which read as follows: Page 1, line 1, following "Act": Insert "relating to coverage for disability from  diseases for certain firefighters;" Page 1, following line 3: Insert a new bill section to read: "* Section 1. AS 23.30.121(b) is amended to read: (b) For a firefighter covered under AS 23.30.243, (1) there is a presumption that a claim for compensation for disability as a result of the following diseases is within the provisions of this chapter: (A) respiratory disease; (B) cardiovascular events that are experienced within 72 hours after exposure to smoke, fumes, or toxic substances; and (C) the following cancers: (i) primary brain cancer; (ii) malignant melanoma; (iii) leukemia; (iv) non-Hodgkin's lymphoma; (v) bladder cancer; (vi) ureter cancer; (vii) kidney cancer; (viii) prostate cancer; and (ix) breast cancer; (2) notwithstanding AS 23.30.100(a), following termination of service, the presumption established in (1) of this subsection extends to the firefighter for a period of three calendar months for each year of requisite service but may not extend more than 60 calendar months following the last date of employment; (3) the presumption established in (1) of this subsection applies only to an active or former firefighter who has a disease described in (1) of this subsection that develops or manifests itself after the firefighter has served in the state for at least six [SEVEN] years and who (A) underwent [WAS GIVEN] a qualifying medical examination (i) upon the first employment as [BECOMING] a firefighter that did not show evidence of the disease; (ii) at least once every two years [(B) WAS GIVEN AN ANNUAL MEDICAL EXAM] during [EACH OF] the first six [SEVEN] years of employment as a firefighter that did not show evidence of the disease; and (B) [(C)] with regard to diseases described in (1)(C) of this subsection, demonstrates that, while in the course of employment as a firefighter, the firefighter was exposed to a known carcinogen, as defined by the International Agency for Research on Cancer or the National Toxicology Program, and the carcinogen is associated with a disabling cancer." Page 1, line 4: Delete "Section 1" Insert "Sec. 2" Renumber the following bill sections accordingly. CO-CHAIR FIELDS objected for the purpose of discussion. REPRESENTATIVE SADDLER explained that the proposed amendment would fall within the title and intent of the proposed legislation. He noted that firefighters and peace officers face special vocational hazards and should not face financial consequences if they should have a work-related disability. He said the proposed amendment simply expands disability coverage for firefighters. He explained that state law allows a presumption that firefighters who contract certain diseases and cancers, often do so as the result of their work and therefore should receive workers' compensation benefits. The current law sets up several "hoops" that firefighters need to jump through to ensure protection; this includes getting costly annual medical examinations. He said that this places stress on departments and personnel, and if someone misses an examination, then they risk losing any benefits from disability coverage. He said that the amendment simply says that firefighters need medical exams every other year and for six years. He said that this would ensure that firefighters are not unduly penalized for missing one exam early in their career, and it relieves smaller departments and even larger departments from ongoing medical costs associated with medical examinations. He reiterated that he believes the proposed amendment is in alignment with the proposed bills intent to ensure that Alaska's first responders are supported. 4:32:02 PM REPRESENTATIVE KOPP noted that he and Representative Saddler had discussed the proposed amendment and was assured that it was in line with the spirit of the bill. Following the meeting, his team investigated the issue and found a key Alaska Supreme Court Decision, Adamson v. Municipality of Anchorage, which interpreted the firefighter presumption statute. The supreme court ruling confirmed that once firefighters met their statutory requirements, the presumption that their condition is work-related applies. He said that this means that employers, not firefighters, must prove that the illness is unrelated to the job. The court also stated that employers cannot suggest that cancer has unknown causes, and this reinforced the standards already in statute. REPRESENTATIVE KOPP raised concerns about any unintended consequences with the amendment, particularly, blurring the line between workers' compensation issues and disability benefits that are already addressed in the bill. He noted that the House Finance Committee would hear the bill next and could grapple with this issue. He recommended keeping the bill in its current format and not adopting the proposed amendment. 4:34:37 PM CO-CHAIR HALL asked how long presumptive coverage lasts and whether there was any consideration to extending this type of coverage. REPRESENTATIVE SADDLER responded that he believes it ends at age 60, or possibly 65. He said that there is a hard chronological end to it. He noted that like all legal decisions, this may require careful review. REPRESENTATIVE SADDLER moved to withdraw Amendment 1. There being no objection, Amendment 1 was withdrawn. 4:36:35 PM REPRESENTATIVE COULOMBE raised concerns regarding the cost of implementing these benefits. She noted that the fiscal note is indeterminate and mentioned that it would require revision since expenses were not certain. She asked Representative Kopp whether the state could afford the increase in benefits. REPRESENTATIVE KOPP confirmed that the state could afford to accommodate the increase in benefits. He explained that the trust funds are well funded. The Public Employees' Retirement System (PERS) disability trust fund has approximately $98.9 million and the Teachers' Retirement System (TRS) fund had approximately $9.8 million. He noted that the PERS fund was significantly overfunded and given the small number of public safety employees impacted from the bill, there was no risk to the fund. 4:38:35 PM CO-CHAIR FIELDS reopened public testimony on HB 210. 4:38:44 PM MICHAEL O'CONNER, representing self, noted that he worked for Anchorage Police Department for 11 years and had a line of duty injury in 2022. He said that he separated from employment under disability and has been receiving disability benefits from the State of Alaska since. He appreciated HB 210 and the effort to address the lack of support that injured first responders receive when serving Alaska communities. He wished to discuss HB 210 and some possible options moving forward. MR. O'CONNOR explained that the new payout proposal of 75 percent of an individual's salary once disabled was a step in the right direction. He added that many people injured in the line of duty often go out on workers' compensation where they receive a significant reduction of pay prior to leaving employment. He said that he received 80 percent base pay for 10 months prior to transitioning to disability benefits which currently pay out at 40 percent of salary. He said that as the committee continues discussions, to consider averaging an employee's high-three years to make a better reflection of true income. MR. O'CONNOR noted that another option could be setting the benefit at 50 percent of an individual's high-three salary but making it a lifetime benefit. He noted that given that disability ends at the 25-year mark, there may be a lot of life left after benefits stop. MR. O'CONNOR noted that the requirements for disabled individuals to reapply every year causes stress and financial uncertainty. Furthermore, some have been unable to get loans because they cannot show stable or consistent income. He concluded by thanking the committee for supporting disabled employees and welcomed any questions. 4:42:38 PM ROBERT TEELING, representing self, noted that he was an Alaska State Trooper for six years and was injured in the line of duty. He reiterated that the 40 percent disability payment is based on the employee's base pay during the 12 months prior to departing service. He stated that annual medical checkups create undue stress. He explained that doctors move or change practices and it can be difficult to find consistent medical care in Alaska. He explained that his disability process was mishandled twice, and despite having a recent evaluation, he needed to return in the upcoming March. He said that this means that there are six months before checkups and it would complicate the financial situation. MR. TEELING also raised attention to Alaska State Troopers working in rural communities. He said that they often live in state housing and do not bring a vehicle with them. Some spouses often need to leave their job to accommodate troopers living in rural communities and have no home outside of state housing. He said that if a trooper is injured while serving in a rural community that family may experience housing challenges, including challenges at getting a mortgage, vehicle loan, or other necessities. He said that this is not hypothetical but a real situation that an Alaska State Trooper may face. MR. TEELING noted that while Alaska requires annual evaluations for disability, some states use a one- or two-year review and allow benefits to continue to the 25-year mark. He said that for troopers, the 25 years of benefits are counted from the start date. He said that some troopers may never qualify for Social Security or Social Security disability because injuries may be sustained early in a career. He reiterated that moving to a 75 percent mark would help first responders significantly, but evaluation of annual reviews and housing challenges were also worth reviewing. 4:48:09 PM REPRESENTATIVE SADDLER asked Mr. Teeling whether he was currently on disability and for how long. MR. TEELING confirmed that he was on disability and noted that he has been on it since 2022. He noted that during this time, he sustained a brain injury. REPRESENTATIVE SADDLER asked about the nature of the annual medical examination requirement and asked Mr. Teeling whether he could describe the process. MR. TEELING responded that it constitutes visiting a general practitioner as well as whatever specialist the state may deem necessary, which could include a psychological assessment. He said that this was to determine whether or not a disabled individual could serve as a peace officer again. He noted that to obtain disability benefits, this determination needed to be made. He noted that it is required to re-evaluate peace officer eligibility on a year-after-year basis, which to him was not practical. REPRESENTATIVE SADDLER asked whether there were automatically additional examinations after checkups and asked for additional clarification. MR. TELLING responded that the state determines what kinds of tests are necessary for disability eligibility. He said that often medical records and other paperwork are sent for an independent review and it could be a week or even a month until eligibility is determined. 4:51:19 PM SCOTT LANIER, representing self, noted that he was hired as an Alaska State Trooper in 2010 and served in a variety of areas. He noted that he was injured in 2019 during the pursuit of a suspect in Fairbanks. Specifically, he damaged his ankle and has required multiple surgeries since the initial injury and since has received an ankle replacement. MR. LANIER said that before he had the replacement surgery, he did some research into disability benefits and what he might be entitled to. He said that he contacted the Department of Public Safety (DPS) to ask for a manual, so he read up on the process. However, he was told that there is no manual and was directed to a website and chart. He noted that online resources stated that one's disability must be directly related to the performance of their job or be an on-the-job injury. He said that the benefit is 40 percent of salary while on occupational disability. He discussed medical insurance eligibility and employer contributions. He noted that for peace officers, disability coverage stops after 25 years, whereas for a regular Tier 4 employee, disability would stop at 30 years. He asked why peace officer benefits stop 5 years earlier than the others. MR. LANIER said that in 2024, his doctor notified him that he would be cleared from duty due to a replaced ankle. He said that in April 2024, he was given a choice to resign, pick administrative separation, or be terminated by DPS human resources (HR). He said that he opted to take the administrative separation but needed to hand write that this was due to a work-related injury. MR. LANIER noted that shortly after, he applied for disability through the Division of Retirement and Benefits (DRB). He said that the process was difficult to navigate and no one could assist along the way. He said that he was forced to do his own research and requests for information regarding disability were often ignored or often incorrect. He said that he continued to advocate for himself and his family and finally received backpay in May 2024. He said that currently, he is receiving a little over $3,900 a month. He said that he was given the option for COBRA health insurance but was quoted $1,700 a month and raised concerns that this was almost half his salary and unaffordable. MR. LANIER said that he was not currently working and had spoken to numerous attorneys during the process to see if he required representation. He was told that under Alaska Statute, workers' compensation attorneys could not be involved until a case was disputed. He remarked that he never had a case that was disputed; therefore, he received no legal representation. MR. LANIER even noted that he had sold all his personal leave back to the State of Alaska, and when receiving the last paycheck, the total was short. He was told that there was a provision in his contract that only lets employees that were injured in the line-of-duty receive payments for one year since the time of injury. He said that he spent six months living off personal leave and noted that this was concerning. MR. LANIER stated that when his disability was ultimately approved, he was told that his calculation was for the entire previous year but suggested that his calculation was only from January 2024 to April 2024. He noted that he did not receive credit for the whole year and noted that his pay in certain geographic areas was higher than others and he was also overtime eligible. He said that overtime should be calculated into disability since many troopers and other law enforcement personnel have mandatory overtime requirements. 4:57:10 PM MR. LANIER said that in June 2024, he received an e-mail from the disability unit that was sent by mistake and intended to be sent to staff. He said that the e-mail called him a "bully." He said that personnel kept sending him the wrong information. Furthermore, it was stated that he was difficult to work with and a highly aggressive individual. He said that he filed a complaint for lack of professionalism. He asked how he could be treated fairly and impartially if this was how staff behaved. MR. LANIER said that in November 2024, the state had still not contributed to the defined benefit plan as required. He said this impacted more than just him. He said that he filed multiple complaints including with the Alaska State Ombudsman's Office and the governor's chief of staff, who never returned a call. He said that the office of the Alaska State Ombudsman gave him a phone number and marked the case as resolved. He said that he contacted the Public Safety Employees Association, and they told him that he was no longer a state employee. He said that he contacted the Division of Retirement and Benefits only to hear that he was technically not an employee but also technically not retired. He said that the only people whom he could speak with were the disability unit personnel, and they did not even have a phone number available. He said that something needs to change since it takes three to four weeks to get a reply regarding any problems with pay. MR. LANIER noted that the State of Alaska had put a hold on all his retirement accounts and there were challenges accessing some of his earnings, even in his deferred compensation plan. He said that he needed to reach out to the Deputy Commissioner of DPS to finally get things corrected. He said that he finally managed to get his workers' compensation claim settled for $26,000, and he stated that this is what his time and leg was worth. He noted that he found the Tier 4 disability program to be not practical, and dealing with staff was challenging. He raised concern that this was inappropriate for someone who put their life on the line for Alaska. Furthermore, he said that the State of Alaska considers him permanently disabled and yet the disability has an expiration date of 25 years and he undergoes annual medical evaluations. MR. LAINIR also noted that there were challenges for him to obtain a loan given the challenges with disability coverage. He said that there should be an advocacy program for people dealing with similar experiences. 5:01:28 PM DOUGLAS SCHRAGE, Fire Chief, Anchorage Fire Deptartment., gave public testimony in support of HB 210. He said that firefighters and police officers work in high-risk environments and are exposed to significant physical demands and long-term health risks. He said that when these professionals are making decisions or taking actions in the fields that could expose them to these risks, they should not have to worry whether they will be taken care of given an injury in the line-of-duty. 5:02:46 PM CO-CHAIR FIELDS, after ascertaining there was no one else who wished to testify, reclosed public testimony on HB 210. 5:02:58 PM BOB WILLIAMS, Alaska Retirement Management Board, said that the Alaska Retirement Management (ARM) Board has not taken a position on HB 210. However, in a previous committee hearing, the ARM Board's work on defined contribution disability coverage came up and he wished to provide additional context. MR. WILLIAMS noted that in 2025 the ARM Board heard direct testimony on multiple occasions from defined contribution members receiving occupational disability, who described the stress of being disabled without healthcare coverage. He said that the testimonies prompted the board to take a closer evaluation of the broader disability structures within the defined contribution system. Specifically, the absence of healthcare coverage during disability and the absence of non- occupational disability coverage. MR. WILLIAMS remarked that current law for defined contribution members covers only occupational disability. He said that approximately 85 percent of disabilities are non-occupational. He said that these members receive neither income replacement nor post-employment healthcare coverage. For members who do qualify for occupational disability, healthcare coverage ends when the employment terminates. He said that a firefighter seriously injured in a structure fire may survive but would be unable to return to work. In this instance the individual would receive some income replacement but would not have healthcare coverage until normal retirement age, which is currently 65. MR. WILLIAMS said that by comparison, defined benefit members would receive both disability income and healthcare coverage during disability. He said that the ARM Board recommends the legislature add non-occupational disability income coverage for defined contribution members with at least 10 years of service, as well as healthcare coverage for defined contribution members while on occupational or non-occupational disability. He said that occupational disability would have no service requirements and non-occupational disability would require 10 years of service. MR. WILLIAMS said that the board asked its independent review actuary, Gabriel, Roeder, Smith & Company (GRS) to evaluate whether the defined contribution disability and retirement medical trust could sustain closing these gaps. The GRS actuary memorandum ("memo") found that the defined contribution trusts were strongly funded, and all four trusts remained above 100 percent funded - even under all modeled scenarios. MR. WILLIAMS noted that these changes require only modest adjustments to normal cost. He said that the combined increase to PERS defined contribution (which includes police and firefighters) is approximately .2 percent of payroll. For TERS defined contribution, there is an approximate increase in .1 percent of payroll. 5:06:14 PM REPRESENTATIVE SADDLER said that he wanted to confirm whether he would have the opportunity to work with the sponsor on the amendment while it was still in the House Labor and Commerce Standing Committee and that he is not involved with the prospective next committee for the proposed bill. CO-CHAIR FIELDS said that this was a misunderstanding; he meant the amendment could be discussed in a subsequent committee or future stage of the legislative process. REPRESENTATIVE KOPP noted that he would still like to work with Representative Saddler on an amendment regardless. 5:06:39 PM REPRESENTATIVE KOPP stated that he appreciates Representative Saddler bringing up the workers' compensation piece. He said that between insurance, disability benefits, and cash payments, there is a system that has failed Alaskans. REPRESENTATIVE KOPP noted that one of the testifiers suffered a traumatic brain injury (TBI) from getting beaten almost to death in Fairbanks. He said that these types of injuries are life- changing, and people put it all on the line every day. REPRESENTATIVE KOPP noted that he had to bury a close officer in the past. Shot and killed on Christmas Day and the finance personnel with the State of Alaska debited his wife's account for the last five days of the year since he was not alive. He said that this was finally rectified but explained that it demonstrates that people often do not experience these things on a visceral level; it is often treated as ethereal and abstract. REPRESENTATIVE KOPP noted that the proposed legislation was addressing a single part of the system. He said that disability is 40 percent pay for the first year and 75 percent pay in subsequent years. Furthermore, disability recipients would be required to reverify disability on an annual basis. He appreciated that Representative Saddler had mentioned that workers' compensation is part of the process because reverification is an issue there, too. 5:08:25 PM CO-CHAIR HALL moved to report HB 210 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 210 was reported out of the House Labor and Commerce Standing Committee. 5:08:48 PM The committee took a brief at-ease at 5:08 p.m. HB 195-PHARMACIST PRESCRIPTION AUTHORITY  5:08:55 PM CO-CHAIR FIELDS announced that the final order of business would be HOUSE BILL NO. 195, "An Act relating to the prescription and administration of drugs and devices by pharmacists; relating to reciprocity for pharmacists; and providing for an effective date." 5:10:47 PM REPRESENTATIVE GENEVIEVE MINA, Alaska State Legislature, as prime sponsor, reintroduced HB 195. She noted that over the interim, the stakeholders worked diligently to integrate a lot of feedback from many different providers in the healthcare sector. She noted that a committee substitute was ready for the committee to consider, and her staff would present it to the committee. 5:11:13 PM KATY GIORGIO, Staff, Representative Genevieve Mina, Alaska State Legislature, on behalf of Representative Genevieve Mina, prime sponsor of HB 195, noted that there are four changes associated with the proposed committee substitute. She explained that Section 1 adds a new provision that prevents the Department of Commerce, Community, and Economic Development (DCCED) from requiring fees for collaborative practice agreements. This would require board approval for those agreements. It also requires each collaborative practice agreement to clearly define the specific patient care services that the pharmacist is allowed to provide. MS. GIORGIO explained that Section 7 was amended for clarity based on feedback from meetings with the State Medical Association. This change specifies that a pharmacist may not make any new diagnosis for an individual who comes in to see them. However, it maintains that when conducting a Clinical Laboratory Improvement Amendment (CLIA)-waived test, the pharmacist may diagnose a new condition identified through that testing process. MS. GIORGIO explained that Section 8 addresses controlled substances by clarifying that pharmacists are not prescribing opioids unless specifically for medication-assisted therapy in a clinical setting. Section 13 updates the effective date to January 1, 2027. 5:13:12 PM CO-CHAIR HALL moved to adopt the proposed committee substitute (CS) for HB 195, Version 34-LS0909\N, Gunther, 2/5/26, as the working document. There being no objection, Version N was before the committee. 5:13:40 PM CO-CHAIR FIELDS announced that the committee would hear invited testimony on HB 195, Version N. 5:13:50 PM BRANDY SEIGNEMARTIN, PharmD, began her invited testimony in support of HB 195, Version N. She said that she serves as the Executive Director of the Alaska Pharmacy Association and as a Clinical Assistant Professor in the University of Alaska Anchorage (UAA), Doctor of Pharmacy Program. She remarked that she testified in support of the bill in the previous legislative session and discussed the role pharmacists already play across Alaska's healthcare system, the importance of standard-of-care framework, and how this legislation could responsibly expand access to routine healthcare services without compromising safety. DR. SIEGNEMARTIN wished to highlight several components of work that was completed over the interim. She said that there were four meetings with the Alaska Board of Pharmacy, the Alaska State Medical Association, and the Alaska Pharmacy Association. She noted that Representative Justin Ruffridge attended several of these meetings. She also stated that close work was conducted with the sponsors of the proposed bill to revise the previous year's legislation. She said that concerns were raised about whether the authority in the bill might be unlimited, or whether pharmacists would be broadly diagnosing new conditions, and whether the legislation would allow pharmacists to function as independent diagnostic practitioners. She said that all these concerns have been taken very seriously. DR. SIEGNEMARTIN explained that Version N reflects meaningful tightening on the proposed bill language. She explained that this is not unlimited authority and pharmacists must already operate within a narrow lane defined under statute, within their education, training, and experience while under the standard-of- care framework. She said that when a condition falls outside that lane or outside the pharmacist's competency, a referral would be required. DR. SIEGNEMARTIN noted that during discussions, there was also acknowledgement which was supported by guidance from the Department of Law. It was noted that if the legislature intends for pharmacists to provide the patient-care services granted, then it is essential that the words "prescribe" and "administer" appear in the statutory section titled "Other Patient Care Services". Without these terms, the authority becomes unclear and legally unworkable. She said that this was not expansion of scope but rather statutory clarity. 5:16:13 PM DR. SIEGNEMARTIN said that one area of genuine alignment with the Alaska State Medical Association was collaborative practice. She explained that there are two lanes of practice in the bill, both collaborative practice and independent authority. She said that there was a shared recognition that Alaska would benefit from a more meaningful and functional collaborative practice agreement. She noted that pharmacists are well positioned to support higher levels of care in team-based models, particularly in chronic disease management and medication assisted treatments for opioid use disorder, which remains an urgent need in the state. She said that current collaborative practice agreements are not functional in Alaska and there is no pathway for pharmacist-to-pharmacist participation in opioid use disorder treatment. The regulatory structure makes these agreements difficult to operate and as a result, there is underutilization. DR. SIEGNEMARTIN explained that Section 1 of Version N helps to address this by making collaborative practice agreements workable in practice. She clarified that the change is not about independent authority, but strengthening team-based care. In fact, during discussions there were talks about holding a joint summit in the event the proposed legislation passes, something focused on collaborative practice. The goal would be to bring pharmacists and physicians together to develop innovative team-based care models and intentionally shift the culture toward more interdisciplinary collaboration. DR. SIEGNEMARTIN noted that in addition to strengthening collaborative models, this bill would allow pharmacists to address routine conditions with clearly defined guardrails. By managing predictable, lower-acuity issues, pharmacists can reduce friction in the system and free physicians to focus on complex diagnostics, procedures, and higher-level care where their expertise is most needed. She said that while she cannot say where the Alaska Medical Association stands on the bill, she acknowledged that the process has been thoughtful and deliberate. She noted that the version of the bill before the committee reflects meaningful effort to address concerns while maintaining the bill's intent. DR. SIEGNEMARTIN referred to the prior testimony from a former Alaska State Trooper who had described the difficulty of getting consistent access to a physician in Alaska. She noted that this underscores one of the reasons that this bill is needed. She explained that this type of authority is not new and that pharmacists operating in federal systems such as the U.S. Department of Veterans Affairs (VA), Indian Health Service (IHS) and tribal organizations across the state have practiced at this level for decades. She noted that many other states and countries allow pharmacists to provide care for minor routine conditions safely and effectively under a similar framework. She said that the data shows high patient satisfaction and lower overall cost of care. DR. SEIGNEMARTIN stated that often the best way to illustrate value is with examples. She noted that during a legislative fly-in last week, she joined meetings with a colleague who was the district manager for Fred Meyer pharmacies. The colleague described a common scenario; a patient brings in a prescription for a nebulizer solution for their child, but not for a device itself. The pharmacist is required to call the provider's office, leave a message, and wait for a response. She stated that this causes care delays and unnecessary administrative "back and forth." She said that the provider's office, which is often busy, needs to generate a second prescription. She said that under the bill, when appropriate, the pharmacist could resolve the issue immediately, the child would receive timely care, and the provider would avoid additional administrative burden. 5:19:35 PM DR. SEIGNEMARTIN said that she also heard from her colleague, the pharmacy director at Yukon-Kuskokwim Health Corporation (YKHC), that if this policy had been in place during Hurricane Halong, it would have allowed for more efficient handling and support for patients when they evacuated to Bethel, Alaska. DR. SEIGNEMARTIN, in conclusion, stated that the proposed legislation is not about replacing physicians or creating parallel healthcare systems. Rather, it is about responsibly leveraging the infrastructure that already exists in communities across Alaska: pharmacies that are accessible, trusted, and already deeply integrated into patient care. This is to close routine gaps and reduce friction in Alaska's healthcare system. She noted HB 195, Version N, reflects months of thoughtful discussion and careful revision. It reinforces guardrails, strengthens collaborative practice, ensures statutory clarity, and preserves the integrity of team-based care. Furthermore, it gives the opportunity for Alaska to use its healthcare workforce more effectively in service of patients. She remarked that the legislation is supported by the Alaska Healthcare & Hospital Association, the Alaska Native Health Board, the University of Alaska Anchorage Doctor of Pharmacy Program, chief medical officers, and many tribal health organizations across the state. She urged support for HB 195, Version N. 5:21:08 PM ASHLEY SCHABER, PharmD, Director of Pharmacy, Alaska Native Medical Center; Member, Alaska Board of Pharmacy, gave invited testimony in support of HB 195, Version N. She said that the proposed legislation is the result of several years of meetings to review Alaska Statutes and regulations to align pharmacy licensing authority with education, training, and experience. The goal is to increase access to care. DR. SCHABER noted that legislation that was passed in 2021 and 2022 added a new section to the pharmacy statutes, titled "Other Patient Care Services" which recognized that pharmacists provide services other than just medication dispensing, whether this was under collaborative practice agreements or independently. She said that after the statute was enacted, the Board of Pharmacy received numerous questions from businesses and licensees. Working with the Department of Law, it was determined that additional clarification was needed, specifically regarding pharmacist prescription and administering practices. DR. SCHABER noted that HB 195 expands access to pharmacist- provided patient care services while aligning state statutes with pharmacy education and training. The bill would encourage interdisciplinary collaboration between pharmacists and other healthcare practitioners. Furthermore, it grants pharmacists the statutory authority to implement proven models of care. She noted that since this proposed bill was last before the committee, representatives of the Alaska Board of Pharmacy, the Alaska Pharmacy Association, and the Alaska State Medical Association have met several times to review and discuss the proposed legislation. Shared goals were identified, and the committee substitute introduced today reflects that collaborative effort. She urged the committee's support of HB 195, Version N. 5:23:17 PM CO-CHAIR FIELDS announced that HB 195, Version N, was held over. 5:24:18 PM ADJOURNMENT  There being no further business before the committee, the House Labor and Commerce Standing Committee meeting was adjourned at 5:24 p.m.