Legislature(2011 - 2012)BARNES 124
03/18/2011 03:15 PM House LABOR & COMMERCE
Audio | Topic |
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Start | |
HB155 | |
HB139 | |
HB11 | |
Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
*+ | HB 139 | TELECONFERENCED | |
*+ | HB 11 | TELECONFERENCED | |
+= | HB 122 | TELECONFERENCED | |
+ | TELECONFERENCED | ||
+= | HB 155 | TELECONFERENCED | |
HB 139-VETERINARIAN LICENSING QUALIFICATIONS CHAIR OLSON announced that the next order of business would be HOUSE BILL NO. 139, "An Act relating to qualifications for licensure as a veterinarian." 3:43:54 PM REPRESENTATIVE P. WILSON, Alaska State Legislature, stated goal of the bill is to increase the number of veterinarians in the state. Currently, the Board of Veterinary Examiners (BVE) allows only one certification program to be used to certify veterinary graduates who have graduated from foreign certification programs. The certification program is the Educational Commission for Foreign Veterinary Graduates (ECFVG). At the time that the statutory board was initiated the ECFVG was the only credentials certification program available. This bill would allow the board to decide which certification program to use. As new programs are developed the veterinarians should determine which programs are appropriate. In 2003, another certification program for foreign veterinarians was developed which she identified as the Program for the Assessment of Veterinary Education Equivalence (PAVE). 3:45:44 PM CHAIR OLSON asked whether the Board of Veterinary Examiners (BVE) had requested the bill since this seems to be a function of the board. REPRESENTATIVE P. WILSON responded that two veterinarian graduates who cannot get licensed in Alaska requested assistance since it is costly, approximately $6,000, to obtain licensure using the current certification program. She explained that 32 states and territories use this approach. This bill would allow the board the option. 3:47:11 PM MICHAEL WISENKAMP, Intern, Representative P. Wilson, Alaska State Legislature, reiterated that this bill would give the Board of Veterinary Examiners (BVE) the latitude to choose which certification program for veterinarians who have graduated from foreign universities. He highlighted that this bill is not about the certification programs themselves. The idea for HB 139 arose with e-mail from a constituent who complained that his wife could not practice veterinary medicine in Alaska even though she was licensed in three other states. His wife is a graduate of a foreign university. She graduated from St. George's University in Granada and completed her clinical year in veterinary medicine at the University of Minnesota. She completed the Program of Assessment of Veterinarian Education Equivalence (PAVE) in order to ensure she could practice veterinary medicine in the U.S. He reported that PAVE is one of two certification programs offered in the U.S. to evaluate foreign veterinarian programs. Currently, the constituent cannot practice in Alaska since Alaska exclusively accepts the Educational Commission for Foreign Veterinary Graduates (ECFVG). The constituent is currently licensed in California and Washington to practice veterinary medicine, he said. 3:49:10 PM MR. WISENKAMP detailed that the constituent had researched the requirements to complete the ECFVG program and discovered it would require two round trips to one of the testing sites in the Lower 48 plus $6,000 in fees. She asked Representative Wilson to introduce a bill that would allow the state to accept both programs. In 2000, PAVE began offering services and 32 states currently accept it as a means for foreign students to have a path for licensure. He referred to a detailed description titled, "American Association of Veterinary State Boards PAVE Standards and Policies" in members' packets. He explained that other states have evaluated the two programs and deem it as equivalent to the ECFVG, he said. Washington and Idaho are among the 32 states that accept PAVE. Since 2006, Idaho or Washington has not experienced any issues with any PAVE candidates. This bill, HB 139, would empower the BVE to select either or both certification programs. The BVE is comprised of four licensed veterinarians and one public member. He referred to the mission statement, which read, "The Board adopts regulations to carry out laws governing veterinarian practice in Alaska. It makes final licensing decisions and takes disciplinary actions against people who violate licensing laws." Currently, the statute precludes the board from making a licensing decision by directing foreign university graduates to a specific program. He concluded if the BVE would like to accept PAVE in addition to the ECFVG that it should be have the ability to do so. 3:52:11 PM REPRESENTATIVE MILLER referred to language on page 2, line 2 of HB 139 that specifies "shall." He asked whether the language should be softened. REPRESENTATIVE P. WILSON answered that the specific language he referred to is current statute. 3:53:11 PM MYRA WILSON, Veterinarian, stated she is a Past President of the Alaska State Veterinary Medical Association (ASVMA). The ASVMA represents 150 licensed veterinarians in Alaska statewide. The ASVMA is opposed to the bill since it does not believe it is a good bill for citizens in Alaska. She expressed concern that it would bring ambiguity to turn over licensing standards to a five member board appointed by the governor on a rotating basis. The Educational Commission for Foreign Veterinary Graduates (ECFVG) is recognized by 50 states and Canada and is the only certification program with federal approval. She emphasized the importance of having all 50 states recognize the same requirements for consistency. 3:55:30 PM DR. WILSON also expressed concern that the public would not know their veterinarian's qualifications. Citizens expect competency and not ambiguity in the certification program, she said. Additionally, it may cause some ambiguity for business owners hiring veterinarians. She commended the current level of excellence in veterinary medicine in Alaska. 3:56:36 PM REPRESENTATIVE HOLMES asked whether she believes the problem is the PAVE certification or if the issue surrounds the Board of Veterinary Examiners' (BVE) ability to make and change standards or both. DR. WILSON related that the bill does not specify PAVE certification but would allow the BVE's choice in selecting accreditation programs. REPRESENTATIVE HOLMES asked whether the ASVMA has a position on the PAVE accreditation program. DR. WILSON answered that the group has not taken a formal position so ASVMA would have to meet as group and vote. She offered to report back to the committee. 3:57:35 PM REPRESENTATIVE SADDLER asked whether she represents the ASVMA. DR. WILSON answered yes. 3:57:51 PM REPRESENTATIVE MILLER asked whether the BVE is an existing board. DR. WILSON answered the BVE is an existing board consisting of four veterinarians and one lay person, with rotating terms. 3:58:30 PM REPRESENTATIVE MILLER said he assumed she had confidence in other licensed veterinarians to assess credentials of candidates. DR. WILSON suggested that question is better answered by the BVE's members. 3:58:55 PM REPRESENTATIVE MILLER related a scenario in which Dr. Wilson was appointed to the BVE. He asked whether she would trust the other board members to determine capabilities of veterinary candidates. CHAIR OLSON reported the BVE's current chair will testify. 3:59:17 PM DR. WILSON stated that she preferred not to get into comparisons between PAVE and ECFVG, but pointed out that the ECFVG certification process requires a clinical competency test. However, not all PAVE graduates are required to do so. 3:59:54 PM REPRESENTATIVE SADDLER asked how many veterinarians are licensed und ECFVG. DR. WILSON answered that is currently the only certification program in statute so she thought all veterinarians licensed in Alaska were ECFVG certified. She suggested the Department of Commerce, Community & Economic Development, Division of Corporations, Business, and Professional Licensing could answer that question. REPRESENTATIVE SADDLER clarified that he was seeking the total number of foreign accreditation licensed veterinarians in Alaska. DR. WILSON said she did not know. 4:00:41 PM DON HABENGER, Director, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community & Economic Development (DCCED), stated he did not have the number either, but he offered to provide the information to the committee. 4:01:25 PM DAVID HUNT, Veterinarian, stated that the Board of Veterinary Examiners (BVE) does not currently accept PAVE, which is the program for assessment of veterinary education equivalence. However, the BVE has researched PAVE and is supportive to accept it. In 2009, the PAVE Committee presented to the board at its meeting in Fairbanks. He indicated he has been to the National Board of Veterinary Examiner's meeting for the past five years and has learned about the PAVE program requirements. The BVE is on record that it is supportive of accepting PAVE and has determined the PAVE program is equal to standards of the ECFGV, which is the test now being used for foreign graduates given by the American Veterinary Medical Association (AVMA) for veterinary candidates. This bill would allow the BVE to decide which programs to accept for veterinary licensure in Alaska and to accept the PAVE program. 4:02:47 PM REPRESENTATIVE SADDLER asked for clarification on the number of veterinarians practicing in Alaska who graduated from foreign schools and were certified under the ECFVG. DR. HUNT answered probably less than ten. He suggested the department would have the figures. REPRESENTATIVE SADDLER asked whether he could predict the number of foreign veterinary candidates who are likely to see licensure using the PAVE program. DR. HUNT answered that he is only aware of one veterinary candidate who is seeing licensure via the PAVE program. He identified the candidate as a woman from Homer. He did not believe a rush of candidates would try to get into the program using the PAVE standard. He offered his belief that the PAVE program is a solid program and in the future it could be an important program. He predicted that in the future all the states would accept the PAVE program. He also offered his view that the PAVE program is just as good as the ECFVG program. He remarked that he has been pretty well educated on the elements of the PAVE program by attending the national meetings. He related that the bill is structured to allow the BVE to decide which program to accept. He did not think any other accreditation programs would surface for veterinary candidates. REPRESENTATIVE SADDLER related his understanding that this bill would allow the BVE to choose which of the accreditation programs to use. He asked whether the BVE board would use one or the other or both programs. DR. HUNT answered the BVE would use both programs. The PAVE process would just represent a different path for veterinary candidates to gain licensure. REPRESENTATIVE SADDLER asked for clarification on the reason that PAVE began in 2000. DR. HUNT answered that the ECFVG only offers examinations once a year and it is difficult for people to take the exams all at one time. The PAVE examination is offered twice a year and has a practical exam that people can take to familiarize themselves with the test. He considered the frequency of testing as the primary reason candidates are interested in PAVE. 4:05:40 PM REPRESENTATIVE SADDLER remarked that the military license bill might allow for licensure via a courtesy license. 4:05:53 PM REPRESENTATIVE HOLMES asked whether the BVE has a position. on the bill. DR. HUNT answered he thought that the BVE would want this bill to pass. REPRESENTATIVE HOLMES asked whether he could address concerns in terms of the ambiguity. She further asked whether simply adding PAVE to the list of accredited programs would suffice. DR. HUNT responded that he did not have any problem with that approach but the current bill offers the board flexibility in the event another program would be offered. He said either way would work. JIM DELKER, Veterinarian, President, Alaska Veterinary Medical Association (AVMA), the Alaska Veterinary Medical Association (ASVMA) represents the majority of the practicing veterinarians in Alaska. The AVMA formally adopted a resolution against HB 139. The main reason for opposition is that presently the licensing standards and requirements are clearly stated in statute in the Veterinary Practices Act. The AVMA does not think the bill should be changed to allow a five-member revolving board since it could subject the board to bias. He agreed with Dr. Hunt that the PAVE and ECFVG programs are likely the only programs that will be offered. He does not believe the board should have the power to select certification programs. He related a scenario in which in which three of five members decided that a veterinary school in India not accredited by the AVMA was sufficient that the BVE could accept students for licensure. He expressed concern that accepting other standards could reduce the overall standards of the veterinarian profession in Alaska. He offered his belief that HB 139 as written is not a good bill. 4:09:48 PM DR. DELKER recalled the bill's purpose would be to increase the number of veterinarians and he did not think this would happen, especially in rural Alaska. He suggested the National Veterinary Medical Service Act as another option to increase rural veterinarians. He reported the NVMSA has allotted five spots for rural veterinarians. Currently, 20 states offer veterinarian student repayment plans for veterinarians that choose to serve in rural communities, which he thought would be more effective. way to increase veterinarian services in Alaska. He reiterated that he does not think HB 139 will accomplish this goal. DR. DELKER stated that AVMA has not formally taken a position so his comments on PAVE are his own. He related that two veterinary schools in the Caribbean gained some benefits by not requiring its students to take a clinical competency exam as other foreign veterinary graduates are required to take. The school arranged to have students take a fourth year in an accredited school in the U.S. Thus, the veterinary students would attend three years at the non-accredited school and one year at the accredited school and would skip the clinical competency test. The general consensus by the AVMA was that it was not fair or equitable approach to take since these foreign graduates do not take the test all the other foreign graduates must take which is why the PAVE program is not approved by all states. He acknowledged that PAVE is a very good program, but it is not equitable in all situations. He offered his belief that it would not be fair to allow two schools in the Caribbean to circumvent the standards by not requiring the competency examination. He acknowledged that one of the two schools just gained AVMA accreditation so this may become a moot point. 4:12:59 PM REPRESENTATIVE HOLMES asked how the AVMA would respond if HB 139 specifically listed the PAVE program and did not offer the BVE any additional discretion. DR. DELKER acknowledged that it would more palatable, but not necessarily fully supported since there is still a little discrepancy in the PAVE program. DR. DELKER suggested that the AMVA may wish to adopt a Model Practice Act in the next year or so. He suggested that the AMVA could review the PAVE program at the time it considers adopting current standards of veterinary medicine. 4:15:15 PM REPRESENTATIVE SADDLER asked for the current supply and demand for veterinarians in Alaska. He further inquired as to whether there is a shortage of veterinarians in Alaska. DR. DELKER responded that it can be somewhat difficult in smaller communities to attract or retain veterinarians. He commented he has practiced in Alaska since 2003 and has always been able to fill positions. REPRESENTATIVE SADDLER stated that he read letters and e-mails indicated adopting the PAVE program would diminish standards. He recalled that Dr. Delker reported the program as a good program. He inquired as to whether HB 139 would diminish the standards. DR. DELKER answered that he would not say it specifically would diminish the standards but it potentially could if programs other than the PAVE or ECFVG accreditation programs were used. 4:16:43 PM JON BASLER, Member, Alaska Veterinary Medical Association (AVMA), stated that he serves as the Alaska delegate to the American Veterinary Medical Association (AVMA). He spoke in opposition to the bill. He has practiced in Alaska since 1985 and also spent three years in rural Alaska in the North Slope Borough. He concurred with earlier testimony that this bill would not bring a significant number of practitioners to Alaska. He expressed concern with HB 139 due to its ambiguity since it leaves it wide open for the BVE to accept other accreditation processes. He agreed with earlier testimony that PAVE may become a moot point if the final school in the Caribbean becomes accredited. He reiterated that his personal opposition to the bill is because the bill would create ambiguity and leaves wide open the standards for veterinarian applicants as to what is acceptable. He related substantial work has been performed nationally to try to standardize and provide specific guidelines for veterinarians. He did not see this as a barrier to entry but as a concern about the level of competency of veterinary candidates. 4:19:18 PM REPRESENTATIVE THOMPSON recalled that the PAVE and ECFVG programs are acceptable. He inquired as to whether other programs exist. DR. BASLER answered that currently the only two programs in the U.S. are the ECFVG and the PAVE process, which he believed was specifically designed for Caribbean schools without full accreditation. 4:20:14 PM DR. BASLER related that other countries have veterinary programs and it really depends on the country as to the quality of the program. He offered his belief that the European Union's programs are likely as extensive as the U.S. programs, but programs in South America, Africa, or India would not be anything like the American programs. 4:21:03 PM REPRESENTATIVE MILLER commented that after hearing each of the organizations testifying against the bill that people just don't seem to trust the BVE. DR. BASLER responded no, that he did not think so. He pointed out that the people serving on the BVE are his colleagues. He emphasized that bills should be clear and not ambiguous and not leave anything open ended. He said he applauded his colleagues for taking the time out of their personal lives for their willingness to serve. He characterized their service as adding to the professionalism of their veterinarian service. REPRESENTATIVE MILLER stated he would defer to the BVE's judgment and other testifiers. He pointed out that he did not see that the bill would "open the door" other than to ask fellow veterinarians to assess certification programs for foreign candidates that do not fall under the ECFVG program. DR. BASLER responded that the national Model Practice Act has been making a big push to standardize Veterinary Practice Acts across the country in an effort to create more uniform laws. He thought this bill would take Alaska away from the model act rather than to move towards it. 4:23:25 PM PAM TUOMI, Veterinarian, stated that she previously served on the BVE and as a veterinarian that has practiced in Alaska since the 1970s. CHAIR OLSON interjected that Dr. Tuomi is his veterinarian. 4:24:04 PM DR. TUOMI stated that she served on the board at the time when some of the initial statutes were adopted and when veterinarians wrote and administered the exam. She acknowledged the difficulty in taking average practitioners appointed by the governor to design and oversee the licensing process. She indicated the board took its responsibilities seriously and welcomed the national examining process. This allowed the board to use the expertise of national academics to verify that veterinary applicants were meeting standards and were qualified to practice nationwide. She expressed concern with HB 139 since it potentially "throws a door open." She reinforced that veterinarians trust their board members and acknowledge the difficult job of serving as a board member. However, the practices act should not be rewritten to serve one individual. She related that valid routes for licensure exist that protect the public health and welfare of animals. The current system works well. She suggested she would be happier if the BVE would like to specifically add the PAVE program as an option than to have a wide open program. 4:26:38 PM CHAIR OLSON inquired as to whether this bill would expand the number of veterinarians working in rural Alaska. DR. TUOMI answered no. She offered her belief that the potential for harm is greater than any potential benefits. 4:27:11 PM REPRESENTATIVE SADDLER related his understanding that she did not like the wide open language to allow the BVE to select its own accreditation and would feel more comfortable although not entirely comfortable if the bill specified the PAVE program. DR. TUOMI answered yes, which is strictly her personal perspective. 4:27:36 PM CATHERINE VERSTEEG, Veterinarian, stated she is also a past President of the AVMA. She stated that she opposes the bill as written. She has worked in rural Alaska and has worked with nonprofits to try to increase the number of practicing veterinarians in Alaska. She did not think HB 139 would attract veterinarians to practice in rural Alaska. She offered her belief that it would be better to have the certification program in statute rather than have a "gray zone" that would allow for changes in the program. 4:28:47 PM JONATHAN MUSMAN thanked Representative Wilson for sponsoring the bill. He originally contacted the BVE in 2009 with respect to PAVE and was referred to the legislature. He related that the BVE originally opposed changing the practice act due to a potential merger of PAVE and ECFVG, but any potential merger is years away according to his sources at PAVE. He listened to testimony today relating that the bill would not benefit Alaska. He said that two Alaskans would benefit if his wife could work in the state. She would like to work in the state and for the past year and a half she has flown to Oregon and Washington to work. Last year she spent nearly three weeks of every month for six months working in Washington to keep her skills sharp. He indicated that the cost of taking the ECFVG. Although the actual test costs are $5,000, the typical process time ranges from 12 to 24 months and requires two trips to testing centers. Her classmates have made more than three trips to complete the testing process. 4:32:12 PM KAREN EWING, Executive Director, Idaho Board of Veterinarian Medicine, stated that the Idaho board changed its rules in 2007 to accept PAVE. The Idaho has not had any problems with the PAVE program. She explained that she has found her board members to be extremely qualified to evaluate a testing program to determine whether a foreign graduate meets the same competency standards. She offered her belief that public could have great faith in their veterinary board members. She related that one of her board members served on the PAVE development committee and he found the program to be outstanding. She reported that what the Idaho board has found an increase of about five percent of licensees in the past four years since the board has accepted PAVE. Additionally, a majority of the foreign graduates grew up in the U.S. but attended the Idaho Board received a letter from a student in a foreign university in a PAVE program who grew up in Idaho and wanted to practice Veterinary medicine in Idaho upon graduation. She indicated that the Idaho Board researched the matter and found PAVE to be an exceptional program, at least as good as the AVMA's ECFVG. She concluded that the public can trust their board members to be qualified to make these decisions. 4:35:32 PM REPRESENTATIVE SADDLER asked whether she was speaking on behalf of the board. MS. EWING answered that she is speaking on behalf of the board to describe Idaho's experience. 4:35:55 PM REPRESENTATIVE MILLER asked whether the Idaho's board is similar to Alaska's board, which is a five member board, four of whom are veterinarians and one public member appointed by the governor. MS. EWING answered that the Idaho Board consists of five licensed veterinarians and one public member. She reiterated that one former Idaho Board member also served on the PAVE committee. The current public member also serves as the public member on the National Board of Veterinary Medical Examiners (NBVME). The NBVME also created the qualifying exam that is part of the PAVE program and the Veterinary Clinical Skills Assessment Test that is part of the PAVE completion pathway, she said. 4:37:10 PM REPRESENTATIVE MILLER related his understanding that once the Idaho Board could accept the PAVE process, the Idaho board created additional testing. MS. EWING explained that in Idaho, the authorizing statute specifically mentioned students of non-accredited universities and mentioned the ECFVG program. Additionally, the Idaho board allowed any equivalency program established for the purpose of evaluating an individual's educational knowledge and clinical skills as it related to the practice of Veterinary medicine and as approved an outlined by the rules of the board. Thus, the Idaho Board did not have to change its statute and just added a rule that incorporated the PAVE program by reference. She added that the ECFVG program was also incorporated by reference. 4:38:59 PM REPRESENTATIVE MILLER related his understanding that the Idaho Board has not seen any diminished in capabilities of the veterinary licensees. MS. EWING answered that in the four years the Idaho Board has accepted foreign graduates who participated in the PAVE program that the Idaho Board has not received a single complaint against any of the veterinarians nor has it taken any disciplinary action against them. However, it has taken disciplinary actions against ECFVG graduates. She characterized the disciplinary process as largely based on individual person since she finds both the PAVE and the ECFVG programs are excellent programs to determine educational equivalency for graduates of non- accredited universities. 4:39:58 PM MARYANN HOLLICK, Veterinarian, stated that she has been a veterinarian in Alaska for over 20 years. She testified in opposition to HB 139. She stated that in addition to clinical practice, she previously owned and operated a large Veterinary Hospital in Anchorage. She said, "I object to HB 139. This bill would delete the requirement for the nationally AVMA testing standard. In my opinion Alaskan pet owners receive and deserve the best care." She found it troubling to see bills of this nature. Since Alaska currently has high standards the implication is that the standard will be reduced. She offered her belief that the bill would create uncertainty for practices from year to year as practitioners await the actions of the board. She urged members not to adopt HB 139. Additionally, she related that she personally has visited the non-accredited Caribbean Veterinary Schools and met with their dean in last six months. They do not have a Veterinary teaching hospital and do not provide any clinical training until the students come to the U.S. She pointed out that a non-accredited university is not the same as an accredited U.S. university. She indicated that the AVMA has decided to accept the ECFVG and not to accept PAVE. If at some point the AVMA accepts PAVE then she would suggest Alaska should reconsider this issue. Until then she does not believe the two programs are equal. [HB 139 was held over.] 4:42:26 PM