Senate Floor Session, 5/20/26, 7pm

Will the Senate come back to order, please? Madam Secretary, will you remind us where we are, how we got here?

Senate— excuse me, CS for House Bill 195, Finance. The motion was made to advance from second to third reading.

And thank you. We had an objection, so you have before you Shall we advance from second to third reading? So the question before you is, shall the Senate advance from second to third reading? Members may proceed to vote.

The Secretary will lock the roll. Do any Senators wish to change their vote? The Secretary will announce the vote.

There we go.

And if you will announce the vote. 16 Yeas, 4 nays. Thank you. 16 Yeas, 4 nays. We will advance from second to third reading.

Senator Giesel to carry the bill. Thank you, Mr. President. Mr. President, this bill has— the title of this bill is Pharmacist Patient Services. I'm sorry, Senator Geese, we need to read the bill for a third time. I apologize.

It is getting late.

Madam Secretary. CS for House Bill 195, Finance, an act changing the term physician assistant to physician associate relating to physician associates relating to collaborative practice agreements for pharmacists relating to the prescription of opioid overdose drugs, relating to the prescription and administration of drugs and devices by pharmacists, relating to reciprocity for pharmacists, amending the definition of practitioner and providing for an effective date before the Senate in third reading on final passage. Thank you. Now Senator Gishel to carry the bill. Thank you, Mr. President.

House Bill 195 is entitled Pharmacists patient services. And that's what it's about, Mr. President. Uh, it is a very collaborative, uh, product from the Board of Pharmacy, the Pharmacy Association, the Department of Law, DCCED, the State Medical Association, many legislative members and stakeholders. This bill opens access to high-quality healthcare by authorizing pharmacists in Alaska to provide direct patient services in alignment with their education, training, and clinical expertise. I will remind everyone, these are doctorally prepared people, uh, Mr. President, and I will speak as a healthcare clinician.

These are the folks I turn to to make sure that what I'm prescribing is not interacting with another medication that the patient is on or has other, um, other warnings related to it. Because pharmacists have the knowledge and skills to assist in providing direct patient care and can certainly take care of minor and chronic ailments. And they're especially, especially able to open access in rural areas where Alaskans face significant barriers to healthcare. Mr. President, I want to give a couple of real-life examples that actually I heard about just this week. You know, when Hilong hit down in southwest Alaska, the Yukon-Kuskokwim Health Corporation could have met so many needs had pharmacists had this authority at the time, Mr. President, because they were right there in the communities.

They were right there in Bethel where people were being evacuated to. They were on— they were on the ground, Mr. President. And that's what we're talking about. Community pharmacists who are equipped to provide patient care. Another story I heard of is of a mom that came in desperate.

Her child was having an asthma attack, but she had run out of the medication for the vaporizer. She came into the pharmacy. Well, without this bill, the pharmacist had to call the prescriber and get authority to give the medic— otherwise he could have simply said, here's the medication, and off she could have gone. This makes a difference in real people's lives, Mr. President, going to their community pharmacy and getting medication. They—.

Pharmacists can manage chronic conditions such as diabetes and those common things like strep throat, a urinary tract infection. You know, many times a child will wake up in the morning with a sore throat and a little bit of a fever, is it strep, should I keep them home? You can go to the nearby pharmacy. The pharmacist would be able to do a cleared— common clinically cleared tests. So these are things, they're called Clinical Laboratory Improvement Amendments or CLIA tests.

These are authorized, easy to do tests that you can do in any clinic, do a quick throat swab and identify strep, influenza, urinary tract infections with a dipstick, lots of really common things, Mr. President. The kinds of direct care would be test to treat, so that's where they would do the simple wave tests, prescribe remedies for things like flu, cold, urinary tract infections, but also tobacco cessation, immunization treatment, pink eye, et cetera. The public would be able to access care. Right now we have a collaboration— we have a Doctor of Pharmacy program right now in the state of Alaska, Mr. President, and they were recognized in the top 3 schools— actually graduates in the country. But they collaborate with the University of Idaho.

Turning out large numbers of pharmacists that are staying in the state. Mr. Pharmacist— Mr. President, the— there are limitations on what pharmacists can prescribe. They are limited by what's called the REMS, the Risk Evaluation and Mitigation Strategy, that the FDA, the Federal Drug Administration, places on certain drugs. There is a list. You can go online, just Google, Google REMS, R-E-M-S.

It'll take you right to the website, and you can see the listing of medications that are not permitted unless you have certain certification and clearance. Mr. President, this bill prohibits the use of any of those medications that are on that REMS list. It also prohibits the pharmacist from prescribing opioid medications themselves. However, they can prescribe or— they can prescribe the overdose drugs such as naloxone or Narcan. They can do that particularly if the patient is also being prescribed benzodiazepines, which really augment if someone is to taking an opioid can really augment the effects of that.

So a lot of those provisions are in the bill, Mr. President. And in fact, bottom line, this helps reduce the cost of healthcare. There was a Washington State study done recently that showed that if a pharmacist is— if a patient is able to go to a pharmacist for minor treatment for these minor illnesses, it costs $277 less per episode than traditionally going to a doctor's office. You might know, Mr. President, sometimes there's quite a charge for seeing a physician or nurse practitioner in a formal clinic. Plus, the treatment is much faster.

So, Mr. President, for all those reasons, this will increase access to health care in Alaska. Thank you, Mr. President. Thank you, Senator Giesel. Is there further No further discussion. If you are ready for the question, the question being, shall CS for House Bill 195 Finance pass the Senate?

Senators may proceed to vote.

The secretary will lock the roll. Do any senators wish to change their vote? The secretary will announce the vote. 15 Yeas, 5 nays.

So with 15 nays— 15 yeas and 5 nays, CSRS House Bill 195 Finance has passed the Senate. Madam Majority Leader. Mr. President, I move and ask unanimous consent that the vote on the bill be considered the vote on the effective date clause. Thank you. Hearing no objection, the effective date clause has been adopted.

Madam Secretary, please read the next item on today's calendar.

Senate CS for CS for House Bill 302, Transportation, an Act Relating to Travel Insurance, Relating to the Business of Insurance, Relating to Exceptions to Prohibited Rebates, Relating to the Powers of the Director of the Division of Insurance, Relating to Prohibited Practices in the Advertisement Insurance and providing for an effective date. Was on the calendar in third reading. We return to second for amendments.

There is an amendment number 3 by Senator— number 2 by Senator Keehl on members' desks. Senator Keehl. Thank you, Mr. President. For the purpose of clarity, I will remove— I move again I move Amendment 2. Thank you.

Amendment 2 has been moved. Senator Keehl to explain. Thank you, Mr. President. We talked about the substance of this amendment once before. This increases the benefit scale for unemployment insurance.

Our unemployment trust fund is tremendously overfunded. If the members would look at page 7 of the amendment, the maximum weekly benefit under this goes up to $470. Mr. President, that doesn't quite get us to the median among other states. I think the— or no, excuse me, that puts us one step above the median. The median is Oklahoma at $461.

But fear not, no one will come to Alaska to sponge off our unemployment system. To get here, you pretty much have to pass through Washington Washington, and their maximum weekly benefit is $1,152. So don't worry, we're safe. Mr. President, with the benefit schedule being adjusted to keep pace with wages— not CPI, but wages— and a modest bump in the benefit per dependent, which is capped at a maximum number of dependents— no, maximum amount excuse me— this simply provides a little improvement to a system of support that you really need when you're looking for a job. It keeps folks housed and fed; certainly doesn't keep anybody rolling in it.

Mr. President, again, we don't expect this to have an impact on employer UI rates any time in the near or even midterm future. With that, I'll ask the members' votes for Amendment 2. Thank you, Senator Keele. Senator Kaufman. Thank you, Mr. President.

I don't believe that we should be taking pieces and parts and stuffing them into this bill. I think it's bad practice and a bad harbinger for the future. Thank you, Senator Kaufman. Is there further discussion?

Is there an objection?

There's an objection. All right. So the question being, if you're ready for the question, the question being, shall the Senate adopt Amendment Number 2? Senators may proceed to vote. The Secretary will lock the roll.

Do any Senators wish to change their vote? The Secretary will announce the vote. 14 Yeas, 6 nays. And so by a vote of 14 yeas to 6 nays, Amendment Number 2 has passed the Senate. Madam Secretary, with no further amendments to be offered, the bill is back before the Senate in third reading on final passage as amended.

Thank you. Senator Bjorkman to carry the bill. I brief it is.

Order, please. Madam Secretary, we have an amendment number My apologies. There is an Amendment Number 3 by Senator Kaufman on members' desks. Thank you. Amendment Number 3, Senator Kaufman.

Thank you. I move Amendment Number 3. There has been an objection. Please explain. Explain yourself.

I'm going to splain myself, Mr. President. Well, amidst all this skullduggery and other hijinks that have been going on. How many birdisms can I hit? Excuse me for that. So, you know, we're taking pieces and parts of stuff and stuffing it in bills that it shouldn't be, and I don't think it's going to work out in the end.

And in that spirit, I offer Amendment Number 3, which is, as Paul Harvey would say, the rest of the story. And so it's the pieces and parts that we're leaving stuck in rules, and my goal is to highlight what we're what we're really doing here as opposed to what we, we should be doing, which is moving that bill that's been stuck in rules. But, um, I understand that that's where it's stuck, and I know this amendment will not make it anywhere. So with that, I'll withdraw my amendment because I don't want to stay here past midnight myself. Thank you.

Amendment number 3 has been withdrawn.

We— Senate—. Madam Secretary, with no further amendments now to be offered, that brings the bill back before the Senate in third reading on final passage. Thank you. Senator Bjorkman, to carry the bill. Thank you, Mr. President.

House Bill 302, travel insurance, modernizes Alaska's travel insurance statutes, which were last updated in 2013 and fit neatly on one piece of paper. However, travel insurance has come a long way since then. Uh, travel insurance language provided in this bill strengthens consumer protections and supports regulators by creating a clear and fair playing field for the insurance industry. Essentially, if you buy travel insurance and you have a loss or a claim to make against the travel insurance policy that you purchased. This ensures that the Division of Insurance, they approve the regulations and forms offered through that travel insurance and make sure that if you do have a claim or loss, that the insurance comes good for the policy and actually pays out if you have a legitimate claim or loss.

42 Other states have passed this model so far, and It's good, good policy. Also added to this piece of legislation is insurance rebates language that the body has previously passed, allowing for companies, insurance companies specifically, to provide risk mitigating factors to their customers for free— smoke detectors, fire extinguishers, other pieces and parts that would mitigate risk and produce lower cost for insurers and their customers. Also, we just amended, as you all heard, some unemployment insurance into this bill, all matching the single subject rule of insurance. I urge members to vote yes. Thank you, Senator Bjorkman.

Is there further discussion? Are you ready for the question? The question being, shall Senate CS for CS for House Bill 302, Transportation, as amended in the Senate. Pass the Senate. Senators may proceed to vote.

The Secretary will lock the roll. Do any Senators wish to change their vote? The Secretary will announce the vote. 14 Yeas, 6 nays. And so by a vote of 14 yeas and 6 nays, Senate CS for CS for House Bill 202, Transportation, amended Senate, has passed the Senate.

Madam Majority Leader. Mr. President, I move and ask unanimous consent that the vote on the bill be considered the vote on the effective date clause. Without objection, so ordered.

Madam Secretary, that brings the title change SCR 28 before the Senate on final passage. Thank you. We're ready for the question. The question being, shall the title change of resolution SCR 28 pass the Senate? Senators may proceed to vote.

The Secretary will lock the roll. Do any Senators wish to change their vote? The Secretary will announce the vote. 16 Yeas, 4 nays. So by a vote of 16 yeas and 4 nays, the title change resolution SCR 28 has passed the Senate.

Madam Secretary, please read the next item on today's calendar.

House Bill number 14, an act repealing programs for catastrophic illness assistance and medical assistance for chronic and acute medical conditions, before the Senate in third reading on final passage. There is an amendment number 1 by Senator Clayman on members' desks. Senator Clayman. Thank you, Mr. President. I'd move and ask unanimous consent to return to second second reading for the purposes of considering Amendment Number 1.

Thank you, Senator Clayman. Hearing no objection, Amendment Number 1 is back in second reading and will remain so until all amendments have been considered. Senator Clayman. I move Amendment Number 1. Has there been objection?

Senator Clayman. Thank you, Mr. President. Amendment Number 1 will add provisions from a bill that is now in the Rules Committee of the other body. This amendment would ensure pay parity for telehealth services, requiring health insurers to reimburse at the same rate— payment rate for telehealth services as in-person care. The COVID-19 pandemic highlighted the critical need for telehealth services and now provides users— now allows providers to use them to supplement their healthcare.

Over 28 states have enacted similar legislation with pay parity and Under current state statutes, providers can invest in healthcare— telehealth technology without the fear of the floor falling out from underneath them if health insurers change their reimbursement rate. Telehealth services are vital for Alaskans with chronic diseases or disabilities or in rural areas or with limited transportation options. It is especially beneficial for Alaskans who need mental health services. This amendment reimburses Alaskan providers at parity but it also allows healthcare insurers to use a geographic pay differential for out-of-state providers. This would remove any incentive, any inadvertent incentive to hire out-of-state providers or more providers outside to receive Alaska-based reimbursements.

This amendment also extends the sunset language for Medicaid telehealth pay parity, which has been in place since 2022, from 2030 to 2040 so that policy would remain the standard for Medicaid program— for the Medicaid program for years to come. And with that, I encourage a yes vote on the amendment. Thank you, Senator Kline. Is there discussion?

Is— there was an objection. Is that true? Yes. Is the objection maintained? Yes.

If you then are ready for the question, the question being, shall the Senate adopt Amendment Number 1 Senators may proceed to vote.

The secretary will lock the roll. Do any senators wish to change their vote? The secretary will announce the vote. 14 Yeas, 6 nays. And so by a vote of 14 yeas to 6 nays, Amendment Number 1 has passed the Senate.

Madam Secretary. Amendment Number 2 will not be offered. There is an Amendment Number 3 by Senator Giesel. On members' desks. Number 3.

Amendment 3 is removed and objected. Senator Giesel. Thank you, Mr. President. Mr. President, I certainly understand the consternation about inserting bills into other bills, especially on the floor. The word in the title of House Bill number 14 is the word catastrophic.

And this amendment addresses something that is very catastrophic. Mr. President, about 10 years ago in a rural community, 2 of our state troopers were killed, shot, as they executed their job. When that happened, their families— they both had families, wives, children— that family immediately lost healthcare coverage. This legislature did something phenomenal. We actually passed legislation that extended state healthcare for those two families for 10 years.

That 10 years just expired. The purpose of that was to give opportunity for these widows to get on their feet and be able to provide and raise the children having lost their husbands in the line of duty, Mr. President, serving us. This is— this amendment is sort of an extension of that. This is actually a bill. It's on our side as well as the other side, and it's simply not going to make it across.

But, Mr. President, the impetus for this, the member who who represents House District 10, and I have received phone calls from 3 state troopers who were shot on the job and are completely disabled now. Full disability. They have lost pay, pay that will sustain them. One of them has lost his house. Another has lost his family through divorce.

The financial stress— they will never be able work again, and they have no healthcare coverage, Mr. President. We have abandoned them. So, Mr. President, this amendment would fill that gap. It would— right now, if they are disabled, if they are judged to be totally disabled, their pay, because they're Tier 4, drops to 40% of their pay. They can't support themselves on this.

This bill will provide 75% of the gross monthly salary for both defined benefit and defined contribution members. Right now, defined benefit members, of course, have coverage, defined contribution do not. Health care will be restored for defined contribution employees who become occupationally disabled. And firefighters in particular are called out here, Mr. President, on the first 2 pages related to the disabilities they encounter due to the line of work they do and the toxins they are exposed to. Mr. President, this corrects a 2-tier system.

2 Police officers or 2 firefighters walk into a burning building. One has defined benefit, one has defined contribution. Both are permanently differently disabled and they have different benefits. This will correct that, Mr. President. The really great thing about this is we can afford it.

The PERS, defined contribution disability trust, is 399% funded, Mr. President. Teachers are included in this as well, but I don't know that— a lot of teachers, of course, of course, will get 100% disabled on the job, but regardless, it could happen, right? School shootings and so forth. TERS, Defined Contribution Disability Trust, is 5,172% funded. Mr. President, I think it will cover this.

Retiree benefit under PERS is 121% covered— funded, pardon me. TERS is 134. Mr. President, this will allow us to stand with our public employees who give it all to serve the state, Mr. President, and are permanently disabled because of that public service. I do hope that we will vote yes on this. Thank you, Mr. President.

Thank you, Senator Giesel. Is there discussion? Senator Steadman. Thank you, Mr. President. This is kind of a tough issue.

I think when we take a look at the healthcare trust, we all recognize it's well overfunded and there is some concern with the disability. So for myself, I'm going to go ahead and support this. I don't— I would have preferred to have it go through the committee with some more analysis on cost. But with the massive surplus we have there, I think if it becomes an issue next winter when analysis is run, we could adjust it, you know, going future, into the future. So I don't think there's a huge risk and I don't think there's any intent here from the state to, you know, put our, putting police and fire at risk unduly with no compensation if something happens.

So with that, Mr. President, I'm going to support this amendment and we'll review it next winter for cost impacts. Thank you, Senator Seppen. Senator Myers. Yeah, Mr. President, so, um, certainly support what the maker of the amendment is attempting to do here. I think it's a a worthy cause.

It does sound like it's going to work, but just looking over it from a legal standpoint without access to alleged legal on the fly here, the underlying bill is in Title 47, which is having to do with welfare benefits, whereas this amendment is in Title— Titles 23 and 29— or excuse me, 23 and 39, having to do with— and it's the amendment is having to do with employee benefits. And I'm concerned that if we pass this amendment, we end up losing the entire bill if it goes to a legal challenge. So I'm reluctant to support it. Not based on the content. I remember looking at the similar content in my first term here with former Senator Holland, but I'm reluctant to support it based on legal concerns, Mr. President.

Thank you. Thank you, Senator Myers, for the discussion. Senator Giesel— no, we've got Senator Coughlin first. Thank you, Mr. President. Just wondering if we can address the validity of that, maybe quickly get an opinion from Ledge Legal.

Um, could you— Will the Senate come back to order, please? We are dealing with Amendment No. 3 To House Bill 14. Senator Velekauskis.

President, just to confirm, I just consulted legislative legal, the drafter of Amendment Number 3, which references A.6, and she confirmed that this amendment does conform with the single subject rule, as does the other amendment, all under the topic of health. Thank you. Thank you, Senator Milkowski. Is there further discussion?

We had an objection. We still have an objection to Amendment Number 3.

Hearing no objection, Amendment Number 3 has been adopted.

Madam Secretary, I have no further amendments. That brings the bill back before the Senate in third reading on final passage. Thank you. Senator Cronk to carry the bill. Thank you, Mr. President.

I was happy to carry this bill on behalf of the member from the other body body of District 32. Uh, HB 14 repeals the Catastrophic and Acute Medical Assistance Program, or CAMA, which has been obsolete for the past 5 years. Originally, the program was designed for people who were not eligible for programs like Medicaid. As Medicaid and other federal programs expanded over time, fewer and fewer Alaskans qualified for CAMA. In 2021, the program only served one Alaskan.

It has not served a single Alaska since that year. The problem with CAMA is that by law, the Department of Health is required to process every application for this program and determine applicants' eligibility on a case-by-case basis. This was problematic as hundreds of working hours were spent processing many thousands of applications for no one to qualify for the program. This administrative oversight cost the state between $100,000 and $150,000 per year. Two years ago, the funding for this program was removed from the conference committee.

So even if someone was deemed eligible for this program, which no one was, they would not have benefited from this program unless funding was restored. So HB 14 completes CAMA's repeal process and significantly alleviates administrative burden for the Department of Health. And it also became a health bill and a workman's comp bill, it looks like. So with that, I urge your yes vote. Thank you.

Thank you, Senator Brock. Is there further discussion?

If you are ready for the question, question being, shall House Bill 14, amended in the Senate, proceed? You may proceed to vote.

The secretary will— Senator Giesel.

The secretary will lock the roll. Do any senators wish to change their vote? The secretary will announce the vote. 19 Yeas, 1 nay. And so by a vote of 19 yeas to 1 nay, House Bill 14 has passed the Senate.

Madam Majority Leader. President, I move and ask unanimous consent that the vote on the bill be considered the vote on the effective date clause. Without objection, so ordered.

Senator Diesel. Mr. President, I move that the Senate recess to call of the chair. Thank you. We will recess to a call of the chair. We're waiting.

We have just discovered a title change.

Madam Secretary, that brings the title change SCR 36 before the Senate on final passage. The title change is before you. Senators may proceed to vote.

Thank you. Will the Secretary close the roll? Do any Senators wish to change their vote? Will the Secretary announce the vote? 20 Yeas, 0 nays.

So by a vote of 20 yeas, 0 nays, SCR 36, title change, has passed the Senate. Madam Majority Leader. Mr. President, now I suggest we— I move that we recess to call of the chair. Thank you. Without objection, we will recess to a call of the chair.

Will the Senate come back to order, please?

Madam Secretary, there are no further items to consider on today's daily calendar. Thank you. Thank you. We are under unfinished business. Is there unfinished business at this time?

Senator Tobin. Thank you, Mr. President. For the last time with you in that chair, I move and ask unanimous consent to be excused from a call of the Senate from May 27th AM plane time to June 22nd PM plane time for personal business as as I take my father to Paris. Without objection, so ordered, Senator Tobin. Additional unfinished business?

Senator Steadman. Thank you, Mr. President. I move and ask unanimous consent that I be excused from a call to the Senate June 7th through June 16th for state business. 7Th to the 16th, without objection. Senator Clayman.

Thank you, Mr. President. I move and ask to be excused from a call to the Senate for June 22nd through June 24th 22nd to 24th for personal and estate business. 22Nd to 24th, without objection, Senator Clayman. Any additional unfinished business at this time? Moving on to committee announcements.

Surely there are none. What about other announcements? Moving on to special orders. Are there special orders?

Senator Hoffman. Mr. President, on my wife— me and my wife's 54th anniversary. I move and ask unanimous— I move that the Senate of the 34th Legislature adjourn sine die. Thank you, Senator Hoffman. Hearing no objection, the Senate of the 34th Alaska Legislature is adjourned sine die.