Legislature(2005 - 2006)CAPITOL 106

04/12/2005 03:00 PM HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 29 HEALTH CARE INSUR./ COMP HEALTH INS. ASSN TELECONFERENCED
<Pending Referral>
+ HB 231 HUMAN SERVICES GRANT ELIGIBILITY TELECONFERENCED
Moved CSHB 231(CRA) Out of Committee
*+ HB 112 CHILD PROTECTION INTERVIEW/TRANSPORT TELECONFERENCED
Scheduled But Not Heard
+ HB 161 REEMPLOYMENT OF RETIREES TELECONFERENCED
Heard & Held
*+ HB 204 OPTOMETRISTS' USE OF PHARMACEUTICALS TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled
                    ALASKA STATE LEGISLATURE                                                                                  
 HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE                                                               
                         April 12, 2005                                                                                         
                           3:10 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Peggy Wilson, Chair                                                                                              
Representative Paul Seaton, Vice Chair                                                                                          
Representative Tom Anderson                                                                                                     
Representative Vic Kohring                                                                                                      
Representative Lesil McGuire                                                                                                    
Representative Sharon Cissna                                                                                                    
Representative Berta Gardner                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                              
HOUSE BILL NO. 231                                                                                                              
"An  Act  relating  to  the   definition  of  'municipality'  for                                                               
purposes of human services community matching grants."                                                                          
                                                                                                                                
     - MOVED CSHB 231(CRA) OUT OF COMMITTEE                                                                                     
                                                                                                                                
HOUSE BILL NO. 161                                                                                                              
"An  Act relating  to reemployment  of and  benefits for  retired                                                               
teachers and  public employees and  to teachers or  employees who                                                               
participated   in   retirement   incentive   programs   and   are                                                               
subsequently reemployed as a commissioner;  repealing secs. 5, 7,                                                               
and  9, ch.  58, SLA  2001; providing  for an  effective date  by                                                               
amending the  delayed effective date for  secs. 3, 5, 9,  and 12,                                                               
ch. 57, SLA 2001, and repealing  sec. 13, ch. 58, SLA 2001, which                                                               
is the delayed effective date for secs.  5, 7, and 9, ch. 58, SLA                                                               
2001; and providing for an effective date."                                                                                     
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
HOUSE BILL NO. 204                                                                                                              
"An Act  relating to the  prescription and use  of pharmaceutical                                                               
agents, including controlled substances, by optometrists."                                                                      
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                              
HOUSE BILL NO. 29                                                                                                               
"An Act relating to health care insurance and to the                                                                            
Comprehensive Health Insurance Association; and providing for an                                                                
effective date."                                                                                                                
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
HOUSE BILL NO. 112                                                                                                              
"An Act relating to child protection, including forensic                                                                        
interviews and transportation of children; and providing for an                                                                 
effective date."                                                                                                                
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                              
BILL: HB 231                                                                                                                  
SHORT TITLE: HUMAN SERVICES GRANT ELIGIBILITY                                                                                   
SPONSOR(S): REPRESENTATIVE(S) WILSON                                                                                            
                                                                                                                                
03/23/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/23/05       (H)       CRA, HES, FIN                                                                                          
04/07/05       (H)       CRA AT 8:00 AM CAPITOL 124                                                                             
04/07/05       (H)       Moved CSHB 231(CRA) Out of Committee                                                                   
04/07/05       (H)       MINUTE(CRA)                                                                                            
04/08/05       (H)       CRA RPT CS(CRA) NT 3DP 2NR                                                                             
04/08/05       (H)       DP: CISSNA, KOTT, LEDOUX;                                                                              
04/08/05       (H)       NR: SALMON, OLSON                                                                                      
04/12/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 161                                                                                                                  
SHORT TITLE: REEMPLOYMENT OF RETIREES                                                                                           
SPONSOR(S): REPRESENTATIVE(S) ELKINS                                                                                            
                                                                                                                                
02/18/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/18/05       (H)       EDU, HES, STA                                                                                          
04/05/05       (H)       EDU AT 11:00 AM CAPITOL 106                                                                            
04/05/05       (H)       Moved CSHB 161(EDU) Out of Committee                                                                   
04/05/05       (H)       MINUTE(EDU)                                                                                            
04/06/05       (H)       EDU RPT CS(EDU) 1DP 5NR 1AM                                                                            
04/06/05       (H)       DP: THOMAS;                                                                                            
04/06/05       (H)       NR: GARA, SALMON, GATTO, LYNN, NEUMAN;                                                                 
04/06/05       (H)       AM: WILSON                                                                                             
04/07/05       (H)       EDU AT 11:00 AM CAPITOL 106                                                                            
04/07/05       (H)       -- Meeting Canceled --                                                                                 
04/12/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                              
BILL: HB 204                                                                                                                  
SHORT TITLE: OPTOMETRISTS' USE OF PHARMACEUTICALS                                                                               
SPONSOR(S): REPRESENTATIVE(S) THOMAS                                                                                            
                                                                                                                                
03/04/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/04/05       (H)       HES, L&C                                                                                               
04/12/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ROSEMARY HAGEVIG, Member                                                                                                        
Board of Directors                                                                                                              
Southeast Conference                                                                                                            
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified during the hearing on HB 231.                                                                    
                                                                                                                                
JANET CLARKE, Assistant Commissioner                                                                                            
Central Office                                                                                                                  
Finance and Management Services                                                                                                 
Department of Health & Social Services                                                                                          
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  During the hearing on HB 231, explained the                                                                
fiscal note prepared by the department.                                                                                         
                                                                                                                                
HEATHER WHEELER, Deputy Director                                                                                                
Municipality of Anchorage                                                                                                       
Department of Health and Human Services (DHHS)                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Her testimony regarding HB 231 was read by                                                                 
Molly Cullom.                                                                                                                   
                                                                                                                                
JIM VANHORN, Staff                                                                                                              
to Representative Jim Elkins                                                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Introduced new information relevant to HB                                                                  
161 on behalf of Representative Elkins, sponsor.                                                                                
                                                                                                                                
MIKE TIBBLES, Deputy Commissioner                                                                                               
Office of the Commissioner                                                                                                      
Department of Administration                                                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on behalf of the department                                                                      
during the hearing on HB 161.                                                                                                   
                                                                                                                                
LEO JOHN KERIN                                                                                                                  
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified during the hearing on HB 161.                                                                    
                                                                                                                                
ROBERT McHATTIE                                                                                                                 
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified during the hearing on HB 161.                                                                    
                                                                                                                                
LARRY WIGET, Director                                                                                                           
Government Relations                                                                                                            
Anchorage School District                                                                                                       
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 161.                                                                            
                                                                                                                                
BRUCE JOHNSON                                                                                                                   
Alaska Association of School Boards (AASB)                                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified that the association is in                                                                       
support of the rehire provision of HB 161.                                                                                      
                                                                                                                                
CHRIS S. CHRISTENSEN, Deputy Administrative Director                                                                            
Administrative Staff                                                                                                            
Office of the Administrative Director                                                                                           
Alaska Court System                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified to express his appreciation of HB                                                                
161.                                                                                                                            
                                                                                                                                
REPRESENTATIVE BILL THOMAS                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Introduced HB 204, as sponsor.                                                                             
                                                                                                                                
CARL ROSEN, M.D., President                                                                                                     
Alaska Eye Physicians and Surgeons                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 204.                                                                         
                                                                                                                                
DONALD J. CINOTTI, M.D.                                                                                                         
Jersey City, New Jersey                                                                                                         
POSITION STATEMENT:  Testified in opposition to HB 204.                                                                         
                                                                                                                                
BOYD WALKER, O.D.                                                                                                               
Homer, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 204.                                                                            
                                                                                                                                
GRIFF STEINER, M.D.                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 204.                                                                         
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
CHAIR PEGGY WILSON called the  House Health, Education and Social                                                             
Services  Standing  Committee meeting  to  order  at 3:10:54  PM.                                                             
Representatives Seaton, Gardner, Cissna,  and Wilson were present                                                               
at  the call  to  order.   Representatives  Kohring, McGuire  and                                                               
Anderson arrived as the meeting was in progress.                                                                                
                                                                                                                                
HB 231-HUMAN SERVICES GRANT ELIGIBILITY                                                                                     
                                                                                                                                
CHAIR  WILSON announced  that  the first  order  of business  was                                                               
HOUSE  BILL  NO. 231,  "An  Act  relating  to the  definition  of                                                               
'municipality' for purposes of  human services community matching                                                               
grants."   [Before  the committee  was  the committee  substitute                                                               
(CS) for HB 231(CRA), Version 24-LS0791\G.]                                                                                     
                                                                                                                                
CHAIR WILSON turned the gavel over to Vice Chair Seaton.                                                                        
                                                                                                                                
3:12:45 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON  introduced HB 231,  as sponsor.  She  described the                                                               
proposed  legislation   as  "a  human  services   matching  grant                                                               
program."     Currently,  the   only  communities   that  receive                                                               
[matching grants]  are Anchorage, Fairbanks, and  - most recently                                                               
-  the  Matanuska-Susitna  (Mat-Su) Valley.    Those  communities                                                               
qualify  because  they  meet  a   population  requirement.    The                                                               
original bill version would expand  the definition of a qualified                                                               
municipality to  include a  consortium of  municipalities located                                                               
in  the same  geographic  area, with  a  population that  exceeds                                                               
50,000; however, an  amendment was adopted in  the last committee                                                               
of referral to change that number to 35,000.                                                                                    
                                                                                                                                
CHAIR  WILSON  said  in  order  to  qualify  for  the  grants,  a                                                               
municipality must:   provide  30 percent  of the  funding, comply                                                               
with  the grant  application process,  and establish  a citizens'                                                               
advisory group to help establish  the priorities in the area "and                                                               
to  see who  gets the  grants."   The proposed  legislation would                                                               
allow Southeast  Alaska to qualify  for the grants "if  they were                                                               
under the umbrella  of someone else."  She  added, "We're looking                                                               
at  Southeast Conference  to be  our  umbrella."   She said  that                                                               
organization  presently works  closely  with  the communities  of                                                               
Southeast Alaska.   She listed [organizations  that are currently                                                               
providing services  in Southeast Alaska]:   Center for Community,                                                               
United  Way,  Alaska Health  Fair,  Inc.,  Southeast Alaska  Food                                                               
Bank,  Catholic Community  Services, [Aiding  Women in  Abuse and                                                               
Rape  Emergencies  (AWARE  Inc.)],  Alaska  Legal  Services,  and                                                               
Southeast Senior Services.                                                                                                      
                                                                                                                                
CHAIR WILSON stated,  "I really think this is  a fairness issue."                                                               
She noted  that there was  a shift  in the legislature  this year                                                               
when it set a precedent by  opening up the availability of grants                                                               
for  utilities that  were private  and previously  could not  get                                                               
grants.                                                                                                                         
                                                                                                                                
3:16:50 PM                                                                                                                    
                                                                                                                                
CHAIR  WILSON,  in response  to  a  question from  Representative                                                               
Gardner, said  she is not aware  of anyone who is  opposed to the                                                               
bill.                                                                                                                           
                                                                                                                                
VICE  CHAIR SEATON  asked Chair  Wilson if  her intention  was to                                                               
have the latest bill version adopted by the committee.                                                                          
                                                                                                                                
3:17:47 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON  said she would  rather work with the  original bill                                                               
than  with   the  committee  substitute  [currently   before  the                                                               
committee, produced  by the House Community  and Regional Affairs                                                               
Standing  Committee].   She  expressed  that  there may  be  some                                                               
reluctance  by the  communities already  receiving the  grants to                                                               
allow  other  communities  to  participate  at  a  lower  minimum                                                               
requirement; they  would rather see communities  pull together in                                                               
order to "get more bang for the  buck."  She said she would leave                                                               
it  up to  the committee  to decide;  however, she  predicted the                                                               
chances of the bill succeeding would  be better if it were in its                                                               
original form.  In response to  a question from Chair Seaton, she                                                               
confirmed that the only difference  between the original bill and                                                               
the  version  from  the  House  Community  and  Regional  Affairs                                                               
Standing Committee is the population requirement.                                                                               
                                                                                                                                
3:19:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  revealed that,  as a  member of  the House                                                               
Community  and  Regional  Affairs  Standing  Committee,  she  had                                                               
participated   in  the   discussion   regarding  the   population                                                               
requirement of  HB 231.   She  said a  committee member  from the                                                               
northern  part of  Alaska had  stated  concern that  it would  be                                                               
difficult enough for communities in  that region to band together                                                               
to meet the requirement of 35,000, let alone 50,000.                                                                            
                                                                                                                                
CHAIR WILSON responded,  "That's left up in the air  in the bill,                                                               
so that  if communities want  to pull  together to do  this, they                                                               
can."  She said geographic area is  not defined in the bill.  She                                                               
indicated  that  the  intent  of  the  bill  is  to  provide  the                                                               
opportunity for communities to succeed  in getting grants if they                                                               
choose to do so.                                                                                                                
                                                                                                                                
CHAIR WILSON [indisc.]                                                                                                          
                                                                                                                                
VICE CHAIR  SEATON, in response  to Chair Wilson,  suggested that                                                               
the  intent of  the committee  now was  [to continue  to use  the                                                               
House Community  and Regional  Affairs Standing  Committee's bill                                                               
version already before the committee].                                                                                          
                                                                                                                                
3:22:06 PM                                                                                                                    
                                                                                                                                
ROSEMARY   HAGEVIG,  Member,   Board   of  Directors,   Southeast                                                               
Conference,  testified on  behalf of  Southeast Conference.   She                                                               
told the committee  that she is also the executive  director of a                                                               
regional  social  services  organization that  could  potentially                                                               
benefit  from the  bill.   She stated  that many  regional social                                                               
services  providers in  Southeast  Alaska support  HB  231.   She                                                               
reported  that the  last U.S.  Census data  shows that  the total                                                               
population in  Southeast Alaska is  just over  70,000; therefore,                                                               
the  region  would  qualify.     She  said  the  social  services                                                               
infrastructure in the region is  having an increasingly difficult                                                               
time  coming  up  with  specific grant  amounts  in  the  various                                                               
budgets.   The proposed legislation would  provide an opportunity                                                               
to infuse  an additional level  of resources into  the community.                                                               
She stated, "Certainly, from my  own personal experience and what                                                               
I know  to be  in place already,  we more than  would be  able to                                                               
meet the required 30 percent match."                                                                                            
                                                                                                                                
MS. HAGEVIG said there was  some discussion in the last committee                                                               
of  referral  regarding the  fiscal  note.    She said,  "In  our                                                               
conversations with  the department, they  shed some light  on why                                                               
that truly  would be a  zero fiscal  note, even thought  they did                                                               
provide  some  scenarios  about eventual  costs."    She  offered                                                               
further  details.   She stated,  "The other  thing that  we would                                                               
like to make  very clear is that we are  not interested in seeing                                                               
anything happen  that would  not hold  harmless our  neighbors to                                                               
the north.   Certainly what is going on  in Anchorage, Fairbanks,                                                               
and now  in MatSu is of  critical importance; we just  would like                                                               
to share  in the  opportunity to  be able  to participate  in the                                                               
same kind of a program."                                                                                                        
                                                                                                                                
MS.  HAGEVIG concluded  by  noting  that there  are  a number  of                                                               
organizations under  the United Way umbrella  in Southeast Alaska                                                               
that  provide region-wide  services,  and  between the  Southeast                                                               
Conference Board  and the United  Way Board, there would  have no                                                               
difficulty  at  all in  putting  together  the required  kind  of                                                               
fiscal oversight that would be necessary.                                                                                       
                                                                                                                                
3:25:54 PM                                                                                                                    
                                                                                                                                
JANET  CLARKE, Assistant  Commissioner,  Central Office,  Finance                                                               
and Management Services, Department  of Health & Social Services,                                                               
explained the fiscal  note prepared by the department.   She said                                                               
the  zero  fiscal  was  prepared  for Version  G.    She  stated,                                                               
"Because  the   program  is  based   on  prorata   proportion  of                                                               
population, it does  not in and of itself require  an increase of                                                               
appropriations."    For  example,  she illustrated  that  if  the                                                               
appropriation is  $1 million, no  matter what number  of grantees                                                               
or  municipalities   qualify,  the  amount  would   be  prorated.                                                               
Second, Ms. Clarke noted that if  the bill were to pass, it would                                                               
not affect  the municipalities who  have already applied  for the                                                               
program  by October  1, 2004  and would  have profound  impact on                                                               
fiscal year  (FY) 07.   She explained, "The  legislation requires                                                               
that  municipalities  apply before  October  1  of the  preceding                                                               
fiscal year, so  for FY 06, the grantees who  would qualify would                                                               
be Anchorage, Fairbanks, and MatSu."                                                                                            
                                                                                                                                
MS.   CLARKE  reviewed   the  two   scenarios  provided   by  the                                                               
department, which  are both  based upon  "the change  to 35,000."                                                               
The first  scenario assumes that regional  consortiums would form                                                               
for  all  regions  of  the  state and  that  there  would  be  no                                                               
additional   money   for   the  program   appropriated   by   the                                                               
legislature.  She added, "If  that were to occur, then Anchorage,                                                               
MatSu, and  Fairbanks would see  significant reductions  in their                                                               
shares  of the  appropriated funds,  and other  communities would                                                               
see a  corresponding increase."   The  second scenario,  which is                                                               
illustrated  on  page  4  of  the  fiscal  note,  uses  the  same                                                               
assumptions in  the first  scenario, but there  would also  be an                                                               
assumption  that  the  legislature would  appropriate  additional                                                               
funds to hold  all communities harmless and  still provide grants                                                               
"for all  the other communities."   The hold-harmless  portion of                                                               
the second scenario would cost an additional $613,483.                                                                          
                                                                                                                                
VICE CHAIR SEATON asked, "Why  is it that only these certain-size                                                               
population  areas  are  given  those  grants  and  they  are  not                                                               
extended to other  areas that may have the same  kind of programs                                                               
and be able to come up with a local match?"                                                                                     
                                                                                                                                
3:29:46 PM                                                                                                                    
                                                                                                                                
MS. CLARKE  responded by  offering a synopsis  of the  history of                                                               
the program.  She said the  program was put into statute in 1992.                                                               
Prior to that, there were  block grants provided to Anchorage and                                                               
Fairbanks, which began in the  early 80s when money was abundant.                                                               
She said, "The idea at the  time was that Fairbanks and Anchorage                                                               
were  disproportionately affected  by  social services  programs,                                                               
because  they were  such large  hub communities;  people came  to                                                               
those communities for  services, and the view was  that the state                                                               
ought to  offset some of  those costs that the  local communities                                                               
were absorbing."   At the  same time there  was a lot  more money                                                               
available for designated grants  for other communities throughout                                                               
the  state.   Ms.  Clarke said  that that  money  does not  exist                                                               
anymore  in her  department,  and she  offered her  understanding                                                               
that  it doesn't  exist  in  any other  department  either.   The                                                               
statute  was written  in  1992 so  that  Anchorage and  Fairbanks                                                               
would  qualify.   Now, because  of its  population increase,  the                                                               
Matanuska  Susitna Borough  qualifies for  the grants,  which has                                                               
changed the dynamics of the funding for the program.                                                                            
                                                                                                                                
MS. CLARKE,  in response  to a question  from Vice  Chair Seaton,                                                               
said she thinks there were  some other designated grants to other                                                               
local communities  that are no  longer designated in  the budget.                                                               
She  stated  that there  was  more  opportunity for  other  local                                                               
municipalities to get social services funding.                                                                                  
                                                                                                                                
CHAIR WILSON interpreted Ms. Clarke  to have said that "everybody                                                               
was getting  some kind  of extra  help -  as funds  - in  all the                                                               
areas, but slowly,  as the money tightened  up, they discontinued                                                               
the  help  in the  smaller  areas,  but Anchorage  and  Fairbanks                                                               
continued with theirs."                                                                                                         
                                                                                                                                
MS.  CLARKE  responded that  that's  correct.   She  offered  her                                                               
understanding  that,  at one  point,  the  social services  block                                                               
grants were  up to $4  million and  have been "ratcheted  back to                                                               
the level they are now."   She added, "Certainly the block grants                                                               
themselves have been reduced, as well."                                                                                         
                                                                                                                                
3:33:30 PM                                                                                                                    
                                                                                                                                
HEATHER  WHEELER,  Deputy  Director, Municipality  of  Anchorage,                                                               
Department  of   Health  and  Human  Services   (DHHS),  had  her                                                               
testimony  read by  Molly Cullom,  Grant Administrator,  DHHS, as                                                               
follows:                                                                                                                        
                                                                                                                                
     The Anchorage  Department of Health and  Human Services                                                                    
     supports HB 231 and the  effort to expand human service                                                                    
     matching   grant  programs   to  benefit   more  Alaska                                                                    
     communities.   However, with  that expansion,  we would                                                                    
     hope  the legislature  would ensure  sufficient funding                                                                    
     to  hold current  recipients  harmless.   Passing  this                                                                    
     legislation  with sufficient  funding  will allow  more                                                                    
     communities  to   provide  the  essential   safety  net                                                                    
     services to  prevent or  alleviate serious  physical or                                                                    
     mental hardship  in this  state, while  not diminishing                                                                    
     services  in current  recipient  communities.   Through                                                                    
     grants to local nonprofit  agencies, the human services                                                                    
     matching  grant supports  the basic  services that  are                                                                    
     critical  to  our  state's  most  vulnerable  citizens:                                                                    
     children, abuse  victims, those in temporary  crisis or                                                                    
     homelessness, and senior citizens.                                                                                         
                                                                                                                                
     ...  Human service  grant funding  was originally  made                                                                    
     available to larger Alaska communities  in the 1980s in                                                                    
     an effort to offset  the disproportionate demand coming                                                                    
     from  people  all over  the  state.   The  municipality                                                                    
     continues  to  serve  the state  as  a  hub  community,                                                                    
     drawing and  attracting people for services  around the                                                                    
     state to  Anchorage.  Because Anchorage  serves so many                                                                    
     people from outside its borders,  it is in this state's                                                                    
     best  overall  interest  for  the  legislature  not  to                                                                    
     decrease funding  for Anchorage  in order to  make room                                                                    
     for more communities.                                                                                                      
                                                                                                                                
     Currently,  65  percent  of Anchorage's  human  service                                                                    
     matching  grant  funding  goes  for  food  and  shelter                                                                    
     programs.   These services  are associated  with people                                                                    
     on  the   move,  people  in   crisis,  and   people  in                                                                    
     transition  to   and  from  rural  communities.     The                                                                    
     municipality   of  Anchorage   believes   in  being   a                                                                    
     responsible  citizen of  the State  of  Alaska and,  as                                                                    
     such,  has  never  closed  its  doors  to  people  from                                                                    
     outside  of Anchorage  who seek  services.   Because of                                                                    
     this,  if more  communities become  eligible for  human                                                                    
     service  dollars, we  ask  that  sufficient funding  be                                                                    
     provided to sustain current services.                                                                                      
                                                                                                                                
VICE CHAIR SEATON  said the committee would  probably be "looking                                                               
at that  support"; however, that would  happen a year, or  so, in                                                               
the  future,  "because  we're  not   talking  about  our  current                                                               
budget."                                                                                                                        
                                                                                                                                
3:37:12 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON stated her intentions for  the bill were not to make                                                               
things worse  for any  other area  in the state.   She  asked Ms.                                                               
Clarke if  she would submit  an increased budget to  the governor                                                               
if, for example, she were to  get two new applications by October                                                               
1.                                                                                                                              
                                                                                                                                
MS. CLARKE responded, "We would  certainly prepare the request to                                                               
the governor so  that he would be aware of  what the implications                                                               
would  be  if  that  was  not  funded."    She  added  that  that                                                               
information would be made available to the legislature, as well.                                                                
                                                                                                                                
VICE  CHAIR SEATON  conveyed to  Ms. Wheeler  through Ms.  Cullom                                                               
that if  all the  grants are going  through the  main communities                                                               
and are not  provided to the outlying communities,  that tends to                                                               
bring the  people who need services  to the hub communities.   He                                                               
said  he  thinks the  purpose  of  the  bill  is "to  allow  some                                                               
distribution so that we can  keep people in the communities where                                                               
they reside."                                                                                                                   
                                                                                                                                
VICE CHAIR SEATON closed public testimony.                                                                                      
                                                                                                                                
REPRESENTATIVE  GARDNER  moved to  report  CSHB  231(CRA) out  of                                                               
committee  with individual  recommendations and  the accompanying                                                               
fiscal  notes.   There  being  no  objection, CSHB  231(CRA)  was                                                               
reported  from the  House Health,  Education and  Social Services                                                               
Standing Committee.                                                                                                             
                                                                                                                                
[Vice Chair Seaton handed the gavel back to Chair Wilson.]                                                                      
                                                                                                                                
HB 161-REEMPLOYMENT OF RETIREES                                                                                             
                                                                                                                                
CHAIR WILSON announced that the  next order of business was HOUSE                                                               
BILL NO.  161, "An Act  relating to reemployment of  and benefits                                                               
for  retired teachers  and public  employees and  to teachers  or                                                               
employees who  participated in retirement incentive  programs and                                                               
are subsequently  reemployed as  a commissioner;  repealing secs.                                                               
5, 7,  and 9, ch. 58,  SLA 2001; providing for  an effective date                                                               
by amending  the delayed effective  date for  secs. 3, 5,  9, and                                                               
12, ch.  57, SLA 2001, and  repealing sec. 13, ch.  58, SLA 2001,                                                               
which is  the delayed effective date  for secs. 5, 7,  and 9, ch.                                                               
58, SLA 2001; and providing for an effective date."                                                                             
                                                                                                                                
3:40:41 PM                                                                                                                    
                                                                                                                                
JIM VANHORN,  Staff to Representative Jim  Elkins, introduced new                                                               
information  relevant  to  HB 161  on  behalf  of  Representative                                                               
Elkins, sponsor.   He reviewed  that the legislation  would allow                                                               
the   rehiring  of  certain public  employees' retirement  system                                                               
(PERS) and teachers' retirement  system (TRS) members who retired                                                               
with a normal  retirement.  These rehired  employees can continue                                                               
to receive normal  retirement and benefits if  they waive further                                                               
participation in the retirement systems.   During their period of                                                               
reemployment,  he said,  no  contributions to  PERS  and TRS  are                                                               
required  from  the  employee  or the  employer.    The  proposed                                                               
legislation would sunset July 1, 2009.                                                                                          
                                                                                                                                
MR. VANHORN  directed attention to  an Alaska  Legislative Report                                                               
entitled, "Results  of the Retiree  Return Program,"  produced by                                                               
the Division of Retirement and  Benefits and dated February 2005.                                                               
The report  shows that,  as of  November 30,  2004, there  were a                                                               
total  of  211  retirees  rehired under  PERS  and  124  retirees                                                               
rehired under TRS,  for a total of 335 employees,  statewide.  He                                                               
said that equates  to one-tenth of 1 percent of  all PERS and TRS                                                               
participants.  He turned to a  paragraph on page 4 of the report,                                                               
which read as follows [original punctuation provided]:                                                                          
                                                                                                                                
     On September  14, 2004 the  Division of  Retirement and                                                                    
     Benefits   received   an   Attorney   General   Opinion                                                                    
     regarding  the employment  status of  returned retirees                                                                    
     as of the sunset date  of the legislation.  The opinion                                                                    
     states  that once  the reemployment  amendments to  the                                                                    
     PERS  and   TRS  statutes  sunset  on   July  1,  2005,                                                                    
     reemployed  retirees can  no longer  receive retirement                                                                    
     benefits while employed by a  PERS or TRS employer.  If                                                                    
     they continue  employment with a PERS  or TRS employer,                                                                    
     they must begin making  contributions to the retirement                                                                    
     systems and have their retirement benefits stopped.                                                                        
                                                                                                                                
MR. VANHORN said the attorney  general opinion came as a complete                                                               
surprise  to many.   He  stated,  "The general  opinion was  that                                                               
after  the  initial  period, the  legislature  would  review  the                                                               
program to  see whether or not  it was successful, and  decide if                                                               
it should be  continued.  Life decisions were made  based on this                                                               
opinion; now they  slam shut in their faces."   Mr. Vanhorn noted                                                               
that  the original  legislation was  a component  of a  workforce                                                               
development initiative  of the state,  and a number  of employers                                                               
undertook to address workforce shortages  that were already being                                                               
experienced.                                                                                                                    
                                                                                                                                
MR.  VANHORN directed  attention to  an article  entitled, "State                                                               
Worker Shortage Looms," from a  February 2005 issue of state news                                                             
[included in the committee packet].   The article shows that many                                                               
states  are  currently  facing  the  effects  of  an  approaching                                                               
retirement implosion that follows  Baby Boomers into their golden                                                               
years.  Mr.  Vanhorn paraphrased some highlights  of the article,                                                               
including:  A  2002 study showed that 30 percent  of many states'                                                               
workforces would be retirement eligible  by 2006; and compounding                                                               
an  approaching shortage  of workers,  a  [Nelson A.  Rockefeller                                                               
Institute  of  Government]  study confirms  that  nationally,  50                                                               
percent  of   government  jobs   are  in   occupations  requiring                                                               
specialized training, education, or  job skills, compared to just                                                               
29 percent in  the private sector.  Mr. Vanhorn  stated that it's                                                               
obvious the  workforce shortage will  not go away, but  will only                                                               
intensify with time.                                                                                                            
                                                                                                                                
MR. VANHORN  said that during  a hearing  on the bill,  the House                                                               
Special  Committee on  Education adopted  a committee  substitute                                                               
for HB 161  that clearly states that  the legislature understands                                                               
that  the  rehire of  retirees  is  a  valuable tool  for  school                                                               
districts  and public  employers to  manage workforce  shortages.                                                               
The committee substitute also finds  that human resource managers                                                               
must plan to meet their  future workforce needs, without reliance                                                               
on retired workers.                                                                                                             
                                                                                                                                
MR. VANHORN directed attention to the  pie charts on pages 13 and                                                               
24 of the previously noted report.   He said the charts show that                                                               
the  majority of  retirees that  have been  rehired were  retired                                                               
over 24 months before coming back  to work, and the percentage of                                                               
rehires has slowly decreased since  2002.  Mr. mentioned the zero                                                               
fiscal note in the committee  packet.  He concluded, "The current                                                               
legislation  has provided  human resource  managers an  excellent                                                               
tool to  retain workers for  hard-to-fill positions, and  we urge                                                               
... passage of this extension."                                                                                                 
                                                                                                                                
3:46:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCGUIRE  stated, "I am  embarrassed that I  was in                                                               
the legislature  at the time  that this bill  passed.  ...   This                                                               
bill was  intended for  very narrow  circumstances:   [For] small                                                               
communities in Alaska  where there was a  teacher shortage, where                                                               
kids were  being left behind  ... because there  weren't adequate                                                               
teachers  there."   Representative McGuire  said there  were also                                                               
statements made about the need  for public health workers in some                                                               
communities where there was a shortage.   She said, "I signed off                                                               
on  those  very  narrow  circumstances, with  the  agreement  and                                                               
understanding that  this program would  sunset and that  we would                                                               
take a look at how it had been  used ...."  She said the time has                                                               
come  to review  the  program.   Representative McGuire  reported                                                               
that there  is a staggering  amount of information  regarding the                                                               
abuse   of   the   program   by   the   current   and   preceding                                                               
administrations.   She  offered an  example  of the  abuse.   She                                                               
stated,  "I don't  even  think  we will  begin  to  see the  full                                                               
effects of what's  happened over the last five  years for decades                                                               
to come."                                                                                                                       
                                                                                                                                
REPRESENTATIVE  MCGUIRE  said  she cannot,  in  good  conscience,                                                               
support the extension  and she thinks the  program should sunset.                                                               
She said  she has heard  concern that the  state may be  sued for                                                               
ending  the  program.    Conversely,  she  stated  that  she  has                                                               
personally studied  the waiver that the  rehired employees signed                                                               
and "there  is no possible way  that a state employee  could have                                                               
reasonably relied upon  anything other than the  waiver that they                                                               
signed,  which clearly  stated that  this sunset  would occur  in                                                               
July."   She  said some  people  would argue  that the  personnel                                                               
board  has  made "other  statements,"  but  she said  many  times                                                               
statements are made  that end up not being true.   She offered an                                                               
example.                                                                                                                        
                                                                                                                                
3:51:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON said  there  has  been a  misunderstanding                                                               
that those on the program would  have to quit their jobs when the                                                               
program sunsets.  He stated for  the record that those people can                                                               
continue their employment;  they would just be put  back into the                                                               
retirement system.                                                                                                              
                                                                                                                                
MR.  VANHORN confirmed  that  is true.   He  noted  that TRS  has                                                               
stringent  "sideboards," while  PERS does  not.   He agreed  that                                                               
there  probably have  been  abuses to  the  program; however,  he                                                               
pointed out  that the [United  Fishermen of Alaska]  are strongly                                                               
behind the bill,  because, without it, 30 or  more fish biologist                                                               
will be  lost.  He  offered further  details.  Mr.  Vanhorn noted                                                               
that [HB 161] is a companion bill to a Senate bill.                                                                             
                                                                                                                                
3:54:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  said it  has been  reported that  PERS and                                                               
TRS are in  trouble.  She stated, "It seems  sort of inconsistent                                                               
to at one  time be talking about  how to fix that  program ... at                                                               
the  same  time that  we're  talking  about ...  continuing  with                                                               
something  that would  only make  it  harder for  the program  to                                                               
exist, because it's the continual  paying in to that program that                                                               
gives  it  the strength  that  allows  it  to continue,  I  would                                                               
assume."                                                                                                                        
                                                                                                                                
MR. VANHORN reminded Representative  Cissna that the bill carries                                                               
with it  a zero fiscal  note.  He added,  "The total cost  ... is                                                               
$106.53."      In   response  to   a   follow-up   comment   from                                                               
Representative  Cissna, Mr.  Vanhorn  indicated  that the  fiscal                                                               
note reflects the  impact on the retirement systems.   He offered                                                               
further details.                                                                                                                
                                                                                                                                
3:55:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON,  in  response  to a  request  from  Chair                                                               
Wilson, offered  some background information  on PERS and  TRS as                                                               
it  relates to  the proposed  bill.   He  said if  [the State  of                                                               
Alaska] was  "collecting under  the normal cost  rate all  of the                                                               
money that  would be  necessary for  a person's  retirement," the                                                               
amount of employees makes no  difference.  However, he explained,                                                               
there  is  a  $15  billion  past  service  cost  liability.    He                                                               
continued as follows:                                                                                                           
                                                                                                                                
     So, what has  happened in the past use of  this bill is                                                                    
     that the  employers are not  paying in on ...  the past                                                                    
     service cost.  ...  The contribution rate is escalating                                                                    
     at 5  percent a year,  so, in  just a few  years, we're                                                                    
     going to be  paying, like, 44 percent  for the teachers                                                                    
     for the  past service  cost.  ...  I haven't  looked at                                                                    
     the new CS on this bill  as to whether this bill is now                                                                    
     going  to  make the  employers  use  their entire  wage                                                                    
     base,  including these  "waivered" employees.   ...  If                                                                    
     they make that contribution  for the waivered employees                                                                    
     -  in other  words if  they  would be  paying into  the                                                                    
     system -  then it wouldn't have  the effect.  If  it is                                                                    
     as  it  has  been  currently, there  is  a  detrimental                                                                    
     effect,  because  they're not  paying  in  on the  past                                                                    
     service cost.                                                                                                              
                                                                                                                                
MR. VANHORN referred  to language in CSHB 161(EDU),  which was on                                                               
page 2, lines 12-14, and read as follows:                                                                                       
                                                                                                                                
          (c) It is the intent of the legislature that                                                                          
     employers  that  benefit  from the  provisions  of  the                                                                    
     retiree  reemployment provisions  pay  any increase  in                                                                    
     unfunded  liability  that  results  to  the  retirement                                                                    
     systems.                                                                                                                   
                                                                                                                                
MR.  VANHORN directed  attention  to page  11  of the  previously                                                               
mentioned report,  which shows  a less than  1 percent  impact on                                                               
the [retirement] system.  He offered further details.                                                                           
                                                                                                                                
REPRESENTATIVE SEATON  moved to  adopt [the  committee substitute                                                               
(CS)  for 161(EDU),  Version 24-LS0645\G,  Craver, 4/5/05],  as a                                                               
work draft.   There being no objection, Version G  was before the                                                               
committee.                                                                                                                      
                                                                                                                                
3:59:58 PM                                                                                                                    
                                                                                                                                
MIKE TIBBLES,  Deputy Commissioner,  Office of  the Commissioner,                                                               
Department of  Administration, regarding the cost  to the system,                                                               
said one concern that has  arisen is about bringing an individual                                                               
back  that  would  receive  a benefit  without  paying  into  the                                                               
system.      He   augmented  Representative   Seaton's   previous                                                               
explanation as follows:                                                                                                         
                                                                                                                                
     When we  hire an  individual, we  are paying  a blended                                                                    
     rate:   a  normal cost  rate and  a past  service rate.                                                                    
     The normal  cost rate is  the amount of  the retirement                                                                    
     benefit that that individual  received after putting in                                                                    
     a number of  years of service - either 30  years, or 25                                                                    
     years, or reaching retirement eligibility  by age.  But                                                                    
     the benefit  that they receive  is based on  the amount                                                                    
     that they and the employer  have been paying over their                                                                    
     lifetime for  their career.   So, for example,  if they                                                                    
     worked 30 years, ... their  pension benefit is based on                                                                    
     the amount  that's paid, so there's  no additional cost                                                                    
     to the system for  that individual coming back, because                                                                    
     that   individual's   not   accruing   any   additional                                                                    
     benefits.                                                                                                                  
                                                                                                                                
     ...  Since we  have this  unfunded liability,  the cost                                                                    
     isn't  associated  with  an individual;  however,  it's                                                                    
     associated  with the  system -  it's $5  billion-worth.                                                                    
     When we  take out  an individual  from the  system ...,                                                                    
     their salary-base  is used to  allocate out a  cost for                                                                    
     past service  rate.  Then  there becomes a  higher rate                                                                    
     among the other members.                                                                                                   
                                                                                                                                
MR.  TIBBLES,  regarding  the  impact of  the  program,  said  an                                                               
actuary  calculated a  separate threshold  for PERS  and TRS  and                                                               
reported that  "at 100 participants of  a 242 waiver, there  is a                                                               
$106,000  impact  to  the  system."    In  PERS,  there  are  211                                                               
employees, so  "the impact doesn't trigger  until 500 employees."                                                               
He explained, "So,  we have a long  way to go on  the PERS system                                                               
before they can actually put a  dollar amount to the impact."  He                                                               
continued as follows:                                                                                                           
                                                                                                                                
     So, what the ... committee  substitute that you have in                                                                    
     front of you does, is  it requires all employers - when                                                                    
     they  bring  an individual  back  -  to pay  that  past                                                                    
     service rate at the point  that they can put the dollar                                                                    
     amount to  it - when  it no longer  becomes negligible.                                                                    
     ...   The  net  effect  is:   When  an employer  brings                                                                    
     somebody back  on a 242  waiver, they're going  to save                                                                    
     the normal  cost rate;  it's going to  be a  savings to                                                                    
     their  system.   The State  of Alaska  saved a  million                                                                    
     dollars.                                                                                                                   
                                                                                                                                
MR. TIBBLES said  although it's certainly not the  reason for the                                                               
program, the State of Alaska  has saved a million dollars because                                                               
of  it.   He concluded,  "Going forward  under ...  the committee                                                               
substitute you  have in  front of  you, we  would be  required to                                                               
pay:   TRS  would  be an  increase  of .01  percent,  and at  500                                                               
participants on PERS would be .02 percent."                                                                                     
                                                                                                                                
MR. TIBBLES, in  response to a question from  Chair Wilson, noted                                                               
that the language  regarding a requirement for  a contribution by                                                               
employers for  the past service cost  is found "in Section  3 for                                                               
TRS  and Section  4 for  PERS."   He explained  that the  way the                                                               
system  is currently  set up,  the  director of  the Division  of                                                               
Retirement &  Benefits monitors the  number of  participants and,                                                               
at the point that he/she has  been told by the actuary that there                                                               
is an impact, then "costs will go  out to all the employers."  He                                                               
said he would  support a change to automatically  charge the past                                                               
service rate  equal to every  other employee; thereby,  even when                                                               
the  cost is  negligible, some  amount could  still be  collected                                                               
into the system.                                                                                                                
                                                                                                                                
4:07:16 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON  said she thinks  the state has a  responsibility to                                                               
be "covering what we need to cover."                                                                                            
                                                                                                                                
4:07:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER  directed attention to language  on page 2                                                               
[of Version G, beginning on line 4], which read as follows:                                                                     
                                                                                                                                
     In extending  the termination date of  the reemployment                                                                    
     provisions,  it is  the intent  of  the legislature  to                                                                    
     allow   school  districts   and  public   employers  to                                                                    
     continue to use this  management tool, while developing                                                                    
     plans   that  address   the   knowledge,  skills,   and                                                                    
     abilities that  need to be transferred  or developed to                                                                    
     assure   the  work   can  be   accomplished  when   the                                                                    
     reemployment provisions terminate.                                                                                         
                                                                                                                                
REPRESENTATIVE  GARDNER  asked  if   that  language  was  in  the                                                               
original "waiver legislation."                                                                                                  
                                                                                                                                
MR. TIBBLES answered that he doesn't know.                                                                                      
                                                                                                                                
4:09:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER clarified  that she wanted to  know if the                                                               
original  plan was  a temporary  one,  with the  intent that  the                                                               
employers  have a  contingency plan  for "the  end of  the waiver                                                               
program."                                                                                                                       
                                                                                                                                
REPRESENTATIVE MCGUIRE  stated her understanding of  the original                                                               
legislation was  designed as a temporary  crisis management tool,                                                               
which is why there was a sunset clause.                                                                                         
                                                                                                                                
4:11:03 PM                                                                                                                    
                                                                                                                                
MR.  TIBBLES said  the original  sunset clause  was added  to the                                                               
original  House Bill  242 in  the House  Finance Committee  after                                                               
discussion regarding the impact  to entry-level positions and how                                                               
the people in those positions would  be able to move up in career                                                               
progression.    He said  that  amendment  was  the basis  of  the                                                               
decision of  the Department of Law  last year that said  that the                                                               
individuals currently enrolled  in a 242 waiver will,  as of July                                                               
1, [2005], stop receiving the pension benefits.                                                                                 
                                                                                                                                
4:12:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MCGUIRE opined  that without  the sunset  clause,                                                               
the bill  would not have passed.   She said there  was concern at                                                               
the  time [House  Bill 242]  was on  the floor  regarding whether                                                               
there may be  other options, such as  recruitment and retraining,                                                               
rather than "giving people paychecks after they retire."                                                                        
                                                                                                                                
REPRESENTATIVE  SEATON   said  the  purpose  of   the  previously                                                               
mentioned language in the bill was  to analyze what the effect of                                                               
the program was  on upward mobility of people  within the system,                                                               
and he noted that letters  had been received indicating that [the                                                               
waiver program] has been a  severe detriment to people attempting                                                               
to have upward  mobility.  He asked, "Where is  that addressed in                                                               
the [previously mentioned] report?                                                                                              
                                                                                                                                
4:14:14 PM                                                                                                                    
                                                                                                                                
MR. TIBBLES responded  that there was language in  House Bill 242                                                               
that  required a  report  to the  legislature;  however, it  only                                                               
applied to the TRS system.   The report provided to the committee                                                               
complies with the requirement that  was submitted in the original                                                               
legislation.   He stated that  the administration  has additional                                                               
concerns  regarding   how  the   program  has   been  implemented                                                               
differently  in each  department.   He stated,  "I would  like to                                                               
walk through  the administrative  order that the  governor signed                                                               
on March 8,  that implements the sideboards and  talks about what                                                               
we're  going  to  require  the  departments to  do  ...  and  the                                                               
workforce  planning that  needs  to take  place  before they  can                                                               
bring an individual back on 242."                                                                                               
                                                                                                                                
4:14:54 PM                                                                                                                    
                                                                                                                                
LEO JOHN KERIN,  at the request of the chair  and in the interest                                                               
of  time,   offered  an  abbreviated   version  of   his  written                                                               
testimony, which  he said  he would  send to  the committee.   He                                                               
said he taught  in a rural school district  and strongly supports                                                               
any measures  taken to support  excellence in education  in rural                                                               
Alaska, but is not convinced that  "the rehire bill is the way to                                                               
do that."   He said he would send alternative  suggestions to the                                                               
committee by facsimile.   Mr. Kerin stated  his strong opposition                                                               
to the  extension of the rehire  bill for PERS employees  for the                                                               
following  reason:    "While  there  ... may  be  a  shortage  of                                                               
qualified teachers willing  to work in rural Alaska,  there is no                                                               
shortage of  qualified applicants  willing to  work in  town with                                                               
the  state  government   bureaucracy,  court  system,  university                                                               
system, or municipal government."  He continued as follows:                                                                     
                                                                                                                                
     If there  was a  problem finding  qualified applicants,                                                                    
     as  was  recently  the  case  for  [the  Department  of                                                                    
     Transportation & Public  Facilities (DOT&PF)] technical                                                                    
     engineers,  the  Department   of  Administration  would                                                                    
     adjust  their ...  internal alignment  of salaries  for                                                                    
     the job class to attract  more applicants.  If there is                                                                    
     a  real short-term  shortage  of experienced  personnel                                                                    
     for a specific job, ... there  is and always has been a                                                                    
     contracting procedure to gain the needed expertise.                                                                        
                                                                                                                                
MR. KERIN said  there has been significant abuse  by the program.                                                               
He  indicated that  the  administration  acknowledged that  abuse                                                               
when  it   brought  forth  a  corrective   administrative  order;                                                               
however, he  said that order  is like  closing a barn  door after                                                               
the horses  are out.  He  mentioned a "flood of  recently retired                                                               
and rehired  employees, many of  whom never bothered  their desks                                                               
during the 30-day  waiting period."  He asked, "If  there is such                                                               
a  brain-drain for  retiring baby  boomers, why  was the  program                                                               
only offered to a select  few higher-level administrators instead                                                               
of all retirement-age employees?"                                                                                               
                                                                                                                                
MR. KERIN said  early retirement legislation has  not been around                                                               
for very  long.   He said  now provisions have  been made  to let                                                               
commissioners come back from early  retirement, without having to                                                               
make  restitution  to  PERS  as is  required  in  the  retirement                                                               
incentive program bills.  He  said there has been much discussion                                                               
regarding  the potential  for lawsuits  from  people who  believe                                                               
that  the  information  given  to   them  from  the  Division  of                                                               
Retirement & Benefits meant that  they would be "grandfathered in                                                               
for life."   He said,  "I would worry  more about all  the people                                                               
who ...  retired early  asserting that they  should be  given the                                                               
same  opportunity as  all the  other double-dippers  in the  same                                                               
job."                                                                                                                           
                                                                                                                                
MR.  KERIN stated  his belief  that no  realistic evaluation  has                                                               
been  made  regarding  "the  cost  of PERS  of  inducing  Tier  I                                                               
employees  to retire  on time,  thereby affecting  the retirement                                                               
program's  actuarials."     He  offered  further   details.    He                                                               
suggested that more testimony against  [HB 161] is not heard from                                                               
"the rank  and file  employees," because  it's only  their bosses                                                               
who  are  being  given  "this platinum  parachute."    He  added,                                                               
"There's a real fear of retaliation."                                                                                           
                                                                                                                                
MR.  KERIN said  that though  the bill  is well  intentioned, the                                                               
sunset needs  to take place.   He asked  that at the  very least,                                                               
the administration make  the positions of those in  PERS who have                                                               
already  been rehired  be subject  to reexamination  "pursuant to                                                               
the safeguards  of the  recent administrative  order."   He said,                                                               
"If it can  be shown that a  true shortage exists for  the job in                                                               
question, the person should be  allowed to retain their job while                                                               
restitution is made  to ... PERS ..., as would  take place if the                                                               
person  had taken  an  early  retirement.   Any  other course  of                                                               
action results  in all  members of PERS  shouldering the  cost of                                                               
these  people's 60  percent bonus."   Mr.  Kerin opined  that the                                                               
legislature also  needs to  be forthright  about the  transfer of                                                               
general fund  operating costs that have  already been transferred                                                               
to PERS/TRS as a result of existing rehire legislation.                                                                         
                                                                                                                                
4:21:56 PM                                                                                                                    
                                                                                                                                
ROBERT  McHATTIE,  testifying  on  behalf of  himself,  told  the                                                               
committee that he is a  retired PERS member, formerly employed by                                                               
DOT&PF.    He thanked  Representative  McGuire  for her  previous                                                               
comments, which he  said mirror his own.  He  said House Bill 242                                                               
originally addressed hard-to-hire  teaching positions, especially                                                               
in the  Bush.  He posited  that the rehiring of  retired teachers                                                               
has generally been more justified  and carefully handled compared                                                               
to the mostly supervisory and  "important person" rehires done in                                                               
PERS.  He offered an example of the careful handling in TRS.                                                                    
                                                                                                                                
MR. McHATTIE,  regarding PERS, said he  thinks it's self-interest                                                               
that makes  those who are  going to be  or have been  rehired and                                                               
those who  represent agencies  that do  the rehiring  support the                                                               
proposed legislation.   He said  he personally  knows lower-level                                                               
staff  members  in several  different  agencies  who are  against                                                               
these hiring practices but are  afraid to give negative testimony                                                               
for fear of reprisals from  management or senior workers who have                                                               
been rehired  or intend to  return.  Mr. McHattie  said obviously                                                               
it  is   the  lower-level  staffers'   paychecks  that   will  be                                                               
diminished when the legislature  jacks up the PERS contributions,                                                               
without  collecting it  from those  who  have been  rehired.   He                                                               
clarified, "[Those  formerly retired  employees who  are rehired]                                                               
collect two  fat paychecks  while paying  nothing into  PERS, and                                                               
the coworkers ... know that's going on."  He concluded:                                                                         
                                                                                                                                
     It   has   been   argued  that   individuals   are   so                                                                    
     knowledgeable and  experienced, that they or  others on                                                                    
     the staff  cannot be  replaced.  While  I am  sure that                                                                    
     long-term  employees  all  consider  themselves  to  be                                                                    
     irreplaceable  - I  know I  did while  I was  working -                                                                    
     that argument  just doesn't wash.   Administrators have                                                                    
     always  had  the  responsibility of  making  sure  that                                                                    
     staff  positions can  be covered  in  case of  illness,                                                                    
     vacations,   death,   or    somebody   just   quitting.                                                                    
     Considering that vacations  for long-term employees can                                                                    
     extend  most   of  a  month,  I   assume  that  various                                                                    
     organizations  don't  fall   apart  during  that  time.                                                                    
     Every employee  is replaceable by necessity,  except in                                                                    
     cases   where  poor   management   or  favoritism,   or                                                                    
     something like that, exists.                                                                                               
                                                                                                                                
4:26:33 PM                                                                                                                    
                                                                                                                                
LARRY  WIGET, Director,  Government  Relations, Anchorage  School                                                               
District, testified  in support of  the legislative intent  of HB                                                               
161 to rehire retired employees  when there is an actual shortage                                                               
of applicants for the vacant  position, and urged the legislature                                                               
to extend  the sunset  date for the  legislation with  the caveat                                                               
that similar restrictions  currently placed on the  rehire of TRS                                                               
employees  - AS  14.21.35 -  be  adopted for  PERS employees,  as                                                               
well.   He stated  concern that the  pre-selection and  hiring of                                                               
retirees to fill  the job they have just  vacated, without regard                                                               
as to  whether or not  there is  a qualified applicant  pool from                                                               
which to draw,  eliminates the career ladder  in state employment                                                               
for other employees  who are qualified and may  apply and, unlike                                                               
the  rehire,  would  be  contributing  to  the  state  retirement                                                               
system.                                                                                                                         
                                                                                                                                
4:28:09 PM                                                                                                                    
                                                                                                                                
BRUCE JOHNSON,  Alaska Association of School  Boards (AASB), said                                                               
that   association's  membership   resolved  itself   behind  the                                                               
extension of  the rehire  provision at  its annual  conference in                                                               
November.   He  said, "We  believe this  is a  valuable tool  for                                                               
school  districts to  have.   I think  it's been  used sparingly,                                                               
when necessary,  and we still -  even with this provision  - have                                                               
positions  that are  unfilled at  the beginning  of every  school                                                               
year, well  into the  semester, in  some cases."   He  offered an                                                               
example.   He said a lot  of money has been  invested in teachers                                                               
who have reached  retirement eligibility age, but  may still have                                                               
a couple  years left  to teach,  perhaps after  going away  for a                                                               
while.   They  can come  back, work  for a  couple of  years, and                                                               
"fill some  vital needs."  He  said most districts would  just as                                                               
soon bring  in a young  teacher to employment and  guarantee that                                                               
he/she will  be there for  a long time,  but the reality  is that                                                               
it's  just not  possible  in  some of  the  areas  with an  acute                                                               
shortage of teachers.                                                                                                           
                                                                                                                                
4:30:38 PM                                                                                                                    
                                                                                                                                
CHRIS   S.    CHRISTENSEN,   Deputy    Administrative   Director,                                                               
Administrative  Staff,  Office  of the  Administrative  Director,                                                               
Alaska Court System,  stated that the retiree  return program has                                                               
been very  helpful to the court  system, and he said  that system                                                               
is hopeful that the program  will be extended by the legislature.                                                               
Mr.   Christianson   reported   that   the   court   system   has                                                               
approximately 650  nonjudicial employees  at 32  locations around                                                               
the  state.     Currently,  there   are  only  about   10  people                                                               
participating in  the program.   Though  that doesn't  sound like                                                               
many, he said,  those positions are critical to  the operation of                                                               
the court system.   He stated that to a  much greater extent than                                                               
the executive  branch, the court  system has a number  of unique,                                                               
one-person job classes.   One example, he said, is  the state law                                                               
librarian.   He  said  it  is crucial  that  these job  positions                                                               
remain filled by knowledgeable persons.   He said it is difficult                                                               
to recruit internally for such  positions, because more than half                                                               
of  the  court  system's  employees are  clerical  employees  who                                                               
cannot be promoted to these specific jobs.                                                                                      
                                                                                                                                
MR.  CHRISTIANSON  stated that  for  certain  jobs in  the  court                                                               
system there  have been  no qualified  applicants and  there have                                                               
been times  when supervisors  [who have retired]  have had  to be                                                               
rehired.  He explained that  the turnover rate in the lower-level                                                               
positions  is about  50 percent  within the  first five  years of                                                               
employment.   In some rural  locations, the turnover is  twice as                                                               
bad.  He said this is primarily because of low pay.                                                                             
                                                                                                                                
MR. CHRISTIANSON  said that the  court system has, for  more than                                                               
the last  decade, been running  a mandatory 30-day  hiring freeze                                                               
for all  positions; the only  person allowed to waive  the freeze                                                               
is  the  administrative  director.     He  said  this  action  is                                                               
financially responsible;  however, because of the  practice, when                                                               
jobs turn  over there are  vacancies that last  for 30 days.   He                                                               
said the  freeze is a double-edged  sword:  it requires  that the                                                               
supervisors be  more experienced in  order to keep the  case load                                                               
moving  during  times  when  there are  job  vacancies,  but  the                                                               
turnover  means that  fewer people  get the  years of  experience                                                               
they need  to become  supervisors.  He  continued:   "The retiree                                                               
return  program  has enabled  the  court  system to  continue  to                                                               
function in  an efficient manner  because of our ability  to hire                                                               
back experienced  and knowledgeable  employees in  the one-person                                                               
job  classes  and in  the  rare  supervisory positions  where  we                                                               
simply cannot fill  the job.  Without it, we  would be struggling                                                               
to fill certain key positions."                                                                                                 
                                                                                                                                
MR. CHRISTIANSON noted that the  court system participated in the                                                               
retirement  incentive  program  (RIP)  several  years  ago.    He                                                               
emphasized how  damaging the RIP  was; the court system  lost the                                                               
core   of   its   long-term,  experienced   supervisors.      Mr.                                                               
Christianson stated, "To some extent,  this program has helped us                                                               
make up for that a little bit.   And that's one of the reasons we                                                               
are appreciative of this."                                                                                                      
                                                                                                                                
CHAIR WILSON closed public testimony.                                                                                           
                                                                                                                                
4:35:12 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON said there are problems  to be worked out, but there                                                               
also is  "an obvious  need."   She mentioned  future work  on the                                                               
bill.                                                                                                                           
                                                                                                                                
4:36:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ANDERSON said  he  has  heard concerns  expressed                                                               
from Alaska State  Troopers and is glad the bill  will be held so                                                               
that they will have a chance to offer their comments.                                                                           
                                                                                                                                
CHAIR WILSON announced that [HB 161 was heard and held].                                                                        
                                                                                                                                
HB 204-OPTOMETRISTS' USE OF PHARMACEUTICALS                                                                                   
                                                                                                                                
CHAIR WILSON announced that the  last order of business was HOUSE                                                               
BILL NO.  204, "An Act  relating to  the prescription and  use of                                                               
pharmaceutical  agents,   including  controlled   substances,  by                                                               
optometrists."                                                                                                                  
                                                                                                                                
4:38:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE BILL THOMAS, Alaska  State Legislature, as sponsor                                                               
of  HB  204,  said  that  he  represents  28  communities,  which                                                               
together have one  optometrist and no ophthalmologists.   He said                                                               
the bill  is critical  for the  needs of  those communities.   He                                                               
said it is important to note  that the unemployment rate in those                                                               
communities ranges from 35 to 85  percent.  The chance of many of                                                               
the citizens in these communities having insurance is "nil."                                                                    
                                                                                                                                
REPRESENTATIVE THOMAS  stated that  HB 204 would  change statutes                                                               
to  allow  optometrists  to administer  oral  pharmaceuticals  to                                                               
provide  better   and  more  complete   eye  care   to  Alaskans.                                                               
Currently, he  noted, optometrists  are limited in  the treatment                                                               
of eye disease that is seen  on a routine basis and would benefit                                                               
from oral medication, including  acute allergic reactions, ocular                                                               
herpes,  ocular   herpes  zoster,   and  chronic   lid  diseases.                                                               
Currently  100  optometrists in  17  locations  serve the  state,                                                               
spanning  from  Barrow  to  Juneau.     There  are  26  eye  care                                                               
specialists   in   6   locations    that   can   prescribe   oral                                                               
pharmaceuticals in Alaska.                                                                                                      
                                                                                                                                
REPRESENTATIVE THOMAS  recounted a  time when  he was  visiting a                                                               
rural community  and was suffering  from diverticulitis.   He was                                                               
surprised   that  the   physician's  assistant   could  prescribe                                                               
medication  for  him,  while  an  optometrist  could  not.    The                                                               
proposed legislation  would enable  the optometrists  to practice                                                               
at the  level at which  they are trained.   Representative Thomas                                                               
reminded the  committee that the  legislature had  recently voted                                                               
in favor  of a bill that  would allow doctors trained  in Asia to                                                               
come  to the  Alaska and  practice.   He  said HB  204 is  simply                                                               
asking that optometrists  be allowed to use  their background and                                                               
education to  the full extent.   He also noted that  another bill                                                               
was  recently  supported that  would  allow  a student  to  carry                                                               
his/her own  syringe and self  treat in the case  of anaphylaxis,                                                               
while  an  optometrist is  not  allowed  to treat  for  emergency                                                               
anaphylaxis.                                                                                                                    
                                                                                                                                
REPRESENTATIVE  THOMAS  said,  without  question,  vision  is  an                                                               
important aspect  of a person's life  and should be treated  by a                                                               
trained  eye care  professional.    Currently, optometrists  must                                                               
refer outpatients to a  general physician, physician's assistant,                                                               
or a  nurse practitioner  for oral  treatment of  ocular disease.                                                               
He said  the proposed legislation  would remove an extra  step by                                                               
having the  ocular treatment  done by  an eye  care professional,                                                               
thereby  saving   the  patient   from  undue   complications  and                                                               
financial costs.   He said, for example, that a  person coming to                                                               
Juneau  from Kake  for eye  care  would spend  $200 roundtrip  by                                                               
plane, or would  have to take a circuitous route  by ferry, which                                                               
is only offered twice a month.                                                                                                  
                                                                                                                                
REPRESENTATIVE THOMAS said  ophthalmologists are specialists, and                                                               
he indicated  that he is  not trying  to take anything  away from                                                               
them.   He said he  just wants people from  the Bush to  get good                                                               
and timely eye care.                                                                                                            
                                                                                                                                
4:47:10 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON stated her intention to  hold the bill because it is                                                               
"different than the one last year."                                                                                             
                                                                                                                                
4:47:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER referred  to Representative Thomas' asking                                                               
that optometrists be  allowed to use their training.   She stated                                                               
her  understanding  that  ophthalmologists are  doctors,  whereas                                                               
optometrists are not, and she asked if that is correct.                                                                         
                                                                                                                                
REPRESENTATIVE    THOMAS   offered    his   understanding    that                                                               
optometrists  have  been  trained  in the  area  of  giving  oral                                                               
medicine for eye care.  He added  that if that were not the case,                                                               
44  states  would  not  have   already  allowed  optometrists  to                                                               
[prescribe oral eye  medication].  He suggested  that the experts                                                               
could enlighten the committee further.                                                                                          
                                                                                                                                
REPRESENTATIVE GARDNER suggested that a  person in the Bush could                                                               
get a prescription from a nurse practitioner.                                                                                   
                                                                                                                                
REPRESENTATIVE  THOMAS said  the  concern is  that  a person  not                                                               
trained  specifically   in  the  care   of  eyes  could   make  a                                                               
misdiagnosis.                                                                                                                   
                                                                                                                                
4:50:40 PM                                                                                                                    
                                                                                                                                
CARL ROSEN, M.D., President, Alaska  Eye Physicians and Surgeons,                                                               
testified in  opposition to HB 204.   He told the  committee that                                                               
he is an  ophthalmologist who practices in Anchorage.   He stated                                                               
that ophthalmologists  attend college for four  years, go through                                                               
four  years of  medical  school  into which  only  1  in 200  get                                                               
accepted,  serve a  one-year internship  in medicine  or surgery,                                                               
and  complete a  three-year intensive  residency, at  which point                                                               
the ophthalmologist learns to diagnose,  treat, and operate.  The                                                               
residency  is  typically  done  in a  large  university  or  city                                                               
hospital  where  the  ophthalmologist conditions  him/herself  to                                                               
deal with  very sick people.   The  system filters out  those who                                                               
can't handle the  surgical anxiety that comes with the  job.  Dr.                                                               
Rosen said  he completed  a fellowship in  addition to  the three                                                               
years of  residency to further  train himself in  orbital surgery                                                               
and neuro-opthomology.                                                                                                          
                                                                                                                                
DR.  ROSEN   said  the  issue   of  the  rarity  of   finding  an                                                               
ophthalmologist  in  a rural  community  is  "yes  and no."    He                                                               
explained that the Native hospital  travels frequently to various                                                               
Native communities and has its  own patient population.  He noted                                                               
that the  U.S. Air Force  also does that.   His own  practice has                                                               
doctors who travel to Kodiak, Cordova,  and Sitka.  He added that                                                               
there are [ophthalmologists] in both Juneau and Fairbanks.                                                                      
                                                                                                                                
DR. ROSEN confirmed that nurse  practitioners have the ability to                                                               
prescribe medications,  but they are specifically  trained to "be                                                               
the  first  line."   They  treat  with  medication and  also  are                                                               
knowledgeable regarding  the pharmacology of medicines.   He said                                                               
anyone trained  as an optometrist  beyond five years ago  did not                                                               
have the  intensive training  to understand  the pharmacokinetics                                                               
and  interaction of  medicines.   Optometrists also  do not  have                                                               
hospital-based privileges or interact  with the medical community                                                               
on a regular basis.  Dr.  Rosen said he frequently consults other                                                               
medical specialists when multiple drugs are involved.                                                                           
                                                                                                                                
DR. ROSEN stated  that HB 204 does not  differentiate treating an                                                               
infant versus a ninety-nine-year-old.   He said there is a danger                                                               
in "just  allowing this to go  forward."  He said  the subject of                                                               
the bill  has been  seen in  the past  and has  consistently been                                                               
thwarted.   He  said,  "If  you read  the  bill,  it's under  the                                                               
jurisdiction of  the optometric community,  which is  outside the                                                               
purview  of the  medical board  and the  medical community."   He                                                               
said he thinks that's a dangerous problem.                                                                                      
                                                                                                                                
DR. ROSEN said ophthalmologists in  Alaska do take phone calls as                                                               
a courtesy to the  people of the state.  He  said he is available                                                               
24 hours a day, 7 days a week.  He said:                                                                                        
                                                                                                                                
     Some states do  have this bill, but if you  look at the                                                                    
     overall number  of optometrists who  use it,  it's very                                                                    
     small ....   Let's say there's 100  optometrists in New                                                                    
     Mexico  who have  this  privilege;  roughly 10-15  will                                                                    
     actually use  medications on a  consistent basis  to be                                                                    
     considered  familiar with  medications.   So, the  vast                                                                    
     majority  don't  have  the numbers.    And  in  medical                                                                    
     school and  in residency training, you're  only allowed                                                                    
     to  graduate if  you can  prove that  you have  the ...                                                                    
     capability  to do  this  procedure  or understand  this                                                                    
     disease.   That's how medical school  training [works].                                                                    
     And  optometric training  will not  have that,  because                                                                    
     now they're  outside of school  and they're  relying on                                                                    
     the optometric  board to give them  a go or a  no-go on                                                                    
     this.  So, I think that's also a problem.                                                                                  
                                                                                                                                
4:57:53 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE ANDERSON indicated that he would like to know if                                                                 
there would be trouble if the bill is not passed.                                                                               
                                                                                                                                
DR. ROSEN answered no.  He stated:                                                                                              
                                                                                                                                
     As  long as  you're  able to  communicate the  clinical                                                                    
     symptoms and  describe the  ophthalmic condition  to an                                                                    
     ophthalmologist, or even [to]  the emergency room which                                                                    
     can transfer [that  information] to the ophthalmologist                                                                    
     ..., we're  able to intervene and  appropriately manage                                                                    
     and  assess   the  patient   and  then   prescribe  any                                                                    
     medication,  if any  is  necessary.   ...  There is  no                                                                    
     public outcry  for this,  and I have  not heard  or [do                                                                    
     not] know of  a problem where an optometrist  has had a                                                                    
     dire  condition and  has not  been able  to contact  an                                                                    
     ophthalmologist  when needed.    I just  don't know  of                                                                    
     one.                                                                                                                       
                                                                                                                                
5:00:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA asked if "telemedicine" is involved.                                                                      
                                                                                                                                
DR. ROSEN said  he not only supports telemedicine,  but it's been                                                               
a hobby and avocation  of his for the past seven  years.  He said                                                               
efforts are  being made to get  more of the medical  community to                                                               
accept [telemedicine].   He listed some of the cases  that he has                                                               
treated by telemedicine.                                                                                                        
                                                                                                                                
5:01:53 PM                                                                                                                    
                                                                                                                                
DONALD  J. CINOTTI,  M.D.,  said  that he  is  from the  American                                                               
Academy of Ophthalmology and is  "on the state affairs committee"                                                               
in New  Jersey.   He said  he monitors  similar bills  across the                                                               
country and  considers the  ramifications of  them.   Dr. Cinotti                                                               
stated  that  the  proposed  legislation   is  by  far  the  most                                                               
expansive of any bill he has seen  in a long time, because of its                                                               
vague language.   For example,  the bill  mentions pharmaceutical                                                               
agents, but  does not specify  oral pharmaceutical  agents, which                                                               
he  said  would   lead  a  person  to   believe  that  injectable                                                               
medications could  be used,  which he  said is  very troublesome.                                                               
He said  another concern is  in regard  to the use  of "off-label                                                               
medication."    The  treatments   for  ophthalmic  disorders  are                                                               
becoming very  complex.  He  offered an example of  medicine that                                                               
can  be  dangerous   in  the  wrong  hands,  and   he  said  some                                                               
complications can lead to death.   He stated, "Certainly we don't                                                               
believe  that   the  optometrists  have  the   expertise  or  the                                                               
knowledge  to  recognize  the  complications   of  use  of  these                                                               
medications, nor the ability to treat them properly."                                                                           
                                                                                                                                
DR. CINOTTI said  it's often mentioned that there  are not enough                                                               
ophthalmologists  around  to  take  care   of  patients,  but  in                                                               
reality, there  are, he said.   He explained that when  a patient                                                               
goes  to  an  emergency  room there  is  usually  an  arrangement                                                               
between that  emergency room and  an ophthalmologist on  call who                                                               
can determine  the proper  treatment.   He said  the bill  has no                                                               
oversight by physicians of optometrists;  there would be no phone                                                               
call  to an  ophthalmologist  to  see if  the  medication or  the                                                               
diagnosis is  correct.  He reiterated  that the bill is  a "very,                                                               
very dangerous" one.                                                                                                            
                                                                                                                                
5:05:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON asked if the  language in the bill that Dr.                                                               
Cinotti  would like  tightened is  that  on page  1, lines  9-10,                                                               
which read as follows:                                                                                                          
                                                                                                                                
               (2) the pharmaceutical agent is prescribed                                                                   
     and  used  for  the  treatment  of  ocular  disease  or                                                                
     conditions,  ocular adnexal  disease or  conditions, or                                                                
     emergency anaphylaxis;                                                                                                 
                                                                                                                                
DR. CINOTTI, in  response, said many treatments  for diseases are                                                               
progressing, and  he offered  examples.   He reiterated  that the                                                               
language  does not  specify oral  versus  injected medicine,  but                                                               
only lists "pharmaceutical agent".                                                                                          
                                                                                                                                
5:07:38 PM                                                                                                                    
                                                                                                                                
DR.   CINOTTI,  in   response  to   a  follow-up   question  from                                                               
Representative Seaton, said  adding "oral" before "pharmaceutical                                                           
agent" would help, but there would  still be the need to consider                                                           
what  is necessary  for an  optometrist  to treat  patients in  a                                                               
rural area.   For  example, if the  concern is  that optometrists                                                               
should  be  able  to  use   antibiotics,  then  the  bill  should                                                               
specifically list what antibiotics they  may use.  He stated that                                                               
an  ophthalmologist,  in  practice,  does not,  in  general,  use                                                               
controlled substances.   He said he  has worked as a  director of                                                               
ocular  trauma in  a  major hospital  for 22  years  and has  not                                                               
written a  subscription for a  narcotic in at least  three years.                                                               
He added,  "So, what is the  point of giving the  optometrist the                                                               
right to subscribe narcotics?"                                                                                                  
                                                                                                                                
5:09:08 PM                                                                                                                    
                                                                                                                                
BOYD WALKER, O.D.,  testified in support of HB 204.   In response                                                               
to remarks from the previous speakers,  he said he believes it is                                                               
up  to the  individual practitioner  to make  the decision  as to                                                               
whether something is  within their scope of practice or  not.  He                                                               
said a family  practice doctor may well be  capable of delivering                                                               
a  baby, but  an obstetrician  may think  otherwise.   Dr. Walker                                                               
said  he  is  not  arguing that  an  ophthalmologist's  level  of                                                               
training is  [not] higher than  that of an  optometrist; however,                                                               
he  stated  that  in  routine  practice,  there  are  times  when                                                               
individual  optometrists -  especially  those in  rural areas  of                                                               
Alaska - need  to have the ability to  prescribe oral medications                                                               
and occasionally even inject medicine.  He continued:                                                                           
                                                                                                                                
     I recall  back in the  70s, when optometrists  were not                                                                    
     allowed to use any medications,  whatever - not for the                                                                    
     purpose of diagnosing eye disease,  nor for the purpose                                                                    
     of  treating  eye  disease.   And  ophthalmology  said,                                                                    
     "Gosh,  people  die from  eye  drops  that dilate  your                                                                    
     eyes."   Well, I believe  today that after 15  years of                                                                    
     experience  that  even   our  ophthalmology  colleagues                                                                    
     would agree that optometry has  served a great function                                                                    
     in terms of diagnosing eye  disease that they would not                                                                    
     have  been able  to find  had not  pharmaceuticals been                                                                    
     allowed to optometry.                                                                                                      
                                                                                                                                
DR.  WALKER said  Dr. Rosen  alluded to  the fact  that "even  in                                                               
states like  New Mexico  that have the  drugs, not  everyone uses                                                               
them."  He  stated his belief that that  proves that optometrists                                                               
are judicious  in the use of  the drugs; they only  use them when                                                               
necessary  and  they probably  do  make  a  lot of  referrals  to                                                               
ophthalmologists who are readily available.   In rural Alaska, he                                                               
said,  there certainly  are cases  where  individuals might  need                                                               
immediate treatment and be unable to get it.                                                                                    
                                                                                                                                
DR. WALKER  said the  education of an  optometrist is  similar to                                                               
that  of a  family practice  physician and  dentist, and  in most                                                               
cases  above  that  of  a   nurse  practitioner  and  physician's                                                               
assistant.   In  conclusion, Dr.  Walker stated  his belief  that                                                               
optometrists  have  the  education  and the  credentials  to  use                                                               
"these  medications" and  will be  careful in  using them  to the                                                               
best interest of their patients.   He said he believes that rural                                                               
Alaskans would  really benefit  from [the  proposed legislation],                                                               
in terms  of not having to  wait for treatment or  having to take                                                               
the time  to travel to  a larger center where  an ophthalmologist                                                               
may be available.  He urged the committee to support HB 204.                                                                    
                                                                                                                                
5:13:35 PM                                                                                                                    
                                                                                                                                
DR.  WALKER,  in  response  to  a  question  from  Chair  Wilson,                                                               
outlined the training  necessary to become an  optometrist:  four                                                               
years  of  undergraduate  work, pre-optometry,  or  pre-medicine,                                                               
followed by  an additional four  years of post  graduate training                                                               
in  optometry school.   Many  optometrist  elect to  subsequently                                                               
complete  either an  internship  or residency,  although he  said                                                               
that is not all that common.                                                                                                    
                                                                                                                                
5:14:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  noted that  she has  heard the  subject of                                                               
the bill for seven  years.  She asked if there  was some way that                                                               
the  optometrists  could  augment  their education  so  that  the                                                               
concerns of the medical community could be solved.                                                                              
                                                                                                                                
DR.  WALKER responded  that optometric  education already  trains                                                               
individuals to use "these medications."   He said it appears that                                                               
it   is   the  ophthalmology   community   who   is  showing   an                                                               
unwillingness to compromise.  He  clarified that he does not even                                                               
categorize   that  group   as   being   the  medical   community.                                                               
Currently,   statute  requires   that  optometrists   partake  in                                                               
continuing medical  education, which  is regulated by  the state.                                                               
Those  optometrists that  utilize pharmaceutical  agents have  to                                                               
have specific  retraining on a  biannual basis in order  to renew                                                               
their licenses.                                                                                                                 
                                                                                                                                
5:19:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   GARDNER  noted   that   a  naturopathic   doctor                                                               
undergoes eight  years of training.   She asked Dr. Walker  if he                                                               
thinks they should have prescriptive rights.                                                                                    
                                                                                                                                
DR. WALKER responded that he  knows nothing about the training of                                                               
a naturopathic  doctor and  therefore cannot speak  to that.   He                                                               
said he thinks every professional  who [prescribes] medication or                                                               
performs  procedures   should  be  willing  to   display  his/her                                                               
curriculum of training.  He said,  "Those who have an M.D. behind                                                               
their name,  once they've received  their training and  they have                                                               
their degree  and their board  exams behind them, really  have no                                                               
one to  answer to other  than the medical  board.  ...  All other                                                               
...  limited   license  practitioners   must  come  to   ...  the                                                               
legislature  to develop  regulation to  delineate their  scope of                                                               
practice."                                                                                                                      
                                                                                                                                
5:21:01 PM                                                                                                                    
                                                                                                                                
GRIFF  STEINER, M.D.,  offered his  medical training  history and                                                               
told the committee that he  is an ophthalmologist who has special                                                               
training in glaucoma and corneal  surgery.  He said that although                                                               
he has  respect for Dr.  Walker and the profession  of optometry,                                                               
he  must refute  a number  of  Dr. Walker's  assertions.   First,                                                               
regarding  Dr. Walker's  claim that  optometrists  have the  same                                                               
amount of training as family  medical physicians and dentists, he                                                               
said  that  during  their  entire  training  period,  physicians,                                                               
dentists,  and  nurse  practitioners  administer  medications  to                                                               
patients under the  supervision of other physicians.   At no time                                                               
during  optometrists' training  are they  prescribing medications                                                               
under supervision, or  at all.  Dr. Steiner said  in his practice                                                               
he has rarely had to prescribe oral antibiotics.  He continued:                                                                 
                                                                                                                                
     The   only  times   I  have   had  to   prescribe  oral                                                                    
     antibiotics  is  when  the  patient  had  a  very  dire                                                                    
     infection, the  kind that could  kill them -  the thing                                                                    
     that would have to be  referred.  If an optometrist saw                                                                    
     lid swelling  and treated it with  oral antibiotics and                                                                    
     it  was instead  a diabetic  infection of  the sinuses,                                                                    
     that patient would die in a  matter of days.  It cannot                                                                    
     be  overstated  that  optometrists  have  no  practical                                                                    
     training  in prescribing  medications,  other than  eye                                                                    
     drops.   During their  training, they do  not prescribe                                                                    
     oral  antibiotics or  pain medications  to patients  in                                                                    
     the hospital; they're not  responsible for any patients                                                                    
     in the hospital during their entire training.                                                                              
                                                                                                                                
DR.  STEINER agreed  with the  prior testimony  of [Dr.  Cinotti]                                                               
that HB 204  is dangerous because of its vagueness.   If the bill                                                               
were to pass,  he warned, optometrists would  then have precedent                                                               
to apply to the federal drug  enforcement agency to be allowed to                                                               
prescribe drugs  that are "way  outside their purview."   He said                                                               
he thinks  the bill  would also be  a stepping-stone  in allowing                                                               
optometrists to do  surgical things they are also  not trained to                                                               
do.                                                                                                                             
                                                                                                                                
DR. STEINER  said the only  way that optometrists  are associated                                                               
with  operations  is by  doing  the  post-operative care  for  an                                                               
itinerate  physician  who flies  to  Alaska  from out  of  state,                                                               
performs  surgery, and  leaves the  patient  in the  care of  the                                                               
optometrist.  He continued:                                                                                                     
                                                                                                                                
     They're not  trained to  do this either.   If  we allow                                                                    
     them  to   do  these  prescriptions,  they   will  keep                                                                    
     prescribing  medications   for  patients   they're  not                                                                    
     trying to take care of  in the first place, and they're                                                                    
     especially not allowed to  prescribe the medications to                                                                    
     those patients.  And they'll  be no supervision as this                                                                    
     itinerate  physician  flies  immediately back  down  to                                                                    
     Seattle.   ...    The itinerate  physician himself  has                                                                    
     said  that he  doesn't  feel qualified  to treat  these                                                                    
     medical patients, so, ... as  an M.D., he does not take                                                                    
     referrals  from  his  optometric   network.    And  the                                                                    
     optometrists are too embarrassed  or reluctant to refer                                                                    
     to us,  because of  the arrangement with  the itinerate                                                                    
     physician, which  ..., albeit  not illegal,  ... allows                                                                    
     for a  $200-400 per  eye payment if  they refer  to the                                                                    
     itinerate physicians.  They would  get no money if they                                                                    
     referred  to  us.   And  so,  ...  the only  M.D.  that                                                                    
     they're strongly  associated with feels  unqualified to                                                                    
     treat   patients   and   refers  them   back   to   the                                                                    
     optometrists,  who then  refer back  and forth  between                                                                    
     optometry.   We've seen patients admitted  to hospitals                                                                    
     treated   by  optometrists   [with]  medications   that                                                                    
     they're not licensed  to prescribe.  ...  I don't think                                                                    
     I can overstate this enough.                                                                                               
                                                                                                                                
[HB 204 was heard and held.]                                                                                                  
                                                                                                                                
5:27:45 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health, Education and Social Services Standing Committee meeting                                                                
was adjourned at approximately 5:30 PM.                                                                                         

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