Legislature(2017 - 2018)BARNES 124
04/02/2018 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB155 | |
| SB108 | |
| HB136 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 108 | TELECONFERENCED | |
| + | SB 155 | TELECONFERENCED | |
| + | HB 136 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 108-MEDICAL CARE/LICENSING/MEDICAL BOARD
4:05:27 PM
VICE CHAIR WOOL announced that the next order of business would
be CS FOR SPONSOR SUBSTITUTE FOR SENATE BILL NO. 108(FIN), "An
Act relating to the State Medical Board; relating to the
licensing of physicians, osteopaths, and podiatrists; relating
to the certification of medical assistants; relating to the
practice of medicine; relating to the practice of podiatry;
relating to the practice of osteopathy; relating to assault of a
medical professional; and providing for an effective date."
4:05:43 PM
SENATOR CATHY GIESSEL, Alaska State Legislature, presented SB
108 as prime sponsor. She indicated her PowerPoint presentation
would also serve a sectional analysis of the proposed bill.
4:06:58 PM
SENATOR GIESSEL pointed to slide 2, "Purpose":
1. Streamline Physician Licensing
2. Need for office assistants
a. Unlicensed
b. Licensed
1. Streamline MD licensing
Section 1, 2, 8, 9, 10
State Medical Board to write regulations to
delegate to EXECUTIVE SECRETARY:
1. review applications and grant license if
requirements are met
2. review applications and issue temporary
license if requirements are met
3. grant certification if requirements are met
4. spells out prohibitions to this delegate
authority
SENATOR GIESSEL explained that the documentation is
maintained until the state Medical Board meets, but the
board only meets four times per year. She said this
creates a backlog. She said that one the examiner looks at
the documentation, it would be forwarded to the executive
secretary who would review the applications and make
appropriate action.
4:09:09 PM
REPRESENTATIVE KNOPP asked why it is not the responsibility of
the executive secretary to prepare the documentation for the
board.
SENATOR GIESSEL reviewed the application process. She stated
the applications could be approved immediately or go to the
board if there were issues with an application.
SENATOR GIESSEL continued to slide 4, "Streamline MD Licensing":
Section 10, 11
1. Allows another person, designated by the board, to
help the Executive Secretary to issue temporary
license.
2. Outlines when this could happen
SENATOR GIESSEL shared that the process is used by the
largest licensing board in the state.
4:14:29 PM
SENATOR GIESSEL moved to slide 5-6, "2.a. Unlicensed Assistive
Personnel":
Unlicensed personnel trained in "routine medical
tasks"
Section 3 Regulations will
o authorize delegation to unlicensed person
o prohibit delegation of pain management or
opioid related activities
o define "routine medical tasks"
Section 6
adds person, performing delegated "routine
medical duties" to exception under "License to
practice medicine, podiatry, or osteopathy"
Section 12
Adds "medical assistant" to list to practice
medicine
Section 14
adds "medical assistants" to definition of
"medical professional" under Title 12 Criminal
Procedure
SENATOR GIESSEL said the bill would correct a gap in the board's
laws.
4:17:00 PM
REPRESENTATIVE JOSEPHSON asked whether there would be a need to
ensure that the unlicensed people have specific training.
SENATOR GIESSEL answered that initially all that was required
was a high school diploma but now there was some education
available. She added there would be a higher level of education
required.
REPRESENTATIVE WOOL asked for confirmation that this first group
of medical assistants won't need a license in the future, but
the physician will be able to delegate to them.
SENATOR GIESSEL answered in the affirmative.
SENATOR GIESSEL progressed to slide 7-8, "2.b. medical
Assistants - license/certification":
Why?
Prescription Drug Monitoring Program (PDMP)
~prohibits access by any unlicensed person
~envisioned clinician delegates "look up" before
prescribing
Problem
~No licensed people in MD clinic, other than the
MD
~Frequent need to check PDMP (AS 17.30.200
requires license).
Solution recognize training and certification
Training programs accredited by
o Commission on Accreditation of Allied Health
Education Programs (CAAHEP)
o Accrediting Bureau of Health Education Schools
(ABHES)
National exams for Certification
Alaska's community colleges training programs
Recognized in many other states/territories.
WA, CA, TX, FL, PA, OH, IL, MT, MS, ND, SD, WY
4:21:17 PM
SENATOR GIESSEL addressed slide 9, "2.b. Medical assistant with
certification process":
Section 4
Certifying process defined in regulation by Board
Section 5
Limits use of term "certified"
Section 13
Certification is equivalent to a license
4:22:41 PM
VICE CHAIR WOOL suggested the licensure is simply to check the
PDMP and maybe enters the new data. He suggested this would be
creating another licensed person who would need training,
licensure, and a background check.
SENATOR GIESSEL corrected that the pharmacist enters the data
into the PDMP. She said the other statement was correct.
VICE CHAIR WOOL suggested a physician could remove themselves
from vulnerability to revocation of their license by having
another licensed person in the office.
SENATOR GIESSEL answered that each licensed person is
accountable for their actions under their license.
4:25:09 PM
REPRESENTATIVE JOSEPHSON suggested that the physician would
still be held responsible [from a legal standpoint].
4:25:43 PM
REPRESENTATIVE BIRCH asked how many applications are rejected a
year.
SENATOR GIESSEL deferred to the department and to the executive
secretary of the state medical board.
REPRESENTATIVE BIRCH said there are a lot of confidentiality
issues in a medical office. He asked whether the proposal was
to certify everyone in a medical office.
SENATOR GIESSEL answered that the provision would not include
the bookkeepers.
4:28:12 PM
SENATOR GIESSEL briefly addressed "Urgent need for SB 108" on
slide 10-11.
Efficient, expeditious and effective licensing of MDs
Legal clarity for delegation of "routine medical
duties" to unlicensed personnel (medical assistants)
More legally stringent delegated activities to
licensed entity, a medical assistant who has achieved
certification
These changes needed this session
SUPPORT:
State Medical Board (requested)
Dept of Commerce
Alaska State Hospital and Nursing Home Association
Alaska State Medical Association
Foundation Health Partners (Fairbanks)
No opposition
4:30:35 PM
FRED PARADY, Deputy Commissioner, Department of Commerce,
Community & Economic Development (DCCED), answered questions in
the hearing on SB 108. He said his department had seen an
increase in requests for licensure. He said the department had
an initiative to streamline the application process. He
indicated the issues that slowed the process had been
identified. He added that only around ten percent of the
applications were complete when they were sent it. He described
changes to the online process that would be implemented.
4:34:41 PM
REPRESENTATIVE SULLIVAN-LEONARD shared her understanding that
the aim was to streamline the process. She asked whether
licensure could be invoked when the coursework is completed.
MR. PARADY said he had not heard that suggestion before but that
it seemed interesting.
REPRESENTATIVE SULLIVAN-LEONARD shared that her hesitation to
fully support the proposal was due to the apparent "double duty"
in the process.
MR. PARADY answered that he thought the school would be quite a
logical location for the online process.
4:36:26 PM
VICE CHAIR WOOL asked whether the licensure was a statutory
responsibility of the state licensing board.
MR. PARADY deferred to the sponsor. He said he thinks it
recognizes the limited board meeting schedule and ability to
address problem-free applications.
4:37:33 PM
DEBORA STOVERN, Executive Secretary, State Medical Board,
Division of Corporations, Businesses, and Profession Licensing
(DCBPL), answered questions in the hearing on SB 108. She said
it is important to note that the board is allowed to grant that
limited authority to the executive secretary under specific
conditions. She added the any application with adverse
information would still require the board to review for approval
of temporary or permanent licenses. She said it would continue
to require specific delegation by the board on an annual basis.
REPRESENTATIVE BIRCH asked how many applicants are rejected.
MS. STOVERN answered that the board actually denies only a
couple of applications per year as an outright denial. She said
other applications that have adverse information or information
of concern would be asked to come into an in-person interview.
REPRESENTATIVE BIRCH said it seemed like a low-risk proposal.
4:42:43 PM
REPRESENTATIVE JOSEPHSON asked what is being licensed. He asked
if someone has done an internship and a residency, what is being
granted with licensure.
MS. STOVERN answered the board issues licenses to practice
medicine in the state.
4:43:45 PM
JEANNIE MONK, Alaska State Hospital and Nursing Home Association
(ASHNA), testified in support of SB 108. She said ASHNA is in
support of fixing the statutory deficiency to allow physicians
to delegate the tasks.
VICE CHAIR WOOL asked about the Certified Medical Assistant
license.
MS. MONK answered there are some concerns about creating new
certified personnel, but it was not enough to avoid supporting
the proposed bill.
VICE CHAIR WOOL asked whether the medical assistant would have
to acquire a new range of skills.
MS. MONK answered that would be left to the board. She added
that she thinks other states do have certified medical
assistants.
4:46:38 PM
VICE CHAIR WOOL opened public testimony on SB 108.
4:46:52 PM
VICE CHAIR WOOL asked whether Certified Medical Assistant is a
one-off certification.
SENATOR GIESSEL answered that the position requirement may
expand. She suggested that if a person is going to pay for the
licensing exam and fees, they may cost more to hire.
VICE CHAIR WOOL held over SB 108.