Legislature(1997 - 1998)

02/05/1998 01:45 PM House FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
HOUSE BILL NO. 193                                                             
                                                                               
"An Act relating to financial assistance for students                          
attending certain graduate education programs; and                             
providing for an effective date."                                              
                                                                               
REPRESENTATIVE CON BUNDE spoke in support of the                               
legislation.  He observed that the WAMI Medical Education                      
Program is subsidized by the state of Alaska.  He noted that                   
not all WAMI students return to Alaska.  He emphasized that                    
the State invests approximately $150 thousand dollars in                       
each student.  He contended that the State would not run out                   
of doctors without an entirely subsidized program.                             
                                                                               
Representative Bunde maintained that the legislation allows                    
Alaska to reap the just reward of its investment in WAMI                       
students.  Students who practice in Alaska for five years                      
would not be impacted.  He observed that the majority of                       
physicians live in the state where they did their residency.                   
                                                                               
Representative Bunde provided members with an amendment                        
(copy on file). The amendment would add intent language to                     
clarify that the first year is not included in the repayment                   
requirement.  It would also add "or participating" on page                     
2, line 5.  Representative Bunde noted that Alaskan                            
physicians have access to WAMI computer files.  He asserted                    
that physicians should be require to pay for this access.                      
                                                                               
Representative Martin stated that the amendment should not                     
be in the form of intent language.  He suggested that the                      
language be inserted into statute.                                             
                                                                               
LYNNE SMITH, STAFF, REPRESENTATIVE BUNDE clarified that                        
students already in the program would not be affected by the                   
legislation.                                                                   
                                                                               
Representative Davies noted that the effective date should                     
be changed to 1998.                                                            
                                                                               
Representative Bunde did not think that additional                             
restrictions to assure participation by Alaskan students                       
were needed.  He explained that the program already requires                   
students to be Alaskan residents.  He stated that residency                    
requirements could be tightened.  He acknowledged that 12 of                   
the 40 students that participated in the program, from 1989                    
to the current year, did not graduate from an Alaskan high                     
school.                                                                        
                                                                               
WENDY REDMAN, VICE PRESIDENT, STATEWIDE PROGRAMS, UNIVERSITY                   
of Alaska stated that the University does not support the                      
implementation of a surcharge.  She maintained that a                          
surcharge would negatively affect low-income students.  She                    
observed that 8 of the 12 students that graduated from out-                    
of-state high schools were attending prep schools, while                       
their parents lived in state.                                                  
                                                                               
Ms. Redman spoke in support of the WAMI program.  She                          
asserted that the program is an integral part of the                           
University's Health Science program.  She observed that the                    
University receives federal research funding as a result of                    
its participation in the WAMI program.  She pointed out that                   
the associated residency program has brought over $5 million                   
dollars to Anchorage.   She emphasized that there are more                     
applicants than the program can accommodate.  She spoke                        
against the amendment.  She observed that students have a                      
debt load of approximately $80 thousand dollars without the                    
additional $59 thousand dollar liability proposed by the                       
legislation.  She observed that 49 percent of Alaskan                          
students return to the State.  The national average is 40                      
percent.  Seventy percent of all WAMI students, who come to                    
Alaska, through rotations and residencies, return to Alaska.                   
She clarified that students would be liable for an                             
additional repayment of $13 thousand dollars if the first                      
year was included in the repayment.                                            
                                                                               
Co-Chair Hanley questioned if there is a shortage of doctors                   
in Anchorage.  Ms. Redman noted that according to the                          
Washington Journal of Medicine, Anchorage has a 42.75                          
percent shortage of primary doctors.  The statewide shortage                   
is 30.95 percent.                                                              
                                                                               
Ms. Redman noted that the state of Alaska pays to reserve 10                   
spots for Alaskan students at the University of Washington.                    
                                                                               
DIANE BARRANS, EXECUTIVE DIRECTOR, POSTSECONDARY EDUCATION                     
COMMISSION, DEPARTMENT OF EDUCATION clarified that the                         
program costs approximately $1.35 million dollars for the                      
second, third and fourth years.                                                
                                                                               
Representative Bunde maintained that rural Alaskans would be                   
better served by placing some of the money into a nurse                        
practitioner program.                                                          
                                                                               
Ms. Barrans pointed out that the current population of                         
doctors in Alaska is aging.  The average Alaskan physician                     
is over 40 years of age.                                                       
                                                                               
Representative Davies emphasized that other students are                       
subsidized by the state of Alaska.                                             
                                                                               
Representative Davis noted that the program provides other                     
benefits to the State.  He pointed out that there are                          
medivac provisions between WAMI states.                                        
                                                                               
Co-Chair Therriault maintained that the state of Alaska                        
would continue to draw students to its residency program.                      
                                                                               
Representative Bunde asserted that the legislation is an                       
attempt to save the WAMI program.  He reiterated that the                      
legislation will only impact students that do not return to                    
the State.                                                                     
                                                                               
Co-Chair Hanley felt that the rural areas would benefit more                   
from a nursing program.                                                        
                                                                               
SUSAN TRYK, UNIVERSITY OF WASHINGTON observed that the                         
University of Washington School of Medicine is partnering                      
with the University of Alaska, Anchorage to develop a                          
physician assistant program, which will be partly in Alaska                    
and partly in the state of Washington.  She did not think                      
the program would require additional state funding.                            
                                                                               
Co-Chair Therriault MOVED to ADOPT an amended effective date                   
of 1998.  There being NO OBJECTION, it was so ordered.                         
                                                                               
Co-Chair Hanley MOVED to ADOPT Amendment 2# (copy on file).                    
Amendment 2# would require repayment of the first year if                      
the student did not return to practice in the state of                         
Alaska for a minimum of five years.                                            
                                                                               
Representative Bunde spoke in support of the amendment.  He                    
observed that the amendment would require repayment of an                      
additional $13 thousand dollars if the student did not                         
return for a minimum of five years.  He emphasized that                        
physicians earn high salaries.  He maintained that the                         
amendment would aid the preservation of WAMI by encouraging                    
students to return to the State. Those that do not return                      
would have an additional liability of approximately $150                       
dollars a month.                                                               
                                                                               
Representative Mulder disclosed that he attended a WAMI                        
presentation in Seattle.                                                       
                                                                               
Representative Mulder spoke in favor of the legislation, but                   
against the amendment.  He considered the first year's                         
exclusion from repayment as a scholarship.  He observed that                   
the first year's funding goes to the state of Alaska.                          
                                                                               
Ms. Redman clarified that WAMI students carry approximately                    
$80 thousand dollars in debt at graduation, regardless of                      
the legislation.  If the legislation were enacted they would                   
have an additional debt of $58 to $74 thousand dollars,                        
depending on the repayment requirements.                                       
                                                                               
Representative Davies spoke against the amendment.  He                         
observed that, if the legislation were enacted, students                       
would face a potential liability of $120 thousand dollars.                     
The amendment would add another $13 thousand dollars.  He                      
feared that students would not want to take the risk.                          
                                                                               
Representative Martin spoke in support of the amendment.  He                   
stressed that students can pay off their debt by working in                    
Alaska for five years.  He expressed concerns that out-of-                     
state students come to Alaska to enter the WAMI program.                       
                                                                               
(Tape Change, HFC 98 - 19, Side 2)                                             
                                                                               
Representative Martin stated that the amendment should                         
clarify in statute that the first year is included in                          
repayment.                                                                     
                                                                               
Ms. Barrans stated that the change to page 2, line 5 would                     
clarify that a student who attended either the University of                   
Alaska or the University of Washington would incur a debt                      
obligation relative to that year.  She felt that further                       
clarification of "contracting" was necessary.  The intent                      
language was added to clarify that all 4 years would be                        
included.                                                                      
                                                                               
Ms. Redman reiterated that of the 12 participating students,                   
who did not graduate in Alaska, 8 were Alaskan students                        
attending prep schools and 2 were military students.  Only                     
two students that did not graduate within the state of                         
Alaska are not accounted for as Alaskan residents.                             
                                                                               
Representative Davies provided members with Amendment 3#                       
(copy on file).  Amendment 3# would insert after "interest"                    
on page 2, line 5, "but does not include costs for the first                   
year of the program delivered at the University of Alaska,                     
Anchorage."  He observed that the amendment could be                           
modified to state the opposite by deleting the "not" before                    
"does".  He clarified that he did not support such an                          
amendment, but offered that it would clarify the intent of                     
Amendment 2#.                                                                  
                                                                               
Co-Chair Hanley WITHDREW Amendment 2#.                                         
                                                                               
Representative Davies MOVED to ADOPT Amendment 3#.  Co-Chair                   
Hanley MOVED to AMEND Amendment 3# to: insert after                            
"interest" on page 2, line 5, "and does include costs for                      
the first year of the program delivered at the University of                   
Alaska, Anchorage."                                                            
                                                                               
Representative Davies OBJECTED to the Amendment to Amendment                   
3#.                                                                            
                                                                               
Ms. Redman clarified that the cost of running the medical                      
program at the University of Alaska is $800 thousand                           
dollars.  In addition, the first year's out-of-state tuition                   
is returned to the University of Alaska, Anchorage.                            
                                                                               
Co-Chair Hanley summarized that the total cost of the WAMI                     
program is approximately $2.1 million dollars for 40                           
students. Co-Chair Therriault stated that it costs $48.2                       
thousand dollars a year per student.                                           
                                                                               
Representative Bunde spoke in support of the amendment.  He                    
maintained that the payback provision needs to be fairly                       
significant.  He compared the salaries of an English teacher                   
and a physician.  He asserted that the payback requirement                     
is not excessive.                                                              
                                                                               
Representative Davies emphasized that, although salaries for                   
some specialties are high, the family or rural                                 
practitioner's salary is not high.  He stressed that the                       
program focuses on the family practitioner.                                    
                                                                               
Representative Davies and Davis disclosed that they also                       
attended WAMI presentations in Seattle.                                        
                                                                               
A roll call vote was taken on the motion.                                      
                                                                               
IN FAVOR: Davis, Grussendorf, Kelly, Martin, Hanley,                           
Therriault                                                                     
OPPOSED: Mulder, Davies                                                        
                                                                               
Representatives Foster, Kohring, and Moses were absent from                    
the vote.                                                                      
                                                                               
The MOTION PASSED (6-2).                                                       
                                                                               
There being NO OBJECTION, the motion to adopt Amendment 3#                     
as amended was passed.                                                         
                                                                               
Ms. Barrans discussed the fiscal noted by the Department of                    
Education.  She estimated that students would be tracked for                   
23 years. She noted that there would be costs associated                       
with form development and administration.                                      
                                                                               
Co-Chair Hanley noted that there would be an increase in                       
general funds of approximately $80 thousand dollars for each                   
student that did not return to practice in Alaska.                             
                                                                               
Representative Mulder MOVED to report CSHB 193 (FIN) out of                    
Committee with the accompanying fiscal note.  There being NO                   
OBJECTION, it was so ordered.                                                  
                                                                               
CSHB 193 (FIN) was REPORTED out of Committee with a "do                        
pass" recommendation and with a fiscal impact note by the                      
Department of Education.                                                       

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