Legislature(1997 - 1998)
03/06/1997 01:35 PM Senate L&C
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 92 BOARD OF VETERINARY EXAMINERS; LICENSE
CHAIRMAN LEMAN said they would set the confirmations aside and
announced SB 92 to be up for consideration.
MS. CATHERINE REARDON, Director, Division of Occupational
Licensing, supported SB 92 which extends the sunset date of the
Board of Veterinary Examiners. The bill reflects the
recommendations made by the Division of Legislative Audit to extend
the Board until 2003, a six-year extension.
MS. REARDON said the other issue dealt with in the bill, the
licensure by credentials for veterinarians, needed some discussion
because the audit recommendations differed from what the Board
advocated. The Division looks to the Board as experts in this
professional area.
MS. REARDON explained that the basic issue is whether the people
who are trying to come in by credentials (holding a license in
another state) should have the same requirements an Alaskan needed
at the same time that person was licensed in the other state.
Alaska now requires, by regulation, a clinical competence test
(CCT) as well as a national board exam (NBE) for licensure. The
auditors are recommending that perhaps the clinical competence test
not be required of everyone who comes in by credentials. Her
impression, however, is that the Board feels that is an important
test to have taken.
Number 267
SENATOR MACKIE asked her to clarify her position on the bill. MS.
REARDON said she supported extension of the Board, the central
theme of the bill; and she supported the Board's view of what
should be required for licensure by credentials which is different
from what is in the bill.
CHAIRMAN LEMAN said he believed the six year extension is greater
than the legislature has traditionally been extending the boards.
Usually it is a four-year cycle.
SENATOR MACKIE asked what was wrong with having to pass a national
board exam that was in effect at the time the applicant became
licensed. He said they have been trying to give boards the
opportunity to upgrade and have a national standard to follow. MS.
REARDON agreed that opportunities for licensure by credential are
important and we don't want to keep people from coming to the
State, particularly because we have Canadian veterinarians who need
to be able to come and go and practice in Alaska. Lines 11 and 12
on page 1 are ungainly comparing periods of history in two states.
The issue starts on line 14 with the requirement of graduation from
an accredited school of veterinary medicine and the deletion of "or
successfully passed the National Board Education Commission for
Foreign Veterinary Graduates' test."
It also appears that instead of having to pass both the National
Board exam and the competency test, they are only going to have to
pass the National Board exam. The issue focuses on a test called
the Clinical Competence Test (CCT). This bill seems to remove that
requirement from people coming in by credentials.
DR. LEACH, Chairman, Board of Veterinary Examiners, said it appears
to him that the proposed legislation is leaving out "that the
applicant has graduated" which needs to be left in. The National
Board examination should remain a requirement. It has been a
national standard for over 20 years. They are also requesting that
the CCT be made part of the required licensure for those applying
for licensure by credentials. This is also a nationally given test
and develops, at least, some indication of the clinical competency
of that individual to practice veterinary medicine. He said they
want to upgrade the requirements for licensure, but do not want to
block any individual from having licensure. They want to assure
that the public is protected. He said the two tests are not at all
unknown and are required of all new graduates. The Board
recommends they (or the equivalent of) be required of applicants by
credentials.
Number 364
MR. RANDY WELKER , Legislative Auditor, explained the language they
are proposing comes from one primary source and for a couple of
reasons. The primary source comes from their audit report on page
11 and model legislation that is currently being reviewed by the
American Association of State Veterinary Boards. The current
statute on credentialing doesn't require graduation. The Board is
placing an emphasis on testing, but Legislative Audit thought it
would be better to put the emphasis on credentialling by the
examination process when it is not by definition now required. The
reason for a broader definition is limiting entry into the
profession, especially for people who may have been practicing for
many years. They may not have passed the exams the Board is saying
they have to have today to be licensed by credential.
CHAIRMAN LEMAN asked Dr. Leach if he was proposing that graduation
from an accredited school be placed in as an "and." DR. LEACH
replied yes, he thought it should be "and" not "or." He said he
graduated among the first of the National Board exams which started
in most states in '62 or '63 and requiring the CCT is merely an
improvement of testing standards. He didn't think taking the test
was the issue. The Board is adjusting somewhat to maintaining a
high standard of practitioner within the State. The CCT is a test
he believes any practitioner who meets most of the other
requirements should be able to pass. It isn't a test that goes
back to the very basic sciences of the first year of undergraduate
school as the NBE does. The CCT is a test for competency. It is
the fairest way the Board has to make that assessment. Since it is
put out by a nationally recognized organization separated totally
from the State, it seems a very fair way to assess individuals who
want to come and practice in the State, he said.
SENATOR MACKIE said currently, as he reads the statute, it's not a
requirement to have graduated from an accredited school of
veterinary medicine. He's thinks that is probably a good idea, but
he assumed that the Department, or by regulation, there is a
requirement for graduation. The way it is written now is that
there is at least the one requirement that you have to pass the
Board's test. He added that he is open to including graduation
from an accredited school, but he thought it was required somewhere
already. MS. REARDON responded that the Board has all of the
regulation writing authority, not the Department. That regulation
authority does not extend to the point of being able to add
qualifications that aren't listed in statute. The Board does not
have the discretion to require graduation if it's not mentioned on
the list of requirements in statute. Current law says you have to
be a graduate of a school or have passed the test for foreign
veterinary graduates.
MS. REARDON thought the issue might be that the accreditation
process for the schools may not extend to enough foreign countries.
She thought the issue might be whether they are required to take
the test for foreign veterinary graduates as well as the NBE and
the CCT or just two of those.
SENATOR MACKIE asked if there has been a problem, because in the
version before the committee they aren't required to have graduated
from an accredited school. He asked if we have any vets in the
State who haven't graduated. MS. REARDON said she didn't know of
any, but would check further.
DR. SANDERS said she thought the "or" graduation from an accredited
veterinary school should be changed to "and." She said most of the
schools in Canada are accredited. Some of the European schools may
not have accredited schools. In most other states those people are
allowed to practice veterinary medicine in the U.S. if they pass a
series of exams that takes several days to complete. She still
thought that veterinary graduates of an accredited school should be
a requirement.
DR. SANDERS said there is some disagreement on the Board about the
CCT, because it might be difficult for someone who has been in
practice 15 or 20 years to pass, as it speaks to both small and
large animals, exotics, and a variety of different types of
practice. Someone may have been in one type of practice for the
whole period of time and not had to deal with large animals or
exotics. It's not that they are not competent in what they do.
She said one thing the Association of Veterinary Boards is moving
towards is more specific competency exams.
CHAIRMAN LEMAN asked if the Board could make the distinction
between small and large animals, exotics, etc. within the framework
of the statutory provision in SB 92. MS. REARDON replied that each
profession's statutory authority varies a lot and she needed time
to look at it carefully. She explained that the committee was
discussing the licensure by credentials qualifications statute and
there is another statute, not under discussion, which is the
regular qualification for licensure.
Number 536
MR. WELKER asked if there were any states that don't require
graduation from an accredited college to obtain initial license.
If all jurisdictions require graduation for licensing, then the
accreditation is almost a moot point in the credentialing process.
MS. REARDON replied that it applies not only to other states, but
to other territories or countries that one could be coming in by
credential from as well.
DR. LEACH commented that there are two factors here. There are the
foreign graduates who come in through a very difficult, complicated
process, for them, to be able to practice within the United States,
period. There are a few schools, about four, that accept the
foreign students, and they go through quite a procedure that
requires months of their time, plus passing a special designated
U.S. test for foreign graduates. Above and beyond that, they must
take NBE and in almost all states the CCT before they can practice
in an individual state. Beyond that, they require a state test
before they can practice there. He knew of no other state that
does not require the individuals to be graduates from an accredited
veterinary school.
Regarding the question of whether they could narrow the scope of
competency tests and that would be a massive undertaking for our
State Board to undertake. There are no single entity competency
tests available. That will come five years or so in the future.
Right now the CCT is the best that is available.
SENATOR KELLY asked who does the accrediting at the various
veterinary schools. DR. LEACH replied that the AVA has been doing
it. SENATOR KELLY asked if they only looked at American schools.
DR. LEACH replied that Canadian schools are accredited straight
across the board, but some in Europe have lesser standards and
cannot be accredited.
SENATOR KELLY asked him if he thought German and Japanese
veterinary schools have lesser standards than American. DR. LEACH
replied that was true as far as the accreditation process goes.
SENATOR KELLY said he didn't believe that; he thought the American
Veterinary Association would choose to believe that. DR. LEACH
suggested he would find visiting some foreign veterinary schools
very interesting.
TAPE 97-9, SIDE B
SENATOR KELLY said he thought the problem was that they weren't
distinguishing between the American resident and the foreign
applicant and they needed to be dealt with differently. He thought
it was easier to not accredit foreign schools and it might also cut
down on the competition.
SENATOR MACKIE thought there should be one standard. The current
bill version concerns him because it doesn't require graduation
from an accredited school, you just have to pass the test. He
suggested an amendment on page 1, line 13 insert "graduated from an
accredited school of veterinary medicine and has" after "has."
SENATOR KELLY objected and said that he agreed that should be the
standard for American veterinarians. However, he thought there
were probably hundreds of veterinary schools throughout the world
that are not accredited by the American accreditation bureau. So
none of those people can come to the U.S., even if they are very
competent, and practice veterinary medicine.
Number of 554
SENATOR LEMAN thought a possible approach would be to not
absolutely require graduation, but have a CCT as an alternative and
demonstrate competence in the lab.
SENATOR MACKIE said he understood Senator Kelly's concern, but he
was concerned that giving an exception to foreign candidates would
allow someone who has never gone to a school a chance to pass the
test and practice in Alaska whereas the standard for our own
American candidates would be more stringent. SENATOR KELLY said
they would have to go to a school somewhere in the world, but it
didn't need to be accredited by the Americans. But they needed to
prove to us that that school was essentially competent. He said he
was
surprised that the existing language had worked all these years
because it is so vague.
SENATOR KELLY asked now, if you are licensed by examination, is it
required to also attend an accredited school. MS. REARDON replied
under AS08.98.165 it repeats the identical language. It says the
applicant has to be a graduate of an accredited veterinary school
or pass the NBE.
SENATOR KELLY asked if there were any veterinarians in Alaska who
hadn't gone to an accredited veterinary school. MS. REARDON said
she would have to look back through the files to be certain.
SENATOR KELLY asked why the system wasn't working right now. MR.
WELKER explained the concern they have is that the Board has
started placing increased emphasis on the CCT. The statute says to
be licensed by credential the person has to meet or exceed the
State requirements at the time they applied, but the focus is being
narrowed and they are concerned with limiting the possibility of
people to come into the State to practice veterinary medicine. He
thinks they can require a broader range of tests. The language
also provides that if they haven't passed one of those tests, the
applicant can satisfy the examination requirement by demonstrating
they have passed the type of licensing examination that was
required for entry level licenses in this State at the time the
applicant became licensed.
DR. LEACH responded that no matter where they may have graduated
from, there are strict test regulations set up by the AVA for
foreign people to enter the United States and practice. He thought
the foreign graduate portion of the bill could be resolved by
inserting a statement "or graduates of foreign schools must have
passed the specific test for foreign veterinarians." He thought
this would certainly demonstrate that they would be fine practicing
anywhere in the country.
CHAIRMAN LEMAN noted that Mr. Welker hadn't included the CCT as one
of the requirements for licensure by credentials for fear people
who had been practicing for some time elsewhere might have
difficulty passing it. Yet Dr. Leach says that most people have
already passed it or could pass it by virtue of their experience.
MR. WELKER said he was open to modifying the specific exams.
Holding everyone to the higher standard at this point in time is a
policy call. His concern is that the Board is headed in that
direction, but the statute doesn't envision that narrowing right
now.
DR. SANDERS pointed out that the CCT is not a lab type of exam; it
is a written exam. She thought the National Board of Examinations
Committee's Education Commission for Foreign Veterinary Graduates'
exam that must be taken in order to practice in the U.S., requires
that they have to show they have graduated from a foreign
veterinary school before taking it.
Number 408
SENATOR MACKIE withdrew his amendment.
SENATOR KELLY said he wasn't so sure he wanted to insert the
language that is suggested here. Standards are increasing in every
profession by leaps and bounds as more knowledge is becoming
available, and he thought more consideration was needed.
SENATOR MACKIE said as a matter of policy he didn't want to extend
anybody for six years. MR. WELKER responded that the cycle has
historically been four years and the Board has been trying to
encourage a longer cycle.
SENATOR HOFFMAN asked when was the last time they recommended a
board be terminated. MR. WELKER replied that they haven't done
that in a long time, because it never happened when they did
recommend it. Today most of the boards are self-supporting as is
the Division.
CHAIRMAN LEMAN said they would hold the bill and see if
coordinating language could be found.
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