SENATE FINANCE COMMITTEE April 22, 2022 1:03 p.m. 1:03:50 PM CALL TO ORDER Co-Chair Bishop called the Senate Finance Committee meeting to order at 1:03 p.m. MEMBERS PRESENT Senator Click Bishop, Co-Chair Senator Bert Stedman, Co-Chair Senator Lyman Hoffman Senator Donny Olson Senator David Wilson (via teleconference) MEMBERS ABSENT Senator Natasha von Imhof Senator Bill Wielechowski ALSO PRESENT Representative Matt Claman, Sponsor; Lizzie Kubitz, Staff, Representative Matt Claman; Chelsea Ward-Waller, Staff, Representative Ivy Spohnholz; Representative Liz Snyder, Sponsor; Arielle Wiggin, Staff, Representative Liz Snyder. PRESENT VIA TELECONFERENCE Sara Chambers, Director, Division of Corporation, Business and Professional Licensing, Department of Commerce, Community and Economic Development; LeeAnne Carrothers, American Physical Therapy Association, Alaska Chapter, Wasilla; Representative Ivy Spohnholz, Sponsor, Anchorage; Royann Royer, Alaska Dental Hygiene Association, Anchorage; David Nielson, Chair, Alaska Board of Dental Examiners, Anchorage; John Zasada, Policy Director, Alaska Primary Care Association, Anchorage; Ron Meehan, Food Bank of Alaska, Anchorage. SUMMARY HB 99 PHYSICAL/OCCUPATIONAL THERAPY BD/PRACTICE HB 99 was HEARD and HELD in committee for further consideration. CSHB 111(FIN) DENTAL HYGIENIST ADVANCED PRAC PERMIT CSHB 111(FIN) was HEARD and HELD in committee for further consideration. HB 168 ELECTRONIC APPLICATION FOR STATE BENEFITS HB 168 was HEARD and HELD in committee for further consideration. HOUSE BILL NO. 99 "An Act relating to the State Physical Therapy and Occupational Therapy Board; relating to the practice of physical therapy; and relating to the practice of occupational therapy." 1:05:03 PM REPRESENTATIVE MATT CLAMAN, SPONSOR, introduced the legislation with prepared remarks: First, I want to thank you for hearing House Bill 99. We often talk of making Alaska open and ready for business, House Bill 99 makes sure we're open and ready for business and specific of the business of providing physical and occupational therapy. My office introduced House Bill 99 at the request of the Alaska Physical and Occupational Therapy Associations. House Bill 99 amends the governing statutes for physical therapists, physical therapy assistants, occupational therapists, and occupational therapy assistants practicing in Alaska. These changes are designed to bring Alaska statutes in line with national standards and terminology and overall make the administrative experience of these professions and professionals smoother and up to date. House Bill 99 is supported by the state Physical Therapy and Occupational Therapy Board, which believes House Bill 99 will help the board and its work to protect the public. The letter stating that support is in your bill packet. Currently, physical therapists, physical therapy assistants, occupational therapists, and occupational therapy assistants are represented by the state Physical Therapy and Occupational Therapy Board. This board is made up of one physician, three physical therapists, two occupational therapists, and one member of the public. House Bill 99 removes the physician from this board and replaces them with another occupational therapist, thereby balancing the representation of the professions on the board. There is good reason for this. When this statute was originally written, the work of physical and occupational therapists required referral by a physician. This has not been the case in Alaska for more than 30 years. House Bill 99 also enables the board to discipline a therapist who commits infractions under AS 08.84.120 such as conviction of a felony, gross negligence, or abuse of alcohol. Currently, the board has the ability to revoke or deny a license based on infractions but has no ability to discipline. Additionally, House Bill 99 clarifies the language and the requirements for those therapists to receive their training outside of the United States, ensuring that their training is equivalent to a U.S. professional physical therapy program and also exempting therapists trained in an English language program from having to take an English proficiency test. Furthermore, this bill updates language in Alaska statute that referenced an accrediting entity that no longer exists and makes the language more general, allowing the state board to designate the appropriate accrediting entity as needed. Several other updates to terminology are made to update the language. House Bill 99 does not constitute a restructuring of the relevant statute, but it contains several long-awaited changes that will make it easier for professionals to do business in Alaska. 1:07:58 PM LIZZIE KUBITZ, STAFF, REPRESENTATIVE MATT CLAMAN, discussed the Sectional Analysis (copy on file): Section 1 AS 08.84.010. Creation and membership of the board. Removes the seat for a physician and balances out the board with 3 physical therapists or physical therapy assistants and 3 occupational therapists or occupational therapy assistants along with one public member, to make up the 7-member board. It also changes the term "physical therapy assistant" to "physical therapist assistant" in this section and throughout the entire statute. This change is to conform to the industry title used nationally. Section 2 AS 08.84.030. Qualifications for licensing. Allows the board to have broader authority over what entities will have accreditation oversight over physical therapy & occupational therapy education programs. Some of the accrediting entities listed in statute are now either renamed or no longer exist, making that statute obsolete. Section 2 removes language from the statute relating to additional supervised field work that occupational therapists must complete as these requirements are covered by the accrediting bodies. Section 3 AS 08.84.032. Foreign-educated applicants. Changes the section headline from "trained" to "educated." New language is added that requires foreign-educated physical therapist or physical therapy assistant students to have attended a "substantially" equivalent educational program that is accredited by a U.S. accreditation entity that has been approved by the board. Outdated and obsolete language is removed that can be found on page 4, lines 3 -9 of this bill. Added to subsection (3) of this section is language that would require that a physical therapist or physical therapist assistant pass a test demonstrating competency of the English language only if their program was taught in a foreign language. Subsection (4) requires that a foreign-educated applicant is a legal alien or a U.S citizen. Subsection (7) requires them to pay the required fee and meet any other qualifications for licensure set by the board under 08.84.010(b). All the above changes in Section 3 are replicated for occupational therapists or occupational therapy assistants on page 4, lines 27-31 and over to page 5, lines 1-22. Section 4 AS 08.84.060. Licensure by acceptance of credentials. Makes conforming terminology changes. Section 5 AS 08.84.065(c). Temporary changes. Makes conforming terminology changes. Section 6 AS 08.84.075(b). Limited permit. Makes conforming terminology changes. Section 7 AS 08.84.075(c). Limited permit. Changes language that would now require that a limited permit is valid for 120 consecutive days. Section 8 AS 08.84.075(d). Limited permit. Allows only one limited permit per 12-month period. Section 9 AS 08.84.090. Licensure. Updates licensure terminology. Section 10 AS 08.84.120(a). Refusal, revocation, and suspension of license. Adds disciplinary action as a possibility to actions a board might consider for an infraction of their licensure and updates terminology in item (7) and states in (9) that failure to comply with the law or regulations or order of the board might result in disciplinary action or suspension of a license. Section 11 AS 08.04.130(a). False claim of license prohibited. Adds updated credentialing and terminology. Section 12 AS 08.84.130(b). False claim of license prohibited. Updates terminology. Section 13 AS 08.84.190. Definitions. Adds a new paragraph defining the updated term "physical therapist assistant." Section 14 AS 11.41.470(1). Definitions. Updates definitions in criminal law/sexual assault statute. Section 15 AS 47.17.290(14). Definitions. Updates terminology under definitions in child protection statute. Section 16 AS 08.84.190(7). Definitions. Repeals subsection (7), which is the definition using outdated term of physical therapy assistant; according to Leg. Legal, when the actual "term" used for the definition is being changed, the entire citing must be repealed. The new definition is set out on page 8, Section 13, lines 11-14. Section 17 Applicability Sets out the applicability clauses for licensure for sections 2 and 3 of this Act and for sections 7 and 8. Section 18 Uncodified law Transition language for the board vacancy and appointments for the PT/OT board, and states that the changes do not apply to current licensees until it is time for their licensure renewal and then all changes to the law will apply. Ms. Kubitz listed individuals available for questions. 1:12:27 PM Senator Olson asked if state medical associations and/or the Medical Board supported the legislation. He highlighted the bill's proposal to remove a physician [from the Physical Therapy and Occupational Therapy Board]. Representative Claman replied that he had spoken with individual physicians. Senator Olson interjected that there were letters of support in the bill packets. Representative Claman replied that the physicians he had spoken to did not have a problem with the bill. Senator Olson asked if there was anything from the boards. Representative Claman replied in the negative. Senator Olson asked for the percentage of foreign medical applicants applying for physical and occupational therapy positions. 1:13:15 PM AT EASE 1:13:35 PM RECONVENED Senator Olson reiterated his previous question. Representative Claman deferred to Ms. Chambers. SARA CHAMBERS, DIRECTOR, DIVISION OF CORPORATION, BUSINESS AND PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT (via teleconference), replied that she would follow up with the answer. Co-Chair Bishop asked Ms. Chambers to provide the answer to his office for distribution to committee members. Co-Chair Bishop moved to invited testimony. LEEANNE CARROTHERS, AMERICAN PHYSICAL THERAPY ASSOCIATION, ALASKA CHAPTER, WASILLA (via teleconference), spoke in support of the legislation. The association represented approximately 450 licensed physical therapists and physical therapist assistants in Alaska. She stated that the bill provided many needed language changes and terminology changes to the existing statute, which would bring Alaska in line with current national standards, terminology, and practice. She elaborated that the bill provided balanced representation by physical and occupational therapy. Additionally, the bill removed a position from the board, which was a relic of a time when physical and occupational therapists required physician supervision and were accredited by the American Medical Association. The bill reduced administrative burden and costs for individuals who graduated from schools taught in English outside of the United States and provided disciplinary capability to the board. She summarized that the bill provided necessary updates, was noncontroversial, and long overdue. 1:16:23 PM Co-Chair Bishop OPENED public testimony. 1:16:37 PM AT EASE 1:17:03 PM RECONVENED Co-Chair Stedman wondered if there was an error in the printing of the bill. He observed the version before the committee was version A. He was being facetious. Co-Chair Bishop CLOSED public testimony. Representative Claman stressed that the bill had received no amendments in the House and there was no committee substitute. SB 99 was HEARD and HELD in committee for further consideration. CS FOR HOUSE BILL NO. 111(FIN) "An Act relating to the practice of dental hygiene; relating to advanced practice permits for dental hygienists; relating to dental assistants; prohibiting unfair discrimination under group health insurance against a dental hygienist who holds an advanced practice permit; relating to medical assistance for dental hygiene services; and providing for an effective date." 1:19:01 PM CHELSEA WARD-WALLER, STAFF, REPRESENTATIVE IVY SPOHNHOLZ, introduced herself. She believed Representative Spohnholz was available online to introduce the legislation. REPRESENTATIVE IVY SPOHNHOLZ, SPONSOR, ANCHORAGE (via teleconference), introduced the legislation with prepared remarks: House Bill 111 creates an advanced practice permit, which would allow experienced and licensed dental hygienists to provide preventative oral healthcare to underserved populations at senior centers, healthcare facilities, daycares, and schools for Alaskans who are eligible for public assistance, are homebound, or who live in a rural underserved community. We know that oral health plays a really critical role in the overall health and well-being of Alaskans and poor oral health contributes to poor health. In fact, bad oral health is linked to cardiovascular disease, Alzheimer's, osteoporosis, as well as poor nutrition and other serious health issues and this is more acute for low income individuals and those who are physically immobile. Currently, dental hygienists can practice in a dentist office or they can practice semi-independently if they have a collaborative agreement with a dentist, which is similar to what physician's assistants do already. An advance practice permit that's proposed by House Bill 111 would allow dental hygienists to care for these underserved populations at senior centers, healthcare facilities, daycare, schools, and those that are eligible for public assistance, are homebound, or live in underserved communities if they have a minimum of 4,000 hours of clinical experience and are approved by the board of dental examiners, which includes both dentists and dental hygienists. The bill lays out specific services allowed under the permit and specific populations that a licensed dental hygienist can provide those services to without the supervision and physical presence of a licensed dentist. Unlike some licensing bills in the past where there was competing license types that had different perspectives, this bill has been developed in consultation with the Alaska Dental Society, the Board of Dental Examiners, and the Alaska Dental Hygienists Association. The advanced practice permit holder will have to maintain malpractice insurance, provide written notice of their service limitations, and make a referral to a licensed dentist if further treatment is necessary. This bill would allow dental hygienists who are experienced to practice to the full scope of their training credentials and professional experience. Importantly, Alaska won't be the first state to make these changes. Dental hygienists are able to practice under advance practice permits or similar permits in six other states and 40 other states are considered direct access states for dental hygienists, which means that dental hygienists can initiate treatment based on their assessment of a patient's needs without the authorization or presence of a dentist. Finally, I will note that we have made important changes to this bill at the recommendation of the Board of Dental Examiners and the Alaska Dental Society including requiring permit holders to maintain patient records for at least seven years, making sure that the Board of Dental Examiners has a separately certified hygienist to administer local anesthesia, and then empowering the Department of Health and Social Services (DHSS) to make regulations related to this bill. We may need to update the DHSS language to confirm with the recent split of the Department of Health and Social Services. Representative Spohnholz listed individuals available to speak to the bill. 1:23:31 PM Senator Olson asked if the bill allowed prescriptive authority to the advanced dental hygienists. Representative Spohnholz replied there was very narrow prescriptive authority regarding topical, preventative, and prophylactic agents that dental hygienists were already allowed to provide. She deferred the question to Royann Royer [with the Alaska Dental Hygiene Association] for further detail. Senator Olson asked if advanced dental hygienists had to participate in the Prescription Drug Monitoring Program (PDMP) that other prescriptive practitioners were required to abide by. Representative Sponholz answered that dental hygienists did not prescribe controlled substances and therefore, did not have DEA [Drug Enforcement Administration] certification and did not have to participate in the PDMP. Senator Olson asked if the permit enabled advanced dental hygienists to perform advanced dental procedures. Representative Sponholz responded that the bill did not allow dental hygienists to practice beyond the scope of their current practice in any way. The bill simply enabled dental hygienists to do what they had already been doing safely for a very long time and without the supervision of a dentist if they had 4,000 hours of experience in addition to a previous dental hygienist license and were approved by the Board of Dental Examiners. 1:25:27 PM Ms. Ward-Waller discussed the Sectional Analysis (copy on file): Section 1 Ability of practice of dental hygienists. (e) Amends AS 08.32.110. to allow a licensed dental hygienist who holds an advanced practice permit issued by the board to perform duties allowed by the permit. Section 2 Advanced practice permits. Adds a new section under AS 08.32.125 creating the advanced practice permit and providing requirements as follows: (a) The Board of Dental Examiners may issue an advanced practice permit to a licensed dental hygienist with a minimum 4,000 documented hours of clinical experience. This subsection lists what duties fall under advanced practice permits: general oral health & cleaning, providing treatment plans, screenings, taking radiographs, and/or delegating to dental assistants. (b) A licensed dental hygienist holding an advanced practice permit may provide services to a patient who is not able to receive dental treatment because of age, infirmity, or disability. The patient may be a resident of a senior center, residential health facility, or held in a local correctional facility. The patient may also be enrolled in certain schools, receiving benefits under the Special Supplemental Food Program (WIC), homebound, or a resident of a community that has a shortage of dental health professionals. (c) A licensed dental hygienist holding an advanced practice permit can provide appropriate services to a patient without the presence, authorization, and supervision of a licensed dentist and without an examination from a licensed dentist. (d) A licensed dental hygienist with an advanced practice permit must maintain professional liability insurance. They must also give the patient, parent, or legal guardian written notice that the treatment provided will be limited to those allowed by the permit, a written recommendation that the patient be examined by a licensed dentist for comprehensive oral care, and assistance in receiving a referral to a licensed dentist for further oral treatment. (e) An advanced practice permit is valid until the license of the dental hygienist expires. A licensed dental hygienist can renew their advanced practice permit at the same time they renew their license. 1:29:31 PM ROYANN ROYER, ALASKA DENTAL HYGIENE ASSOCIATION, ANCHORAGE (via teleconference), spoke in support of the legislation. She shared information about her work in dentistry for many years in Alaska. She shared that approximately six years back she had seen a significant need that was not being addressed in Alaska. She had started a nonprofit organization that served residents in long-term care facilities. She spoke to the importance of the legislation. She currently practiced under a collaborative practice agreement, which allowed dental hygienists to provide treatment under the general supervision of a dentist. She was able to see a patient prior to the dentist. She was lucky to have several dentists to collaborate with on the project and would continue as long as possible. However, if the bill went through, it would provide another option to continue the program if needed. For example, if she did not have a dentist to work with, she would be able to continue seeing the long-term residents and provide assessments, radiographs, preventative services, and oral health education. The patients could then see a dentist either in or outside the facility as needed. Ms. Royer relayed that many hygienists wanted to work in underserved areas, but they could not find a dentist who would work in a collaborative agreement. The legislation had been brought forward by a hygienist in Fairbanks who wanted to find a way to provide services. She shared that assessment and treatment done routinely were less expensive than waiting for a person to notice problems, which necessitated more extensive and expensive procedures. She highlighted that preventative treatment helped to prevent systemic conditions such as pneumonia, diabetes complications, and heart disease. She stated that Alaska needed more providers in underserved areas and the registered dental hygienist advanced practitioner would help decrease the disparity. 1:32:54 PM DAVID NIELSON, CHAIR, ALASKA BOARD OF DENTAL EXAMINERS, ANCHORAGE (via teleconference), shared that discussion about the advanced dental hygiene permit had come up several times over the past couple of years and the support had always been good. He shared that the bill sponsor had been receptive to board comments and had made a couple of changes to the original bill. He relayed that the board supported the bill in its current form. He highlighted that Section 4 specified that the dental board would draft regulations to clarify what additional tasks, if any, would be delegated dental assistants by the advanced hygiene permit holder and under what level of supervision. Co-Chair Bishop looked at Section 2 (a) and wondered how the 4,000 hours was documented. He asked if students or individuals had a logbook. Mr. Nielson replied that there was typically an affidavit where someone attested to the fact that a person had 4,000 hours of practice. He stated that it would likely be a person's employer. 1:35:24 PM JOHN ZASADA, POLICY DIRECTOR, ALASKA PRIMARY CARE ASSOCIATION, ANCHORAGE (via teleconference), spoke in support of the legislation. He detailed that the association supported the operations and development of Alaska's 29 non-tribal and tribal federally qualified health centers. He provided detail about the association. He stressed that dental services and oral health were vital components of the whole person care that community health centers provided patients. He detailed that many health centers offered on-site dental services provided by staff or contracts with other dental health professionals. Smaller sites relied on sending patients to larger hub facilities or neighboring urban health centers for dental care. One frequently cited reason for the shortage of dental services was the lack of providers. He stated that persistent provider shortages at all levels in the community healthcare dental system resulted in providers not working at their highest level of licensure, which created inefficiencies, decreased provider satisfaction, and barriers to patient care. The bill would add a valuable layer of staffing between dentists and other hygienists to provide comprehensive services. He spoke to further attributes of the program. The new provider type would lead to an adjustment of the overall health spend, potentially lessening the reliance on higher cost dentists to lower cost hygiene. He urged the passage of the bill. 1:37:44 PM Co-Chair Bishop OPENED and CLOSED public testimony. 1:38:03 PM AT EASE 1:38:43 PM RECONVENED CSHB 111(FIN) was HEARD and HELD in committee for further consideration. HOUSE BILL NO. 168 "An Act requiring the Department of Health and Social Services to provide and allow submission of an electronic application for certain state benefits; and providing for an effective date." 1:39:16 PM REPRESENTATIVE LIZ SNYDER, SPONSOR, introduced the legislation. She detailed that the legislation required the Department of Health and Social Services or soon to be Department of Health to make applications for public assistance available for completion and submission online. The bill would keep all other existing paper-based and email options available as well. The required deadline for the action to occur was July 1, 2022. She stated that online forms could increase accessibility and efficiency, which would be beneficial to Alaskans and the Division of Public Assistance. Online applications had been supported by past and current administrations, as evidenced by the stated goal to do such and by ongoing efforts; however, efforts had not been consistent and had not been finalized. She relayed that requiring online availability in statute protected the department's current work to get the forms online and ensures the effort would cross the finish line after more than a decade of false starts. 1:40:40 PM ARIELLE WIGGIN, STAFF, REPRESENTATIVE LIZ SNYDER, reviewed the Sectional Analysis (copy on file): Sec. 1: Adds a new subsection (19) to AS 47.05.010 Duties of Department requiring the Department of Health and Social Services to create and provide an entirely online application process for individuals applying for public assistance and defines an online application. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. It does not mandate applicants apply online or remove the written option. Sec. 2: Amends AS 47.08.150(b) Assistance For Chronic or Acute Medical Conditions by adding language requiring the Department of Health and Social Services to establish an entirely online application process for individuals applying for the Chronic and Acute Medical Assistance program. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 3: Adds a new subsection (6) to AS 47.25.001(a) Powers and Duties that requires the department establish an entirely online application process and allows applicants to apply in any form required by state and federal law. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 4: Adds a new section (7) to AS 47.25.071(e) Child Care Grant Program that requires the department establish an entirely online application process for assistance under the Child Care Grant Program. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 5: Amends AS 47.25.095 Definitions For Day Care Assistance and Child Care Grant Programs to define electronic application. Sec. 6: Amends AS 47.25.150 Application For Assistance by adding language requiring the Division of Public Assistance to establish an entirely online application process for individuals applying for assistance from the department and defines an online application. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 7: Amends AS 47.25.440 Application For Assistance by adding language requiring the Department of Health and Social Services to establish an entirely online application process for individuals applying to receive Adult Public Assistance and defines an online application. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 8: Adds a new subsection (4) to AS 47.25.622 Alaska Affordable Heating Program requiring the Department of Health and Social Services to create and provide an entirely online 4.9.2021 application process for individuals applying for the Alaska Affordable Heating Program and defines an online application. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 9: Adds a new subsection (4) to AS 47.25.980(a) Duties of Department requiring the Division of Public Assistance to create and provide an entirely online application process for individuals applying for the Supplemental Nutrition Assistance Program and defines an online application. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 10: Amends AS 47.27.020(a) Application Requirements by adding language requiring the Division of Public Assistance to establish an entirely online application process for individuals applying for the Alaska Temporary Assistance Program. Defines online application. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 11: Amends AS 47.45.302(a) Cash Assistance Benefits by adding language requiring the Department of Health and Social Services to establish an entirely online application process for individuals applying for the cash assistance program. Defines online application. Adds language requiring the department inform applicants that making false statements on the application is a punishable act. Sec. 12: Adds a new section to the uncodified law of the State of Alaska allowing the Department of Health and Social Services to adopt regulations needed to create and implement online applications. Sec. 13: Requires Section 12 to take effect immediately under AS 01.10.070(c). Sec. 14: Provides an effective date of July 1, 2022. 1:42:04 PM Senator Olson asked how the bill would help rural applicants with poor internet connections. Representative Snyder replied that in areas where connectivity was not an issue, the demand for paper services and associate assistance should go down, which would free up additional time for the division to meet the needs of rural Alaskans. Senator Olson asked how the bill would help people in areas of his district like Diomede or St. Lawrence Island. Representative Snyder responded that the bill was not necessarily designed to be particularly beneficial for individuals without online access. She pointed out that the division had a functional phoneline where it could walk applicants through the forms. She relayed the demand for the phone line had been very high. The bill aimed to free up time for the division and make it faster to receive service. Co-Chair Bishop hoped it would be the case. He highlighted that some people were waiting 45 minutes trying to get services. Representative Snyder agreed. She shared it was the motivation of the legislation. Stakeholders reported repeatedly on the challenging wait time. She stated that the longer the delay, the odds of an eligible applicant completing the form diminished. She had heard about the issue for quite some time, and she had advocated in subcommittees for additional positions to meet the gap until applications were online. She hoped the bill would be part of the solution to a persistent problem. 1:44:47 PM Co-Chair Bishop moved to invited testimony. RON MEEHAN, FOOD BANK OF ALASKA, ANCHORAGE (via teleconference), spoke in support of the bill. He shared that the Food Bank of Alaska had a robust staff outreach team that was federally funded in partnership with the state. He provided detail about the work provided by the Food Bank. He shared that almost one-quarter of the people eligible in Alaska for SNAP [Supplemental Nutrition Assistance Program] benefits were not accessing the program. He stated that Alaskans faced unique challenges in accessing benefits. One of the major barriers was the lack of options for how to apply. He stated the creation and addition of an online program would reduce the problem. He elaborated that Alaska currently used a paper application. The current online option required someone to provide a finger or stylus signature, which many people were unable to do. He relayed that not all communities had a public assistance office, and many offices were still currently closed. He provided further detail about the difficulties associated with the current system. He stated that the current process could take weeks for individuals in rural communities. He highlighted high wait times on the phone. The bill would streamline the process and the application could be simplified. He reviewed benefits of the bill. He enthusiastically supported the legislation. 1:48:25 PM Co-Chair Bishop OPENED and CLOSED public testimony. HB 168 was HEARD and HELD in committee for further consideration. Co-Chair Bishop discussed the schedule for the following Monday. ADJOURNMENT 1:49:17 PM The meeting was adjourned at 1:49 p.m.