Legislature(2011 - 2012)BARNES 124

03/23/2012 03:15 PM House LABOR & COMMERCE


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03:24:07 PM Start
03:24:28 PM HB251
04:44:46 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 300 GEOGRAPHIC COLA FOR JUSTICES AND JUDGES TELECONFERENCED
<Bill Hearing Canceled>
+= HB 251 PRACTICE OF VETERINARY MEDICINE TELECONFERENCED
Heard & Held
             HB 251-PRACTICE OF VETERINARY MEDICINE                                                                         
                                                                                                                                
3:24:28 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON  announced that the  only order of business  would be                                                               
SPONSOR SUBSTITUTE  FOR HOUSE BILL  NO. 251, "An Act  relating to                                                               
the Board of Veterinary Examiners  and the practice of veterinary                                                               
medicine."                                                                                                                      
                                                                                                                                
3:24:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSON  made  a  motion to  adopt  the  proposed                                                               
committee  substitute  (CS)  for  HB  251,  labeled  27-LS1062\R,                                                               
Martin, 3/20/12.                                                                                                                
                                                                                                                                
CHAIR OLSON objected  for purpose of discussion.   [Version R was                                                               
before the committee.]                                                                                                          
                                                                                                                                
3:25:21 PM                                                                                                                    
                                                                                                                                
ANNETTE KREITZER,  Staff, Representative Alan Dick,  Alaska State                                                               
Legislature,  explained the  changes in  the proposed  CS for  HB
251, Version R, as it relates to  Version D.  She noted that some                                                               
concern had  been expressed  about the  language "or  country" on                                                               
page 1, line 11 of Version D.   This language has been deleted in                                                               
Version R.  She stated that  Version R also deletes language that                                                               
removed  the  veterinary  board   oversight  of  Alaska  licensed                                                               
veterinarians practicing uncompensated care.   In other words, it                                                               
would  put veterinarians  who are  practicing uncompensated  care                                                               
back under the  purview of the board.  She  stated that Version R                                                               
deletes  language limiting  the  Board to  determine the  license                                                               
status of a person and deletes the immunity clause.                                                                             
                                                                                                                                
MS.  KREITZER stated  that Section  2 was  confusing since  there                                                               
were  two terms  pertaining  to nonmonetary  compensation so  the                                                               
term   "nonmonetary  donations"   was  removed.     Uncompensated                                                               
practice does  not include reimbursement  for actual  expenses or                                                               
other nonmonetary consideration.                                                                                                
                                                                                                                                
MS.  KREITZER related  that  Version R  deletes  the language  in                                                               
Section  2 of  Version  D -  with respect  to  the surrender  and                                                               
reinstatement of  a license - as  a result of testimony  given at                                                               
the last  meeting.  Additionally,  the sponsor deleted  the words                                                               
"or  experimental"  from  page  2,  lines  22-26  of  Version  R.                                                               
Version  D  had the  language  negligent  conduct solely  on  the                                                               
experimental   or  unconventional   nature   of  the   licensee's                                                               
practice.   She explained  that this language  is in  the medical                                                               
statutes but it made some people uncomfortable.                                                                                 
                                                                                                                                
MS. KREITZER  stated that  on page  3, lines  13-14 of  Version R                                                               
corrects a  drafter's error which  corrects that the notice  of a                                                               
complaint  describing  the  allegation   shall  be  sent  to  the                                                               
licensee and not  the complainant.  Section 4 would  create a new                                                             
section that  requires the Board  of Veterinary  Examiners (BVE),                                                               
in  conjunction with  the Department  of Commerce,  Community and                                                               
Economic  Development  (DCCED),  to   prepare  a  report  on  the                                                               
availability  of  veterinary  services  in  rural  Alaska.    She                                                               
indicated the  report is due  to the legislature by  December 31,                                                               
2012.    The BVE  must  consult  with  the Alaska  Federation  of                                                               
Natives (AFN)  in preparing  the report.   She related  that some                                                               
testimony by veterinarians indicated that  if the state would pay                                                               
their  way they  would  go  to rural  Alaska.    The language  in                                                               
Version  R says  the solution  should not  be the  expenditure of                                                               
additional state funds.                                                                                                         
                                                                                                                                
3:28:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MILLER  commended  the changes  improved  HB  251                                                               
considerably.   He referred  to page 1,  Section 1,  which states                                                               
that veterinarians must  work within the scope  of their license.                                                               
He referred  to page 2,  line 25, which  speaks in terms  of "...                                                               
negligent conduct  solely on the  unconventional nature...."   He                                                               
related his  understanding that if  a veterinarian  is practicing                                                               
within   the   scope   of  their   license,   the   language   of                                                               
unconventional would not really apply.                                                                                          
                                                                                                                                
MS. KREITZER  answered that  there is  a section  that identifies                                                               
the  standard of  care, which  indicates  basically what  another                                                               
veterinarian might do.  She  suggested that a veterinarian may be                                                               
practicing  within   the  scope   of  their  practice,   but  the                                                               
conventional  nature  aspect  may differ  between  practitioners.                                                               
She offered to identify the specific language for members.                                                                      
                                                                                                                                
3:31:10 PM                                                                                                                    
                                                                                                                                
DIANE  PREZIOSI, Veterinarian,  Alaska Veterinary  Specialists of                                                               
Alaska; President,  Alaska Veterinary Medical  Association (AVMA)                                                               
stated  that she  graduated from  the University  of Missouri  in                                                               
1992, and has practiced in Texas,  Missouri, and Alaska.  She has                                                               
practiced  as a  small animal  practitioner  and has  gone on  to                                                               
specialty  practice in  dermatology.   She has  also lectured  to                                                               
students, veterinarians, and lay people  in Alaska.  She said she                                                               
has  clients in  Anchorage, Fairbanks,  Matanuska-Susitna valley,                                                               
Delta Junction, Tok, Barrow, Nome,  Bethel, Kodiak, Dutch Harbor,                                                               
Haines, Petersburg,  Juneau, Cordova, Valdez, and  Kotzebue.  She                                                               
has flown to the  Bush on one occasion with Dr.  Jim Leach to see                                                               
patients.   She  offered that  she does  pro bono  work with  the                                                               
Alaska Zoo and Bird TLC in  Anchorage.  Speaking on behalf of the                                                               
Alaska  Veterinary Medical  Association (AVMA),  she stated  that                                                               
veterinarians take an  oath, which reads, "to  use our scientific                                                               
knowledge and our  skills for the benefit of  society through the                                                               
protection  of  animal health  and  welfare,  the prevention  and                                                               
relief   of  animal   suffering,  the   conservation  of   animal                                                               
resources, the  promotion of public  health, and  the advancement                                                               
of  medical knowledge."    She indicated  the  AVMA supports  any                                                               
effort that brings  better service to the citizens  of Alaska who                                                               
own animals no matter where they  are.  She related that the AVMA                                                               
realizes  some areas  in Alaska  are without  fulltime veterinary                                                               
care   and   small   communities  cannot   support   a   fulltime                                                               
veterinarian  and may  be  reliant on  fly-in  services or  other                                                               
methods of  care.  Several  veterinarians serve the  larger rural                                                               
communities  off the  road  system, but  that  still leaves  many                                                               
smaller villages without adequate care.   Although the AVMA would                                                               
like to  see all  animals receive routine  care, the  AVMA cannot                                                               
support a  bill that  erodes adequate standards  of care.   Under                                                               
the current  statutes and regulations,  Article 2,  AS 08.98.120,                                                               
licensing is required in the  state when a veterinarian practices                                                               
in Alaska.                                                                                                                      
                                                                                                                                
3:34:42 PM                                                                                                                    
                                                                                                                                
DR. PREZIOSI stated that Section  4 establishes standards for the                                                               
practice of  veterinary medicine under  the powers and  duties of                                                               
the BVE.  Ms. Kreitzer discussed  the standards of care such that                                                               
veterinarians  approach a  medical  or surgical  case in  various                                                               
ways.                                                                                                                           
                                                                                                                                
The   committee   took  a   brief   at-ease   due  to   technical                                                               
difficulties.                                                                                                                   
                                                                                                                                
3:35:39 PM                                                                                                                    
                                                                                                                                
DR.   PREZIOSI   continued.     She   said   she   thought   some                                                               
misconceptions  exist  with  respect to  veterinarians  providing                                                               
care.     Further,  she  stated   that  some  people   thought  a                                                               
veterinarian  would  be  prosecuted  for handling  a  case  in  a                                                               
specific  manner; however,  she related  there are  many ways  to                                                               
provide veterinarian care.  She  also thought there has been some                                                               
misconception about veterinarians  providing oversight over other                                                               
veterinarians, but that simply is not the case.                                                                                 
                                                                                                                                
DR.  PREZIOSI referred  to  proposed Section  1  [of Version  R],                                                               
which  would  allow a  veterinarian  not  licensed in  Alaska  to                                                               
practice in  the state so  long as  they were not  compensated by                                                               
wages.   She  said  this  would not  ensure  the veterinarian  is                                                               
licensed or is in good standing  in another state.  She explained                                                               
that  a mechanism  currently exists  to  verify a  veterinarian's                                                               
licensure and  standing in another  state; however,  this control                                                               
would be  lost under  the bill.   She  reiterated that  this bill                                                               
does  not  provide  any  assurance  the  person  volunteering  to                                                               
provide veterinary care in Alaska  is in good standing in another                                                               
jurisdiction.                                                                                                                   
                                                                                                                                
3:37:30 PM                                                                                                                    
                                                                                                                                
DR. PREZIOSI  questioned how an  owner could make a  complaint if                                                               
the veterinarian is not registered in  the state.  She also asked                                                               
how an  owner could  get copies  of a  record or  a prescription.                                                               
She  further asked  and who  would pay  for any  investigation of                                                               
volunteer  veterinarians.    She   then  indicated  the  BVE  and                                                               
licensees'  fees   pay  for  the  BVE   and  any  investigations.                                                               
Further,  the   AVMA  believes  it   is  unjust  to   use  Alaska                                                               
veterinarians' license fees  to support those who  are allowed to                                                               
practice  without   paying  any  fees,  particularly   since  the                                                               
veterinarians' license fees  are already high.   She related that                                                               
monetary compensation  is still  undefined for  such compensation                                                               
as a hunt, a  cabin, or a plane ride.   She questioned the reason                                                               
these volunteer  veterinarians are absolved from  licensure.  She                                                               
further questioned how  voluntary veterinarians' activities would                                                               
be monitored to  ensure they are confined to the  rural areas and                                                               
do not  practice in  Anchorage, Juneau,  Fairbanks, or  the Kenai                                                               
Peninsula.                                                                                                                      
                                                                                                                                
3:39:00 PM                                                                                                                    
                                                                                                                                
DR. PREZIOSI  referred to proposed  Section 2 [Version R]  of the                                                               
bill with respect  to the grounds for  imposition of disciplinary                                                               
sanctions.   She reported  the AVMA has  numerous concerns.   She                                                               
said  that just  because repeated  professional incompetence  has                                                               
not  yet harmed  an  animal does  not  mean it  will  never be  a                                                               
problem.   She related a  scenario in  which a person  could spay                                                               
animals  using  unsterilized  equipment,   which  she  said  will                                                               
eventually cause a  problem.  She predicted that it  may not kill                                                               
the first animal,  but eventually an animal will die  due to poor                                                               
surgical procedures.   She questioned whether it  is necessary to                                                               
wait  for an  animal's  death from  poor  practice before  taking                                                               
action.   She stated that  adding gross negligence  and negligent                                                               
misconduct  seems  to  raises  the  bar  significantly  to  prove                                                               
incompetence  making  it  very   difficult  to  prosecute.    She                                                               
indicated  that  the term  "unconventional"  is  not defined  and                                                               
should be  or other language  should be inserted to  indicate the                                                               
term will be defined by the BVE.                                                                                                
                                                                                                                                
3:40:28 PM                                                                                                                    
                                                                                                                                
DR. PREZIOSI  remarked that veterinarians  do not  police another                                                               
veterinarian's  cases.   She pointed  out  the varied  practices,                                                               
including    that   some    veterinarians   employ    homeopathy,                                                               
acupuncture, and Chinese herbal  remedies, in addition to Western                                                               
medicine.       Many   would   consider   these    practices   as                                                               
unconventional;   however,   the  veterinarians   using   Western                                                               
medicine do not try to  police those who choose less conventional                                                               
forms  of  medical  therapies although  veterinarians  do  expect                                                               
standards to  be followed.   She suggested  that having  the term                                                               
"unconventional" defined by  the BVE would be  consistent with AS                                                               
08.98.050,  which  gives the  board  the  authority to  establish                                                               
standards for the practice of veterinary medicine.                                                                              
                                                                                                                                
3:41:28 PM                                                                                                                    
                                                                                                                                
DR.  PREZIOSI referred  to proposed  Section 3  of HB  251, which                                                               
relates   to  complaints,   investigations,   and  hearings   for                                                               
veterinarians.    She  offered that  this  provision  establishes                                                               
guidelines  for   complaints  and  subsequent  handling   of  the                                                               
complaints, which could  be beneficial.  She  outlined the AVMA's                                                               
concerns.     She  questioned,  specifically,  which   entity  is                                                               
responsible for  expenses for interviews  under oath for  all the                                                               
outlying parties.  Additionally,  she suggested the limitation on                                                               
who can lodge  a complaint can be problematic.   She indicated if                                                               
a  trend  of misconduct  is  suspected  by someone  not  directly                                                               
involved in  the care  or ownership of  the animals  in question.                                                               
She related a scenario in which  an animal is spayed in the Bush,                                                               
but the  ureter is  tied off  during the surgery.   She  said the                                                               
animal will  die within  the next week.   She  questioned whether                                                               
the  owner will  understand the  reason the  animal died  and who                                                               
will report the veterinarian's poor  performance.  She reiterated                                                               
that under  HB 251 only the  owner can report the  complaint, but                                                               
if someone  associated with the animal  or in the village  sees a                                                               
pattern these  people will  have no right  or recourse  to report                                                               
the problem.                                                                                                                    
                                                                                                                                
3:43:05 PM                                                                                                                    
                                                                                                                                
DR. PREZIOSI turned  to proposed Section 4 of HB  251. She stated                                                               
that  the AVMA  would  support any  ongoing  dialogue to  address                                                               
veterinary  needs in  Bush Alaska.   She  said AS  08.98.050 (7),                                                               
reads,  "As requested  by the  department, monitor  the standards                                                               
and  availability of  veterinary services  provided in  the state                                                               
and report its findings to  the department."  She reiterated that                                                               
this  is  current  statute.   She  suggested  that  the  proposed                                                               
language that  requests the report on  availability of veterinary                                                               
services in rural  Alaska seems redundant except  it requires the                                                               
information by  [December 31, 2012]  and asks the BVE  to consult                                                               
with  AFN when  preparing the  report.   She asked  if the  board                                                               
should  also be  consulting  with the  Alaska Veterinary  Medical                                                               
Association  and  the  Interior Veterinary  Medical  Association.                                                               
She reported that there is also  a newly formed group, the Alaska                                                               
Rural  Veterinary Outreach,  who  seeks to  bring  care to  rural                                                               
communities.    She questioned  who  will  pay for  the  proposed                                                               
study.  She wondered in the  event HB 251 passes whose funds will                                                               
be spent and  how the veterinarian services will  be delivered to                                                               
the Bush.                                                                                                                       
                                                                                                                                
3:44:35 PM                                                                                                                    
                                                                                                                                
DR. PREZIOSI  pointed out that  veterinarians under the  bill are                                                               
not  licensed  in  the  state  and  cannot  legally  give  rabies                                                               
vaccinations.    She stated  that  these  "not for  compensation"                                                               
veterinarians will  not be covered  under other  states' statutes                                                               
related  to  licensed  veterinarians.   She  concluded  that  the                                                               
issues present  significant health concerns that  impact not only                                                               
animal  public health  but also  human health  and welfare.   She                                                               
stated that  the AVMA  believes this bill  could ultimately  be a                                                               
disservice  to  Alaskans  by  opening  the  door  to  substandard                                                               
veterinary care.   She  related that  the AVMA  is eager  to work                                                               
with any interested  group to provide qualify  veterinary care in                                                               
rural Alaska.                                                                                                                   
                                                                                                                                
3:45:45 PM                                                                                                                    
                                                                                                                                
ROCKY  L.  JAMES,  Gwichyaa   Zhee  Gwich'in  Tribal  Government,                                                               
testified  in  support  of veterinarians  providing  services  in                                                               
rural villages  in Alaska.   He said he consulted  with community                                                               
members via the radio and heard  back from them.  He reported the                                                               
current animal count  in Fort Yukon is  178 dogs and 3  cats.  He                                                               
added that Fort  Yukon will also have some  chickens this summer.                                                               
Most  of the  concerns expressed  by villagers  are related  to a                                                               
desire  to have  licensed veterinarians  come to  the village  to                                                               
administer rabies shots,  document the dogs, and spay  dogs.  The                                                               
villagers  also   expressed  concern   that  lots  of   dogs  not                                                               
registered since the dogs must be  sent to Fairbanks to do so and                                                               
to receive  medicines if they  are sick  or injured.   He thanked                                                               
the  committee   for  considering  HB   251.    He   related  his                                                               
understanding  that  some  veterinarians would  like  to  perform                                                               
services in  rural Alaska and this  bill would make it  easier to                                                               
work  with  the  Alaska  Federation  of  Natives  (AFN)  to  find                                                               
solutions  for veterinary  care.   He reported  that about  three                                                               
years  ago   a  veterinarian  visited  and   performed  services.                                                               
Further about  30 years  ago, Johnny Thomas,  who worked  for the                                                               
Tanana Chiefs Conference (TCC),  was trained to administer rabies                                                               
shots and  kept records.   Mr. Thomas traveled to  Circle, Arctic                                                               
Village, Venetia,  Beaver, and Stevens  Village to  reduce rabies                                                               
and  parvovirus incidence.    He concluded  by  stating that  the                                                               
Gwichyaa  Zhee Gwich'in  Tribal  Government  and community  would                                                               
like to see the bill pass.                                                                                                      
                                                                                                                                
3:49:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MILLER  asked him  to describe the  general result                                                               
of having visiting veterinarians come  to the village and perform                                                               
routine services.                                                                                                               
                                                                                                                                
MR. JAMES  answered that  he personally has  three dogs,  but one                                                               
died last summer.  He stated  that the village had the facilities                                                               
to  accommodate   the  veterinarians.    He   reported  that  the                                                               
community was very supportive and  paid the airline fares for the                                                               
veterinarian.   Additionally, the experience was  educational for                                                               
Fort Yukon  students since  they were  invited to  participate in                                                               
documenting the dogs  and cats in the village.   He said at least                                                               
one  or  two  students  wanted   to  continue  with  veterinarian                                                               
services.   However, the veterinary  service has stopped  and the                                                               
village is concerned about diseases  the dogs may contract, which                                                               
could easily spread.                                                                                                            
                                                                                                                                
3:52:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   MILLER  related   his  understanding   that  the                                                               
voluntary  veterinarian did  an  adequate job  and satisfied  the                                                               
villagers and documented the animals.                                                                                           
                                                                                                                                
MR. JAMES answered that the  villager was very satisfied with the                                                               
work.  He noted that there may even  be more than 178 dogs in the                                                               
village as he may have missed some.                                                                                             
                                                                                                                                
CHAIR OLSON inquired  as to why there are only  three cats in the                                                               
village.                                                                                                                        
                                                                                                                                
MR.  JAMES concluded  by  thanking the  committee  and hoped  for                                                               
progress.   He  offered  to inform  the  community about  today's                                                               
hearing.                                                                                                                        
                                                                                                                                
3:53:39 PM                                                                                                                    
                                                                                                                                
JAMES  DELKER, Veterinarian,  Past  President; Alaska  Veterinary                                                               
Medical  Association (AVMA),  stated  he  is providing  follow-up                                                               
testimony to Dr. Preziosi, who  outlined the AVMA's concerns very                                                               
well.   He reiterated some  concerns, noting  Section 2 and  3 of                                                               
the  bill  are  protective  of veterinarians  and  make  it  more                                                               
restrictive to  pursue disciplinary actions  against veterinarian                                                               
malpractice across the  state.  He emphasized  that ethically the                                                               
veterinarians are concerned with  adequately protecting rights of                                                               
Alaskans  to  lodge  complaints for  medical  malpractice  within                                                               
veterinary medicine.   While some parts of Section 2  and 3 of HB                                                               
are appealing at  first glance, he said he  was uncertain whether                                                               
the  provisions  are in  the  best  interests  of Alaskans.    He                                                               
specifically referred  to Section 4 and  said he was unsure  if a                                                               
study is really necessary.                                                                                                      
                                                                                                                                
3:56:04 PM                                                                                                                    
                                                                                                                                
DR.  DELKER  offered his  belief  everyone  is aware  that  rural                                                               
Alaska needs services and the  debate currently is focused on how                                                               
to  best  provide  the  necessary   services  and  the  financial                                                               
support.  He  acknowledged that the standards of  care can happen                                                               
in field  medicine.   He said  it seems  apparent from  Section 4                                                               
that  state funds  would not  be  used so  the hurdle  is how  to                                                               
obtain  the  funds.    He  questioned  whether  nonprofits  would                                                               
provide  the  funding.    He  suggested  that  the  Alaska  Rural                                                               
Veterinary   Outreach,  Inc.   (ARVO)   is   probably  the   best                                                               
organization  to address  the rural  veterinary care  issue.   He                                                               
recalled  other  organizations  have  tried  to  provide  similar                                                               
services  in rural  Alaska, but  the formula  ARVO uses  includes                                                               
using Alaska  veterinarians licensed  in the  state.   He offered                                                               
his belief this  will avoid many issues  and problems surrounding                                                               
providing  rural veterinary  care  using volunteer  veterinarians                                                               
not  licensed in  Alaska.   He  indicated issues  have arisen  by                                                               
using  Lower 48  veterinarians since  they provide  periodic care                                                               
and may come  in once or twice a year  to communities with little                                                               
follow-up care.   He pointed out that the ARVO  is working to set                                                               
up  a process  for periodic  service, follow-up  care, and  phone                                                               
support  outside the  veterinarians'  visits.   He applauded  the                                                               
sponsor's  intentions by  introducing  HB 251  and commended  the                                                               
sponsor and staff for their intentions.                                                                                         
                                                                                                                                
3:58:31 PM                                                                                                                    
                                                                                                                                
KEN HILL, Veterinarian, Waterways  Veterinary Clinic, stated that                                                               
he has  a rural  veterinary practice  that serves  communities of                                                               
Cordova, Petersburg,  Wrangell, Thorne  Bay, Elfin  Cove, Haines,                                                               
Skagway, and Hoonah.  He  related in his experience that offering                                                               
free veterinary  services in areas  in which  other veterinarians                                                               
have established a practice can  be very disruptive to veterinary                                                               
practices.   He explained that the  voluntary veterinarians often                                                               
perform   spays,  neuters,   and  vaccinations,   which  can   be                                                               
disruptive  to  the  established   veterinarian  since  they  are                                                               
uncertain  which  services  communities   will  need  until  they                                                               
arrive, yet the veterinarian incurs  the same travel costs to the                                                               
communities.  He suggested that  members should be cautious about                                                               
allowing  volunteer veterinarians  to provide  services in  areas                                                               
with an  established rural practice  since it does not  serve the                                                               
communities at  all when someone else  comes in.  He  offered his                                                               
belief that the work tends to  be spotty and does not provide the                                                               
full range  of veterinary services.   He described  his practice,                                                               
such  that he  performs  spays,  neuters, vaccinations,  performs                                                               
surgeries,  dentistry,  prevention,   problem  solves,  including                                                               
anticipating  problems the  animals  may develop.    He said  the                                                               
continuity of care is lacking  with volunteer veterinarians since                                                               
the same veterinarian may not visit the communities.                                                                            
                                                                                                                                
4:02:40 PM                                                                                                                    
                                                                                                                                
DR.  HILL  elaborated  that  he  usually  brings  in  substantial                                                               
equipment,  including anesthesia,  dentistry,  and surgical  unit                                                               
important for  more complicated  surgeries to  rural communities.                                                               
He related that  if a veterinarian visited Fort  Yukon or another                                                               
community  that he/she  would  be able  to do  some  of the  more                                                               
complicated surgeries  if the veterinarian  had the same  kind of                                                               
equipment.   He  offered his  belief that  a volunteer  would not                                                               
likely  include  this  type  of   service.    He  emphasized  the                                                               
importance  of  having more  specialized  services  offered by  a                                                               
veterinarian who knows the communities' needs.                                                                                  
                                                                                                                                
4:04:04 PM                                                                                                                    
                                                                                                                                
DR. HILL recalled  Mr. James mentioning in  earlier testimony the                                                               
importance  of   documentation.    He  offered   that  he  brings                                                               
computers and  enters all  the records  of animals  and documents                                                               
any rabies  and distemper shots  administered.   Additionally, he                                                               
can provide copies of these records  upon request by the owner or                                                               
referral.    He  doubted  whether a  visiting  veterinarian  from                                                               
another state  could do so,  as well  as whether they  could also                                                               
provide  telephone  follow-up  consultations.   He  concluded  by                                                               
stating  that  type  of  care   would  be  reduced  by  volunteer                                                               
veterinarians.                                                                                                                  
                                                                                                                                
4:06:02 PM                                                                                                                    
                                                                                                                                
JIM LEACH, Veterinarian, Trail Doc,  said he has been in practice                                                               
for a number  of years and is licensed in  numerous other states,                                                               
including  Missouri  and  California,   which  gives  him  varied                                                               
experience.   He stated that he  initially came to Alaska  in the                                                               
early 70s and  his practice extended from Nome to  Eagle and from                                                               
Seward to  Bethel via airplane travel.   He reported that  he has                                                               
held  clinics  in  communities  on  the  Aleutian  Chain  and  in                                                               
Yakutat.   He offered  his belief that  two separate  issues have                                                               
arisen  -  nonlicensed care  and  providing  service to  outlying                                                               
communities.    He  offered  during  his  35  years  of  offering                                                               
veterinary services  to rural  Alaska that he  has had  very good                                                               
relationships with  villagers, including that many  help organize                                                               
his clinics  and assist on  clinic day.   He acknowledged  one of                                                               
the difficulties is  the cost of travel since aviation  gas is so                                                               
costly.   He recalled earlier  testimony from a villager  in Fort                                                               
Yukon indicating  the village  paid for  a round-trip  ticket for                                                               
the veterinarian  to travel.  He  suggested that Section 4  of HB
251 could be amended if  villages could provide some compensation                                                               
for travel.                                                                                                                     
                                                                                                                                
4:09:25 PM                                                                                                                    
                                                                                                                                
DR.  LEACH  stated  that  much of  Alaska's  veterinary  care  is                                                               
unique.  He  said normal care is given at  a veterinary hospital,                                                               
but that  type of facility is  not available in the  Bush so care                                                               
is handled differently.  He  suggested a non-Alaskan veterinarian                                                               
may  not understand  how to  handle vaccines  to ensure  they are                                                               
still viable  vaccines.  He expressed  concern about non-licensed                                                               
veterinarians practicing in the state,  which is a serious matter                                                               
since   without  BVE's   licensure   and  oversight   non-Alaskan                                                               
veterinarians may  not understand  the difficulties  in providing                                                               
veterinarian  services in  rural  Alaska.   He further  suggested                                                               
veterinarians in  the state should  work directly  with villagers                                                               
rather  than  through  AFN  to  address their  needs.    He  also                                                               
expressed  concern about  the  lack  oversight by  the  BVE.   He                                                               
acknowledged the veterinary service is  needed but pointed out it                                                               
is costly to fund the village  clinics and that issue needs to be                                                               
addressed.                                                                                                                      
                                                                                                                                
4:12:13 PM                                                                                                                    
                                                                                                                                
HAYDEN NEVILL, Veterinarian, agreed  the veterinary care needs is                                                               
significant  in  rural  Alaska.    He  stated  that  HB  251  has                                                               
significant  problems.   He offered  his belief  that the  bill's                                                               
sponsor  does not  have a  good grasp  of what  standard of  care                                                               
means.  He stated that  removing the word "experimental" does not                                                               
resolve the  issue of people  not being informed in  instances in                                                               
which the  animal is receiving  unusual treatment.   He suggested                                                               
that  as  a  veterinarian  it is  his  responsibility  to  inform                                                               
clients   if  they   are   receiving  unconventional   treatment.                                                               
Alaskans  have  the right  to  know  if  their pets  are  getting                                                               
unconventional treatment, he said.   He highlighted that the bill                                                               
would limit  reporting requirements  which guts  some protections                                                               
Alaskans have.   He  related his understanding  that HB  251 does                                                               
not protect people against dangerous  drugs used in food animals,                                                               
inactive  rabies vaccines  being  used, or  controlled drugs  not                                                               
being handled  properly resulting in  the drugs ending up  on the                                                               
street.   The bill would  require that the  BVE make a  report to                                                               
the AFN, which he  agreed is a great idea.   He suggested that if                                                               
the BVE  is required to do  this that the funding  should also be                                                               
available to cover the expenses of that report.                                                                                 
                                                                                                                                
4:13:57 PM                                                                                                                    
                                                                                                                                
DR. NEVILL  remarked that  the no  bill will  fix the  problem of                                                               
poor  veterinary care  in the  villages.   He offered  his belief                                                               
that  the issue  of rural  veterinary care  is not  a legislative                                                               
issue but one  of people needing to work together.   He suggested                                                               
that the  AFN and  other interested groups  work with  the Alaska                                                               
Veterinary  Association (AVA)  to  organize and  hold clinics  in                                                               
villages.    He highlighted  that  plenty  of interested  parties                                                               
could hold clinics, including the  ARVO and other people who take                                                               
a professional approach  to veterinary care.   He emphasized that                                                               
this problem is not a  legislative issue and continuing to pursue                                                               
this bill is  a waste of resources.  He  concluded that there are                                                               
better  ways to  address the  problem of  veterinary care  in the                                                               
villages.                                                                                                                       
                                                                                                                                
4:14:57 PM                                                                                                                    
                                                                                                                                
SARAH  LOVE,   Veterinarian,  Veterinary  Internal   Medicine  of                                                               
Alaska, stated  that she is  a small animal  veterinary internist                                                               
who practices  in Fairbanks and Anchorage.   She did not  wish to                                                               
repeat  testimony,  but  offered   to  highlight  some  important                                                               
points.   She  said everyone  is aware  rural health  care is  an                                                               
important issue, but  it is a huge undertaking, even  in areas as                                                               
close to  larger communities, such  as Fort Yukon.   She referred                                                               
to  Section 1  of  HB  251 and  suggested  the committee  further                                                               
evaluate  other  Alaska  boards and  professions,  such  as  law,                                                               
medicine  and dentistry,  with  respect  to unlicensed  practice.                                                               
She offered  her belief  that these  professions would  not allow                                                               
professionals  from other  states to  practice in  Alaska without                                                               
consent and  oversight.  She  characterized that  infringement as                                                               
demeaning to  the veterinary profession  as a whole.   She stated                                                               
that  no  veterinarian she  knows  would  expect to  practice  in                                                               
another state without licensure.                                                                                                
                                                                                                                                
4:16:32 PM                                                                                                                    
                                                                                                                                
DR.  LOVE  referred to  Section  2  of  HB  251 would  allow  any                                                               
individual licensed by the BVE  has the right to maintain his/her                                                               
license or not.  She  related that individuals could surrender or                                                               
allow their licenses to lapse  without consequence, regardless of                                                               
their standing  with the  board, which  she supported.   However,                                                               
she  questioned  whether this  bill  was  written with  a  single                                                               
individual  in mind.   She  said she  did not  believe that  laws                                                               
should  be changed  to  address the  needs of  one  person.   She                                                               
referred  to  Section  3  of  the  bill,  which  further  defines                                                               
professional  incompetence,   which  would  allow  for   a  broad                                                               
interpretation of  the term  and could  lead to  unacceptable and                                                               
possibly  unethical care.   She  related the  committee discussed                                                               
the term  "unconventional" as it  pertains to a  clinical setting                                                               
in  urban  Alaska.    This  bill does  not  give  permission  for                                                               
substandard  care to  occur in  rural Alaska.   She  acknowledged                                                               
that  veterinarians  must  make  do  and  are  very  creative  in                                                               
developing  their  field  practices,  but  to  allow  substandard                                                               
practices to, take place simply due to location is unacceptable.                                                                
                                                                                                                                
4:18:01 PM                                                                                                                    
                                                                                                                                
DR.  LOVE referred  to Section  4 of  HB 251  and stated  that no                                                               
Alaskan  should  be  prevented  from making  a  complaint.    She                                                               
emphasized that any citizen - and  not just the owner - should be                                                               
able  to make  complaints to  the board.   She  pointed out  that                                                               
significant  public  health  concerns   could  arise.    Further,                                                               
additional  reporting may  not be  necessary since  some services                                                               
are availability,  but the important  thing is to figure  out how                                                               
to get  services to rural Alaska  and fund them.   She has worked                                                               
in  rural Alaska  as  a veterinarian  and as  an  educator.   She                                                               
characterized  the veterinary  needs  as huge  and  the issue  as                                                               
complex,  but holding  veterinarians  to a  sensible standard  of                                                               
care and  allowing protection for  Alaska's animals  and citizens                                                               
is of utmost  importance.  She offered her belief  that this bill                                                               
does not address this.                                                                                                          
                                                                                                                                
4:19:09 PM                                                                                                                    
                                                                                                                                
GERALD  RILEY  stated  that  he  is  an  Alaskan  Native  musher,                                                               
fisherman, and  has worked as a  captain on push boats.   He said                                                               
he is an elder from Nenana and  would like to speak in support of                                                               
HB  251  since  he  is  concerned about  the  dangerous  lack  of                                                               
veterinary care in remote Native  communities.  He suggested that                                                               
most  of   the  rural  communities   go  several   years  between                                                               
veterinary  visits.   He highlighted  that it  has been  three or                                                               
four years  since Nenana has  had a visiting veterinarian.   Many                                                               
of the  same communities without  veterinary care have  had their                                                               
rabies vaccination  program cut  by the  state since  2007, which                                                               
leaves thee communities completely  unprotected and vulnerable to                                                               
disease.  He  related that TCC cannot help either.   He predicted                                                               
that  if HB  251 does  not pass  the situation  will not  get any                                                               
better so  the community cannot drop  the issue. When there  is a                                                               
lack of  veterinarian care  disease and  parasites can  spread to                                                               
people.   He concluded by saying  that Nenana should not  have to                                                               
beg for these life-saving services.                                                                                             
                                                                                                                                
4:20:42 PM                                                                                                                    
                                                                                                                                
HAROLD  DAVID  stated   that  his  community  is   in  a  similar                                                               
circumstance  as  Fort Yukon  and  other  rural areas  that  lack                                                               
veterinary  services.    The  village  has had  to  pay  to  have                                                               
veterinarian services.   He said  he is  a local dog  musher, and                                                               
along  with other  members of  the Dog  Mushers Association  have                                                               
close to 200 dogs in the  village.  He expressed concern about an                                                               
increase in  diseases, such as  parvo that have been  killing off                                                               
the  pups.   He also  expressed  concern that  the village  needs                                                               
veterinary care  to sustain  healthy dogs  that can  produce good                                                               
pups.  He concluded that  the village needs veterinarians to come                                                               
to  the  village   just  as  Fort  Yukon   and  Nenana  residents                                                               
testified.  He urged members to support HB 251.                                                                                 
                                                                                                                                
4:22:57 PM                                                                                                                    
                                                                                                                                
VICKI  MOYLE,  Executive  Director,   Nenana  Council  on  Aging,                                                               
related  that the  council cares  for the  elderly and  disabled,                                                               
many of  whom have pets.   She stated that they  previously had a                                                               
rural  veterinarian visit  and set  up a  clinic near  the senior                                                               
center.  She recalled  the last visit was in 2009.   She said she                                                               
wrote letter  to BVE to  point out their  needs, but she  did not                                                               
receive an answer.  She  recalled that the prior veterinarian had                                                               
some grant money that would help  cover costs to neuter and spay.                                                               
He gave immunizations, cleaned animal's  teeth, provided spay and                                                               
neuter  services -  sometimes without  charging a  fee.   He also                                                               
performed  surgery  in sterile  environments.    She offered  her                                                               
belief  that comparing  the  quality of  care  between rural  and                                                               
urban Alaska is like comparing  apples and oranges.  Since Nenana                                                               
does   not  have   veterinarian  services,   the  community   has                                                               
experienced an  increase in  unwanted pups and  stray dogs.   She                                                               
pointed out  that many people live  on fixed income and  the cost                                                               
of gasoline  is high.   She  offered her  belief that  instead of                                                               
taking their animals to health  care, often times they go without                                                               
care.      She   recalled  earlier   testimony   about   visiting                                                               
veterinarians.    She  pointed  out that  when  the  veterinarian                                                               
visited  her community  experienced  fewer  strays, records  were                                                               
kept, the  veterinarian provided  diagnostics and  surgeries, and                                                               
an  assistant  kept  records.   She  characterized  the  previous                                                               
program as a good one.  She  emphasized that no one has been able                                                               
to  fill the  gap once  their veterinarian  stopped coming.   She                                                               
acknowledged funding as an issue.   She recalled that some people                                                               
would pay  more to cover  the costs of  those that could  not pay                                                               
for services.   She concluded her testimony by  offering that the                                                               
when  her  community  had veterinarian  services  the  number  of                                                               
strays  were  reduced  drastically,  the  animals  received  much                                                               
better care,  and the veterinarian  was respected.   She remarked                                                               
that some people  will always complain.  She  offered her support                                                               
and the support of her clients for  HB 251.  She asked members to                                                               
look at the  positive things in the bill since  it all boils down                                                               
to a need for care in rural communities.                                                                                        
                                                                                                                                
4:28:11 PM                                                                                                                    
                                                                                                                                
LORRAINE LANDERS stated  that she is a musher, but  also works in                                                               
the Indian Health  Services system.  She testified  in support of                                                               
HB  251.   She did  not want  to repeat  testimony, but  echoed a                                                               
longstanding  argument  of why  things  are  done differently  in                                                               
Alaska.   She stated that  some arguments used against  this bill                                                               
are ones  that have been  used against establishing  programs for                                                               
community and dental  health aides.  She said  that community and                                                               
dental health aide programs have had  a great deal of success and                                                               
has translated  to people receiving consistent  standards of care                                                               
in villages.   She  suggested that animals  need to  have similar                                                               
care.    She  argued  against  imposing  stricter  standards  for                                                               
veterinary  care  in  villages.   She  said  she  also  considers                                                               
veterinary  care  as  a  public   health  care  issue  since  the                                                               
incidence of rabies continues to  climb in Alaska.  Additionally,                                                               
more children have been bitten  by an excessive number of animals                                                               
in   the   villages.     She   finds   that  some   people   feel                                                               
disenfranchised  and  neglected  since  they  suffer  with  their                                                               
animals.   She  related  a  scenario in  which  a  child is  very                                                               
attached to dog and the dog  gets parvovirus or rabies, but there                                                               
is not a  veterinarian in the village to euthanize  an animal the                                                               
only option  is to kill the  animal.  Thus children  are impacted                                                               
in big  ways and the memories  linger.  She emphasized  that this                                                               
situation creates a level of  desperation and unless a person has                                                               
lived  through the  experience cannot  know what  it feels  like.                                                               
She emphasized  that things become desperate  at times especially                                                               
since this is a state and  country with resources.  She viewed HB
251 as a prescriptive formula for  future care.  She recalled she                                                               
once had  a dog with  an eye infection  and went to  the hospital                                                               
for  advice.   The hospital  staff suggested  that she  clean her                                                               
dog's eyes  with baby  shampoo and that  solution worked  and how                                                               
wonderful it was to have her  dog's eyes fixed.  She related that                                                               
she had called  veterinarians long distance for  advice, but they                                                               
were not able  to help her since the veterinarians  could not see                                                               
the dog.   She then said, "That  is not helpful."   She asked the                                                               
committee to please consider HB  251, which would allow people to                                                               
be empowered since so many animals are part of our families.                                                                    
                                                                                                                                
4:34:04 PM                                                                                                                    
                                                                                                                                
LINDA  JOHNSON   stated  she   is  a   small  kennel   owner  and                                                               
recreational musher.  She asked to  testify in support of HB 251.                                                               
She said  the bill  is long overdue  and is a  step in  the right                                                               
direction.   She said it  has been  interesting to listen  to the                                                               
veterinarians.    She asked  to  thank  the villagers  for  their                                                               
testimony.    She  agreed  with   Ms.  Landers  and  Ms.  Moyle's                                                               
comments.    She witnessed  a  veterinarian  who held  a  clinic,                                                               
performed surgeries,  vaccinations, and  did a  professional job,                                                               
which the community  appreciated.  She predicted that  if it were                                                               
left up to the veterinarians  in Alaska, Manley Hot Springs would                                                               
not have any help whatsoever.   She pointed out that she respects                                                               
veterinarians and has  used them in Fairbanks  and Anchorage, but                                                               
none of them are able to help  her community.  She stated that HB
251  is  a  step  in  the  right  direction.    She  related  her                                                               
understanding that money  is an issue, but it  should not prevent                                                               
the issue from moving forward.   She said she hopes the committee                                                               
will  consider the  needs of  the people  in rural  Alaska.   She                                                               
predicted that  if the veterinary  care issues are  not addressed                                                               
that  people will  get ill  and it  will ultimately  affect human                                                               
health.                                                                                                                         
                                                                                                                                
4:36:59 PM                                                                                                                    
                                                                                                                                
TOM KNUDSON  stated that he  owns sled dog with  health problems,                                                               
including  that the  dog has  blood  in its  feces.   He said  he                                                               
called  four veterinarians  in Fairbanks  for advice  in treating                                                               
his dog.   He said he  let them know he  would be glad to  sign a                                                               
hold harmless  letter, but he  still did not  get help.   He said                                                               
his  dog  is  lying  on  the  rug right  now.    He  related  his                                                               
understanding that  it is just  a matter  of time before  his dog                                                               
dies.    He  pointed  out  that what  goes  on  in  Fairbanks  is                                                               
different from what happens in his village.                                                                                     
                                                                                                                                
CHAIR  OLSON  responded  that  he  is also  a  dog  owner  so  he                                                               
understands how he feels.                                                                                                       
                                                                                                                                
4:38:31 PM                                                                                                                    
                                                                                                                                
GREGORY  TAYLOR stated  that he  is an  Alaska fisherman  and dog                                                               
musher.   He asked to  testify in support of  HB 251.   He thinks                                                               
this bill will help communities.                                                                                                
                                                                                                                                
4:39:46 PM                                                                                                                    
                                                                                                                                
PAM REDDINGTON  stated that she  has been  a dog musher  for many                                                               
years.    She  asked to  testify  in  support  of  HB 251.    She                                                               
explained  that veterinary  care  in rural  areas very  important                                                               
especially in  areas not  on road system.   She  acknowledged the                                                               
cost and time involved to try  to get animals to veterinary care.                                                               
She emphasized the  importance to have veterinarians  come to the                                                               
villages.    She said  it  has  been  over  six years  since  her                                                               
community  has  had veterinary  care.    She commented  that  the                                                               
veterinary  care  was  excellent   and  people  depended  on  the                                                               
veterinarian.   She said the  legislature needs to work  with AFN                                                               
on this bill in order to have  a better standard of care in rural                                                               
Alaska.  She stressed that this  is not just about care standards                                                               
for animals but also for humans.                                                                                                
                                                                                                                                
4:41:42 PM                                                                                                                    
                                                                                                                                
MR. TAYLOR said he does  not understand why private veterinarians                                                               
are  so  threatened  by  HB  251.   He  said  that  the  villages                                                               
sometimes go years  without veterinary care.   He said, "Everyone                                                               
in the world supports this bill  except a small group of business                                                               
owners."   He listed AFN,  Doyon, Limited, TCC,  Fairbanks Native                                                               
Association and  the Humane  Society as  supportive of  the bill.                                                               
He thanked  the legislature for protecting  the rural communities                                                               
from the obviously  greedy people who oppose HB 251.   He offered                                                               
his belief  that the  BVE and  its supporters  do not  care about                                                               
standards, but only care about  protecting their pocketbooks.  He                                                               
reiterated his  concern that  the BVE  is self-serving  and self-                                                               
interested.  He said if HB 251  does not pass it lends support to                                                               
establish a  rural veterinary board to  represent rural Alaskans.                                                               
He hopes his legislative representatives  support the people.  He                                                               
further thought that the veterinarians put more effort towards                                                                  
opposing the bill than to help protect rural Alaskans.                                                                          
                                                                                                                                
4:44:13 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON, after first determining no one else wished to                                                                      
testify, closed public testimony on HB 251.                                                                                     
                                                                                                                                
[HB 251 was held over.]                                                                                                         

Document Name Date/Time Subjects
SSHB251 Draft Proposed CS ver R.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Sponsor Statement for Draft Proposed CS ver R.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Changes from Draft Proposed CS ver D to ver R.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Sectional Analysis for Draft Proposed CS ver R.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Supporting Documents-Letters of Support.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Opposing Documents-North Pole Veterinary Hospital 3-22-12.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Supporting Documents-List of Supporters.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Opposing Documents-Email J Delker 3-23-12.pdf HL&C 3/23/2012 3:15:00 PM
HB 251
SSHB251 Other Documents-Email response from DCCED.pdf HL&C 3/23/2012 3:15:00 PM
HB 251