Legislature(2005 - 2006)SENATE FINANCE 532

04/27/2005 09:00 AM FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Moved SCS CSHB 76(FIN) Out of Committee
Heard & Held
-- Testimony <Invitation Only> --
Moved HB 102 am Out of Committee
Moved CSSB 124(L&C) Out of Committee
Scheduled But Not Heard
+ Bills Previously Heard/Scheduled TELECONFERENCED
     HOUSE BILL NO. 102 am                                                                                                      
     "An Act relating to the licensure of foreign medical graduates                                                             
     and to applications for a license to practice medicine; and                                                                
     providing for an effective date."                                                                                          
This  was the first  hearing  for this  bill in  the Senate  Finance                                                            
BEN  MILLIGAN, Staff  to  Representative  Bill Stoltze,  the  bill's                                                            
sponsor,  explained  that this  bill  is an  effort  to address  the                                                            
shortage of doctors in  the State as measured on a per capita basis,                                                            
particularly in  specialty fields. "In order to curb  this shortage,                                                            
it is important to recognize  foreign medical school graduates." The                                                            
current  requirement  is  that doctors  must  complete  a  residency                                                            
program in the United States  (U.S.). This legislation would provide                                                            
the Alaska State Medical  Board the discretion to establish proof of                                                            
competency and  professional qualifications requirement  in order to                                                            
allow foreign  medical school graduates to practice  medicine in the                                                            
Co-Chair Green  noted that Members' packets include  a one-page bill                                                            
summary  letter  [copy on  file] dated  January  25,  2005 from  the                                                            
Alaska State  Medical Association  and addressed  to Representative                                                             
9:20:00 AM                                                                                                                    
Senator Olson  spoke in "strong favor"  of the bill. He shared  that                                                            
during his membership  on the State Medical Board,  this issue was a                                                            
continuing  "snag",  as  many "very  good"  foreign  medical  school                                                            
graduates were unable to practice in the State.                                                                                 
Co-Chair Wilken  asked how Alaska  compares to other states  in this                                                            
9:20:48 AM                                                                                                                    
Mr. Milligan deferred to  a forthcoming testifier, Jim Jordan, as he                                                            
would be more qualified to address that question.                                                                               
GEORGE  STEWART, MD,  testified via  teleconference  from an  offnet                                                            
site  to  attest   to  the  shortage   of  doctors  in  the   State,                                                            
specifically  in specialty  areas  such as pulmonary  critical  care                                                            
medicine in which he practices.  While, ideally, there should be ten                                                            
such practitioners, there  are currently only eight and two of them,                                                            
himself  included,  are 68  years old.  This legislation  would  not                                                            
"dumb down" acceptance for medical licensure in the State.                                                                      
Dr. Stewart  cited two  examples of very  qualified foreign  trained                                                            
medical doctors  who could  not practice in  the State due  to their                                                            
not meeting  the  State's U.S.  training program  requirement.  This                                                            
legislation  would have allowed  the Medical  Board to review  these                                                            
doctors'  qualifications  and allowed  the issuance  of licenses  to                                                            
these  doctors.   The  Board  was  disappointed  that   the  current                                                            
interpretation  to existing requirements disallowed  such action. In                                                            
response  to   Co-Chair  Wilken's   question  as  to  how   Alaska's                                                            
requirements  compared  to other states,  he noted  that most  other                                                            
states require  24-months  of U.S. training.  Alaska requires  three                                                            
years of training.                                                                                                              
9:24:53 AM                                                                                                                    
Co-Chair Green pointed  out that a letter [copy on file] dated April                                                            
7, 2005,  from Dr.  Stewart and  addressed to  herself and  Co-Chair                                                            
Wilken included the examples presented by Dr. Stewart.                                                                          
JIM JORDAN,  Executive Director, Alaska  State Medical Association,                                                             
noted  that  the  aforementioned  letter  from  the  Association  is                                                            
indicative  of the Association's support  of the bill. He  urged the                                                            
committee to adopt  the legislation as it would provide  the Medical                                                            
Board "the  needed flexibility" that  is required in regards  to the                                                            
qualification of foreign graduates.                                                                                             
9:25:48 AM                                                                                                                    
Mr.  Jordan  added  that  a March  third  issue  of  the  USA  Today                                                            
newspaper [copy  not provided] cautioned that by the  year 2020, the                                                            
nation would  experience a  shortage of between  85,000 and  200,000                                                            
physicians. The State must  be able to attract quality, well-trained                                                            
physicians, including  those who might not have been  trained in the                                                            
Mr. Jordan stated that  some "very positive unintended consequences"                                                            
could  occur  were   this  legislation  adopted.  Eighty   different                                                            
languages  have  been  reportedly  spoken  in  the  Municipality  of                                                            
Anchorage  school  district.  "That  is reflective  of  the  diverse                                                            
ethnicity   of  our  population."   It  is   "very  critical"   when                                                            
administering  medical  care  "that the  care  that is  provided  be                                                            
culturally  competent". This bill  would be an opportunity  for some                                                            
foreign nationals  to provide such  culturally competent  care. They                                                            
would also  serve as teachers for  the physicians in the  community.                                                            
9:27:56 AM                                                                                                                    
Co-Chair  Wilken  asked  Mr. Jordan  how  the  State's requirements                                                             
compare with other states.                                                                                                      
9:28:20 AM                                                                                                                    
Mr.  Jordan understood  that  numerous  other states  require  fewer                                                            
years  of graduate  level  training  programs.  In  addition,  other                                                            
states'  medical  boards  are  allowed  "the latitude  to  adopt  by                                                            
regulation  different standards that  would provide for competency"                                                             
of foreign trained medical doctors.                                                                                             
Mr.  Jordan  noted  that competency   considerations  could  include                                                            
licensure   in  another  state  for   a  period  of  time;   English                                                            
competency;  specialty  certifications  or passage  of  a U.S.  core                                                            
clinical  competency  examination.   "The  key  is  to  provide  the                                                            
discretion  to the State  Medical Board to  adopt by regulation  the                                                            
standards"   that  would  assure   that  the  State  has   competent                                                            
9:29:38 AM                                                                                                                    
Senator Olson questioned  the reason that "such a good bill" had not                                                            
been introduced before.                                                                                                         
9:29:58 AM                                                                                                                    
Mr. Jordan  responded that,  the fact that  medical doctors  such as                                                            
Dr. Stewart, have  stepped forward and provided "specific  hard core                                                            
examples" of need have furthered the cause.                                                                                     
9:30:30 AM                                                                                                                    
RICK   URION,  Director,   Division   of   Occupational   Licensing,                                                            
Department  of  Community  and  Economic  Development  testified  in                                                            
strong  support of the  bill. He  acknowledged the  comments  of the                                                            
testifiers   and  stated  that  providing   the  Board  the   needed                                                            
discretion  would be "a  step in  the right direction".  "This  is a                                                            
good fix."                                                                                                                      
9:31:27 AM                                                                                                                    
Co-Chair  Wilken  moved  to  report the  bill  from  Committee  with                                                            
individual recommendations and accompanying fiscal note.                                                                        
There being no objection,  HB 102am was REPORTED from Committee with                                                            
zero Fiscal  Note #1 dated February  2, 2005 from the Department  of                                                            
Commerce, Community and Economic Development.                                                                                   
9:32:04 AM                                                                                                                    

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