05/14/1999 08:35 AM House HES

SB 71 - PHYSICIAN LICENSURE CHANGES                                                                                             
                                                                                                                                
Number 0032                                                                                                                     
                                                                                                                                
CO-CHAIRMAN DYSON announced the first order of business as                                                                      
Committee Substitute for Senate Bill No. 71(RLS), "An Act relating                                                              
to licensure by the State Medical Board."                                                                                       
                                                                                                                                
Number 0126                                                                                                                     
                                                                                                                                
SHARON CLARK, Legislative Assistant for Senator Mike Miller, Alaska                                                             
State Legislature, came forward to present SB 71.  Senate Bill 71                                                               
is an act relating to licensure by the State Medical Board.  This                                                               
bill was requested for introduction by the Senate Health, Education                                                             
and Social Services (HES) Committee by the State Medical Board who                                                              
fully support the bill.  This bill resolves licensure problems for                                                              
the board, updates Alaska statutes in relation to other states and                                                              
corrects unintended problems within the current law.  On behalf of                                                              
the Alaska State Medical Board, they would like to convey their                                                                 
appreciation to House HES committee members for scheduling this                                                                 
bill, and they would ask their consideration and support of it.                                                                 
                                                                                                                                
MS. CLARK noted that there is a concern with the final version of                                                               
the bill, and a conceptual amendment will be offered.  She                                                                      
indicated that Senator Miller has no problem with it.                                                                           
                                                                                                                                
CO-CHAIRMAN DYSON asked if the State Medical Board was in agreement                                                             
with the changes.                                                                                                               
                                                                                                                                
MS. CLARK acknowledged this bill was written specifically on the                                                                
recommendations of the medical board.  Ms. Clark indicated that                                                                 
they have worked closely with the State Medical Board and the                                                                   
Division of Occupational Licensing.  It was actually Dr. Martha                                                                 
Cotten and Dr. Sarah Isto who came to Senator Miller and asked him                                                              
to sponsor this legislation.                                                                                                    
                                                                                                                                
Number 0399                                                                                                                     
                                                                                                                                
DR. SARAH ISTO, Chair, Alaska State Medical Board, came forward to                                                              
testify in support of SB 71.  This is basically a housekeeping and                                                              
update bill for the medical board.  The board has been working on                                                               
this for a long time.  They have talked with the Alaska State                                                                   
Medical ASsociation, the Alaska Osteopathic Association, and the                                                                
Alaska Family Practice Residency and solicited comments from                                                                    
licensees and rural hospital administrators.  She said she believes                                                             
there is broad support for this.                                                                                                
                                                                                                                                
DR. ISTO noted that SB 71 helps accelerate renewals of licenses.                                                                
Some licenses can be renewed only if the board meets, and the board                                                             
meets quarterly which can be a very awkward situation.  This bill                                                               
will allow the board to consider felony convictions of unclassified                                                             
and Class A felonies that were not committed during the practice of                                                             
medicine.  She cited an example of someone who had committed murder                                                             
at home, not during the practice of medicine, and the statute did                                                               
not allow them to consider that part of his application history.                                                                
Fortunately his application was deficient in other areas, but that                                                              
situation alerted them to a problem that could be of great concern                                                              
to them.                                                                                                                        
                                                                                                                                
DR. ISTO explained that SB 71 requires new applicants who have                                                                  
recently graduated from U.S. and Canadian medical schools to have                                                               
at least two years of postgraduate training.  The vast majority of                                                              
applicants have three years which is the standard number.  There                                                                
are no one-year rotating internships anymore.  People who have only                                                             
one year have started a three-year program and have stopped                                                                     
prematurely.  The board feels that represents an undertraining risk                                                             
to the public.  Other states are going to this same plan, and some                                                              
states require more than two years.  The Alaska board wants to                                                                  
phase it in.  Doctors who did a rotating internship in 1980 and                                                                 
have worked in the state of Washington all this time have all kinds                                                             
of history behind them, and they aren't worried about their                                                                     
competence.  It is the new graduate, who quit training early, that                                                              
they want to address.                                                                                                           
                                                                                                                                
Number 0575                                                                                                                     
                                                                                                                                
CO-CHAIRMAN DYSON told Dr. Isto that he had a member of the                                                                     
profession call him a few months ago who was concerned that the                                                                 
board was not doing fingerprint checks to find out if there is a                                                                
criminal record.  He asked her if that is true.                                                                                 
                                                                                                                                
Number 0596                                                                                                                     
                                                                                                                                
DR. ISTO answered that is correct.  The board requires extensive                                                                
documentation from residencies, the National Practitioner Data                                                                  
Bank, hospitals and other boards.  In the course of that,                                                                       
theoretically, any criminal activity should come up.  If the                                                                    
legislature were interested in that, they should consider nurses                                                                
aides, nurses, people who work with people at home who may be                                                                   
disabled and maybe consider some kind of broad area.  The board has                                                             
not felt the need of doing fingerprint checks.  They investigate so                                                             
extensively that the chances of a medical applicant having a secret                                                             
are pretty slim.  The same extensive documentation would also apply                                                             
to foreigners.                                                                                                                  
                                                                                                                                
CO-CHAIRMAN DYSON asked Dr. Isto why they don't do fingerprint                                                                  
checks.                                                                                                                         
                                                                                                                                
Number 0679                                                                                                                     
                                                                                                                                
DR. ISTO answered that it is not in the statute or regulations.                                                                 
                                                                                                                                
CO-CHAIRMAN DYSON asked her what keeps them from putting it into                                                                
regulation.                                                                                                                     
                                                                                                                                
Number 0692                                                                                                                     
                                                                                                                                
DR. ISTO answered there would probably need to be some kind of a                                                                
statute that would deal with licensing of health care professionals                                                             
for them to then develop a regulation.                                                                                          
                                                                                                                                
CO-CHAIRMAN DYSON asked Dr. Isto if she had seen the amendment.                                                                 
                                                                                                                                
Number 0739                                                                                                                     
                                                                                                                                
DR. ISTO said it had been described to her.  She noted that SB 29                                                               
is also working its way through the process, and it contains                                                                    
exactly the language of this amendment, and this amendment will                                                                 
prevent a conflict between the two bills.  They support SB 29 as                                                                
well.                                                                                                                           
                                                                                                                                
CO-CHAIRMAN DYSON asked her if there was some overlap between the                                                               
two bills.                                                                                                                      
                                                                                                                                
DR. ISTO answered that now both bills delete the requirement for                                                                
citizenship which is what the board desires.  There are qualified                                                               
people who are legally in this country who could be treating                                                                    
patients, but they aren't citizens.                                                                                             
                                                                                                                                
Number 0826                                                                                                                     
                                                                                                                                
CATHERINE REARDON, Director, Division of Occupational Licensing,                                                                
Department of Commerce and Economic Development, came forward to                                                                
testify.  She offered their strong support to this legislation and                                                              
encouraged the committee to pass SB 71 this year if possible.  It                                                               
will help the efficiency which helps all of their customers.                                                                    
                                                                                                                                
REPRESENTATIVE GREEN asked Ms. Reardon if she saw any problem with                                                              
Amendment 1.                                                                                                                    
                                                                                                                                
MS. REARDON answered it is a good idea.                                                                                         
                                                                                                                                
Number 0891                                                                                                                     
                                                                                                                                
CO-CHAIRMAN COGHILL made a motion to adopt a conceptual amendment                                                               
that would on page 2, delete lines 12 and 13, which reads:                                                                      
                                                                                                                                
     (5)  be a citizen of the United States or be lawfully                                                                      
     admitted for permanent residence.                                                                                          
                                                                                                                                
CO-CHAIRMAN DYSON asked whether there was any objection.  There                                                                 
being none, Amendment 1 was adopted.                                                                                            
                                                                                                                                
Number 0927                                                                                                                     
                                                                                                                                
REPRESENTATIVE BRICE made a motion to move HCS CSSB 71, as amended,                                                             
out of committee with individual recommendations and zero fiscal                                                                
note.  There being no objection, HCS CSSB 71(HES) moved from the                                                                
House Health, Education and Social Services Standing Committee.