04/03/2009 08:00 AM House EDUCATION

HB 204-POSTSECONDARY MEDICAL EDUC. PROG.                                                                                      
                                                                                                                                
9:18:55 AM                                                                                                                    
                                                                                                                                
CHAIR SEATON announced that the  final order of business would be                                                               
HOUSE BILL  NO. 204,  "An Act increasing  the number  of students                                                               
pursuing  a  medical  education who  are  provided  postsecondary                                                               
educational  services   and  programs;   and  providing   for  an                                                               
effective date."                                                                                                                
                                                                                                                                
9:19:19 AM                                                                                                                    
                                                                                                                                
CHAIR SEATON reminded  the committee that pending before  it is a                                                               
motion to adopt CSHB 204,  Version 26-LS0778\R, Mischel, 3/31/09,                                                               
to which he had objected.                                                                                                       
                                                                                                                                
9:19:59 AM                                                                                                                    
                                                                                                                                
SAM  DIX, Staff,  Representative  Nancy  Dahlstrom, Alaska  State                                                               
Legislature, relayed that the [sponsor]  has decided to [support]                                                               
returning to the  original version of HB 204,  which would merely                                                               
add four  students to the  Wyoming, Washington,  Alaska, Montana,                                                               
and Idaho (WWAMI) program.                                                                                                      
                                                                                                                                
9:20:25 AM                                                                                                                    
                                                                                                                                
CHAIR SEATON  informed the committee that  there have discussions                                                               
within the legislature, the medical  field, and the WWAMI program                                                               
regarding eliminating  the section of [Version  R] that addresses                                                               
medically underserved  areas of the state  because the definition                                                               
of "area"  wasn't a particular  practice.  The  existing language                                                               
could  result  in  a  situation  in  which  there's  a  medically                                                               
underserved  area  with  a  profitable practice.    There  was  a                                                               
proposal to remove the aforementioned  section and the definition                                                               
of "underserved  area."   There was  also discussion  of changing                                                               
the  definition   of  "qualified  practice"  to   refer  only  to                                                               
uninsured and Medicare  because Medicaid and Denali  Kid Care are                                                               
profitable  in  some  practices.    The  concern  was  that  [the                                                               
legislation] would dilute  the incentive for doctors  to take the                                                               
three-year reimbursement.                                                                                                       
                                                                                                                                
CHAIR  SEATON explained  that the  motion to  adopt Version  R is                                                               
before the committee and there is an objection to it.                                                                           
                                                                                                                                
9:23:18 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WILSON withdrew  her  motion to  adopt CSHB  204,                                                               
Version 26-LS0778\R,  Mischel, 3/31/09, as the  working document.                                                               
There  being no  objection,  it  was so  ordered  and before  the                                                               
committee was the original version, HB 204.                                                                                     
                                                                                                                                
9:24:17 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER  encouraged  the  committee  to  move  the                                                               
legislation  out  so that  it  can  be  considered in  the  House                                                               
Finance Committee.   From  a policy  perspective, he  opined that                                                               
the  legislation shouldn't  be passed  in a  vacuum and  that the                                                               
entire  workforce  shortage  in   the  medical  field  should  be                                                               
considered.                                                                                                                     
                                                                                                                                
9:25:53 AM                                                                                                                    
                                                                                                                                
CHAIR  SEATON noted  that Version  R  was discussed  so that  the                                                               
policy questions incorporated in Version R were fully vetted.                                                                   
                                                                                                                                
9:26:22 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARDNER   agreed  with   Representative  Keller's                                                               
comments, particularly since the real  way to increase doctors in                                                               
Alaska  is  to increase  the  residencies.   Simply  having  more                                                               
Alaskan students  in a medical  program doesn't  necessarily mean                                                               
those students will return to the state.                                                                                        
                                                                                                                                
9:26:52 AM                                                                                                                    
                                                                                                                                
CHAIR SEATON  stated his  agreement, adding  that he  has learned                                                               
much about the value of slots  in medical schools.  The slots are                                                               
filled with  the students from  the states with  medical schools,                                                               
which is why WWAMI is so important.                                                                                             
                                                                                                                                
9:27:35 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WILSON inquired as to how the benefit works.                                                                     
                                                                                                                                
9:28:00 AM                                                                                                                    
                                                                                                                                
CHAIR SEATON  explained that the  state support amounts  to about                                                               
$56,000, half of  which is converted into a loan  and the student                                                               
pays about  $23,000.  That  $23,000 loan  can be forgiven  if the                                                               
student returns  to Alaska.   A returning  student who  serves in                                                               
rural  Alaska receives  a 33  1/3 percent  per year  reduction in                                                               
their  repayment obligation  while those  who serve  in non-rural                                                               
Alaska  receive  a  20  percent   per  year  reduction  in  their                                                               
repayment  obligation.   He  recalled that  about  50 percent  of                                                               
Alaska's WWAMI students return to  the state and about another 38                                                               
percent  of other  WWAMI  students come  to  Alaska.   Therefore,                                                               
Alaska receives about 88 percent  of WWAMI students, although the                                                               
state funds  much less than that.   Chair Seaton opined  that the                                                               
WWAMI program is successful at the current reimbursement rate.                                                                  
                                                                                                                                
9:29:45 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER  moved to report  HB 204 out  of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There being no objection, it was so ordered.