Legislature(2005 - 2006)CAPITOL 17

02/04/2005 03:15 PM LABOR & COMMERCE


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 102 FOREIGN MEDICAL SCHOOL GRADUATES TELECONFERENCED
Moved Out of Committee
*+ HB 109 SCREENING NEWBORNS FOR HEARING ABILITY TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled
HB 102-FOREIGN MEDICAL SCHOOL GRADUATES                                                                                       
                                                                                                                                
CHAIR ANDERSON  announced that the  first order of  business would                                                              
be  HOUSE BILL  NO.  102  "An Act  relating  to the  licensure  of                                                              
foreign medical graduates; and providing for an effective date."                                                                
                                                                                                                                
REPRESENTATIVE  BILL STOLTZE, Alaska  State Legislature,  sponsor,                                                              
pointed out  that his specialty  was listening to people  and that                                                              
through  listening,   he  has  ascertained  that   a  shortage  of                                                              
specialties   in  medicine   exist   here  in   Alaska.  He   then                                                              
acknowledged that  there are many  qualified people here  that can                                                              
help solve this problem.                                                                                                        
                                                                                                                                
CHAIR ANDERSON  pointed out that one  of the things we  don't want                                                              
is the insurgence  of doctors into Alaska who  come from countries                                                              
that  are  not  standards  are  lower.  He  then  asked  what  the                                                              
representative  thought concerning this  and whether  changing the                                                              
board rules would weed these kind out.                                                                                          
                                                                                                                                
REPRESENTATIVE   BILL  STOLTZE   answered   that   a  board   with                                                              
professionals  will weed  these people out  and furthermore,  they                                                              
will be  asking those  who are qualified  to practice  outstanding                                                              
medicine into the state.                                                                                                        
                                                                                                                                
3:24:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE LYNN  asked if there  was anything that  will cover                                                              
English speaking ability for those that practice medicine.                                                                      
                                                                                                                                
REPRESENTATIVE BILL STOLTZE answered that he did not know.                                                                      
                                                                                                                                
CHAIR  ANDERSON  stated  that  this question  would  be  held  and                                                              
reexamined by  one of the doctors  that are here as  witnesses. He                                                              
then opened the floor up to the public.                                                                                         
                                                                                                                                
3:25:23 PM                                                                                                                    
                                                                                                                                
RICK  URION,   Director,  Division   of  Occupational   Licensing,                                                              
Department   of  Commerce,  Community,   &  Economic   Development                                                              
(DCCED), standing  in favor of the  bill, stated that  the biggest                                                              
problem  here is  that in all  of the  Alaskan laws  there are  no                                                              
discretionary powers  within his grasp. He pointed  out that there                                                              
had been  many instances when he  could have solved  many problems                                                              
if he was given them.                                                                                                           
                                                                                                                                
MR. URION further  stated that the laws are written  for the worst                                                              
case scenario  and that life was  not black and white.  He ends by                                                              
stating that  public safety  could have  been less jeopardized  if                                                              
he had been given some discretionary opinion.                                                                                   
                                                                                                                                
3:26:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   GUTTENBERG  mentioned   that   the  question   by                                                              
Representative Lynn  was an interesting one and that  he wanted to                                                              
revisit  it. He  postulated that  in the  event of  a Chinese  and                                                              
Eastern European  coming into take the test for  competency, would                                                              
there be a standard  that the board would take  to test competency                                                              
and  also,  if   they  translate  foreign  documents   to  aid  in                                                              
licensing.                                                                                                                      
                                                                                                                                
MR. URION  answered by stating  that they  are not going  to allow                                                              
people in  that cannot speak  English. He  then said that  most of                                                              
the people are already licensed elsewhere in the United States.                                                                 
                                                                                                                                
3:27:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   LEDOUX   mentioned  that   she   was  under   the                                                              
impression  that doctors simply  would not  be practicing  in this                                                              
state unless they have been practicing in other states.                                                                         
                                                                                                                                
MR. URION  commented that  people will not  be practicing  in this                                                              
state unless they  are highly skilled in their  field. The problem                                                              
that exists is that  these very people cannot come  into the state                                                              
and practice due to constraints in the current law.                                                                             
                                                                                                                                
CHAIR  ANDERSON  further  stated   that  through  the  application                                                              
process there  would be  enough background  research to  determine                                                              
their abilities.                                                                                                                
                                                                                                                                
3:28:49 PM                                                                                                                    
                                                                                                                                
Dr. JAMES JORDAN,  executive director of the Alaska  State Medical                                                              
Association,  stated that  he would  be  augmenting to  previously                                                              
submitted testament.  In the written  statement he stated  that he                                                              
referred  to a  2002  study that  showed that  a  shortage of  200                                                              
physicians  in  their  market  area.  He then  said  that  he  has                                                              
information that  this is  corroborated in a  2005 study.  He then                                                              
continues to  say that in 2009 there  will be a need  for 261 more                                                              
physicians.                                                                                                                     
                                                                                                                                
3:31:01 PM                                                                                                                    
                                                                                                                                
DR.  JORDAN continued  by  stating  that one  of  the problems  is                                                              
delivering   culturally   competent   care.  He   supported   this                                                              
statement  by saying  that in the  school system  alone there  are                                                              
instances  of at  least 80  languages being  spoken by  indigenous                                                              
peoples.  He ended  by  stating  that foreign-born  doctors  could                                                              
offer an excellent venue for culturally diverse treatment.                                                                      
                                                                                                                                
DR. GEORGE  STEWART, physician in  Alaska, stated that it  is very                                                              
difficult  to recruit  specialists  here.  From his  own  personal                                                              
experience,  he  stated that  his  own  specialty suffers  from  a                                                              
shortage. He  asserted that  the state of  Alaska is getting  to a                                                              
critical point. The  idea behind the bill is to not  lower the bar                                                              
to allow less  qualified people in, but to allow  highly qualified                                                              
people in that do  not fit the tight temporal  guidelines that are                                                              
found  in  the  current  law. He  emphasized  that  Alaska  has  a                                                              
critical  shortage  of  physicians.   By  denying  physicians  the                                                              
access to  Alaska, he  stated that you  are also denying  Alaskans                                                              
healthcare.                                                                                                                     
                                                                                                                                
REPRESENTATIVE  LYNN wanted  to know if  there is  going to  be an                                                              
active effort to recruit these medical specialties.                                                                             
                                                                                                                                
DR.  STEWART  indicated that  he  has  been recruiting  for  eight                                                              
years. He  commented that these are  not for people that  are from                                                              
areas far and remote  but people that have been  practicing in the                                                              
United States for years.                                                                                                        
                                                                                                                                
3:38:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GUTTENBERG pointed  out that  last year the  state                                                              
was not  very supportive of the  Naturopathic bill. He  then asked                                                              
if the two doctors were supportive of this practice.                                                                            
                                                                                                                                
DR.   JORDAN  commented   that   his   group  is   supportive   of                                                              
naturopathic physicians.                                                                                                        
                                                                                                                                
CHAIR ANDERSON asked if there was anything else to be added.                                                                    
                                                                                                                                
REPRESENTATIVE STOLTZEE  pointed out that as a diabetic,  he has a                                                              
small  conflict  of interest  in  supporting  the bill,  but  that                                                              
others like him  suffer the same lack of physicians.  It takes six                                                              
months  to  schedule  an  appointment  with  endocrinologists.  He                                                              
pointed  out that his  particular  doctor is  aging and that  this                                                              
trend  is   a  growing  one  in   Alaska.  He  advised   that  the                                                              
specialists  the state  does have  are  going to  be retiring  and                                                              
gone very soon.                                                                                                                 
                                                                                                                                
REPRESENTATIVE GUTTENBERG  asked if anyone  at the meeting  was on                                                              
the medical  board, and he then  followed this up with  a question                                                              
concerning  the  mechanics  and   procedures  of  the  application                                                              
process.                                                                                                                        
                                                                                                                                
CHAIR  ANDERSON   reiterated  the  question  by   asking  how  the                                                              
application process works.                                                                                                      
                                                                                                                                
3:41:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STOLTZE   answered  by  stating  that   the  state                                                              
medical board  sits down  to look at  and decide what  alternative                                                              
criteria   is   available,   and   then  they   go   through   the                                                              
administrative  process of  adopting new  regulations so  they are                                                              
outlined  for everyone,  and thus,  the tests  for competency  are                                                              
then  made very  apparent. These  regulations  will include  three                                                              
requirements.  The  first  is  licensure   in  another  state  and                                                              
second, a  board specialty. A new  requirement would be  passing a                                                              
core comprehension  test. The medical student is  presented with a                                                              
patient  (an  actor)  who  presents  with  various  symptoms.  The                                                              
student  doctor   must  properly  diagnose  the   problem  without                                                              
failure.                                                                                                                        
                                                                                                                                
3:43:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE LEDOUX  points out that  in section 3B,  that these                                                              
requirements are  in the language.  She then  asked if it  was the                                                              
intent  of this  medical board  to  have the  option of  requiring                                                              
licensure  in  another  state  for  three  years,  but  not  being                                                              
required to adopt the criteria.                                                                                                 
                                                                                                                                
REPRESENTATIVE  BILL  STOLTZE answers  that  this  is correct.  It                                                              
does give  the board an alternate  criteria to use  in exceptional                                                              
cases. He said that it removes the current rigidity.                                                                            
                                                                                                                                
REPRESENTATIVE  LEDOUX asked  if  it means  'either  one of  these                                                              
requirements'. She  further asked if  this meant that  someone who                                                              
graduated from  Oxford or  Edinburgh would have  the same  ease in                                                              
application  as someone from  the Universities  of Washington  and                                                              
Oregon.                                                                                                                         
                                                                                                                                
REPRESENTATIVE  BILL  STOLTZE  noted   that  it  is  not  lowering                                                              
standards- it  provides alternatives  for equitable  standards for                                                              
applicants.                                                                                                                     
                                                                                                                                
3:45:51 PM                                                                                                                    
                                                                                                                                
DR.  JORDAN   interjected  and   reiterated  that   Representative                                                              
Stoltze is correct  in saying that what the bill  is giving Alaska                                                              
an alternative  competency requirements  that would equate  to the                                                              
three years  required for American  applicants. He  further stated                                                              
that the  committee is not talking  about new graduates;  they are                                                              
talking about  graduates not in  US medical programs  that require                                                              
the completion of a three-year residencies.                                                                                     
                                                                                                                                
REPRESENTATIVE   KOTT  pointed  out   that  this  would   allow  a                                                              
physician  who has  practiced  for  15 years,  who  then moved  to                                                              
Arizona and practiced  for a year, eligibility to  work in Alaska.                                                              
As it stands now,  he said that he would not  be eligible since he                                                              
missed  the  three-year rule.  He  then  said that  this  language                                                              
offers a competent professional the prospect of getting by this.                                                                
                                                                                                                                
CHAIR ANDERSON closed public testimony.                                                                                         
                                                                                                                                
REPRESENTATIVE   KOTT  moved   HB  102  out   of  committee   with                                                              
individual  recommendations  and  the accompanying  fiscal  notes.                                                              
[No objection  was  stated, and  therefore HB  102 was treated  as                                                              
moved out of the House Labor and Commerce Standing Committee.]                                                                  
                                                                                                                                

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