The Senate Health and Social Services Committee voted Thursday to advance a bill expanding Alaska's participation in interstate health care compacts, despite concerns from two members that the legislation erodes state sovereignty.

Senate Bill 281 passed the committee 3-2, with Senators Giesel and Tobin voting no. The bill adds genetic counselors and respiratory care practitioners to the list of health care professionals licensed by the Department of Commerce, Community, and Economic Development. It also includes multiple interstate health care compacts designed to speed up licensing for qualified health care providers who want to practice in multiple states.

The committee held its fourth hearing on SB 281 on Thursday, having previously met on the bill March 31, April 9, and April 23. The committee adopted a committee substitute that adds genetic counselors and respiratory care practitioners to the list of health care professionals licensed by the Department of Commerce, Community, and Economic Development. The substitute also repeals the Rural Health Transformation Program on December 31, 2031.

The committee withdrew an amendment that would have required electronic fingerprinting for compact applicants after learning the state lacks the infrastructure to support it. Senator Giesel proposed adding electronic format requirements to fingerprint submissions, calling the current paper-based system archaic. But Division of Corporations, Business and Professional Licensing Director Sylvan Robb said the Department of Public Safety can only accept electronic fingerprints from other government agencies, not from applicants directly or from third-party vendors.

"Our understanding is that there are many places where a person cannot obtain electronic fingerprints," Robb said. She added that requiring electronic submission would slow down licensing and increase costs for applicants until the department can accept fingerprints from third-party vendors.

Giesel withdrew the amendment after the discussion, though she noted the issue has persisted since she served on the Board of Nursing starting in 2002.

Senator Giesel objected to the bill's passage, citing fundamental concerns about interstate compacts. "These compacts, I fundamentally, it is not anyone specific, it is the whole concept of these compacts. I believe that it significantly erodes state sovereignty," she said.

Senator Tobin also voted against the measure, though he did not elaborate on his reasoning during the hearing.

Supporters argued the compacts address rural health care access by making it easier for out-of-state providers to practice in Alaska.

The bill now moves to the Senate Labor and Commerce Committee.