Legislature(1999 - 2000)
02/25/1999 01:38 PM L&C
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
SB 29-REQUIREMENTS FOR PHYSICIAN'S LICENSE CHAIRMAN MACKIE called the Senate Labor and Commerce Committee meeting to order at 2:38 p.m. and announced SB 29 to be up for consideration. MR. MARK HODGINS, staff to Senator Ward, sponsor of SB 29, said at the end of the last meeting there was some opposition concerning the time period for training American physicians. So, he took out references to American and Canadian physicians' training and kept the requirements for foreign physicians. The Medical Board continues to support this change. SENATOR LEMAN moved to adopt Lauterbach draft LS0270\H, dated 2/11/99. There were no objections and it was so ordered. MR. HODGINS explained that the CS changes the requirements for foreign physicians to practice in the State of Alaska. It requires a three-year term that can be either an internship, a residency, or to satisfactory performance of the duties and functions of an intern/resident. A candidate must submit documentation to the program which has to be approved by the American Board of Medical Specialists. One other change is the citizen language, "citizen of the United States or lawfully residing in the United States" and the deletion of the phrase, "admitted for permanent residence". SENATOR MACKIE asked if this change was one of the three things the committee was originally trying to accomplish. MR. HODGINS answered yes, this is one of the suggestions from the Medical Board. There was a lot of opposition to this bill, because the Board had not educated people. Therefore, they removed the more controversial portions. Basically, he repeated, CSSB 29 increases the time limit from one year to three years for a foreign applicant to satisfactorily perform the duties of resident physician or intern at a recognized hospital. The time increase is because of a variety of different foreign curriculums across the world. Three years gives the Medical Board a good feeling that the doctor has learned what is adequate for residents of the State of Alaska. CHAIRMAN MACKIE asked if there was currently a shortage of locally trained doctors and if there was a need for foreign doctors now. MR. HODGINS replied that there is a need for certain specialists, not necessarily general practitioners. The Medical Board supports this. CHAIRMAN MACKIE asked if other states allow the same thing. MR. HODGINS replied in other states licensure of immigrating doctors requires from one year to three years. A majority of states require two years and above. Alaska would be requiring the most time. Nine states require one year, 16 states require two years, and 29 states require three years. CHAIRMAN MACKIE asked if we are the only state that doesn't allow licensure of foreign doctors right now. MR. HODGINS replied that all states allow foreign doctors; only the residency requirements differ. CHAIRMAN MACKIE asked if this bill does more than make the requirements more stringent. MR. HODGINS said that's all it does and added that it corresponds with the Immigration Act of 1996 which changes the classification of visa to H1B visa, a three year requirement. SENATOR LEMAN asked what other states do for non-foreign medical graduates regarding citizenship. Currently, you must be a citizen of the U.S. or be admitted for permanent residence. The proposal is to change that to "being a citizen" or to be "lawfully residing." MR. HODGINS responded that to be lawfully residing a person must possess a H1B visa which he thought would bring us into conformance with federal law and with what other states are doing. SENATOR LEMAN questioned the requirements in sections 1 and 2 for non-foreign and foreign medical graduates which don't have corresponding provisions for citizenship. MR. HODGINS explained that language on page 2, line 9, Section 1, paragraph 5, "be a citizen of the United States or lawfully residing in the United States" covers the immigration status. MS. CATHERINE REARDON, Director, Division of Occupational Licensing, said the division provides staff support to the Medical Board and supports the changes in the most recent committee substitute. She said there are two separate issues: can you get a license if you don't have a green card, but you do have another visa you would be working under in the United States; and, if you went to school outside the country, regardless of your citizenship status, should you be required to have additional years of training in the U.S. She believed the State would not be out of compliance with any federal law by leaving things as they are, but the Medical Board and the department support changing them for public policy reasons. MS. REARDON believed there are no other states requiring U.S. citizenship for a medical license. One other Alaska licensing program requires U.S. citizenship, marine pilotage, which also requires a U.S. Coast Guard license requiring citizenship. Ideally, the State would like to remove the issue from the statute altogether, but if it remains in law, it is an improvement to say "or lawfully resides." There are doctors in Alaska right now working for the federal government and they don't need a state license although they can't work outside of their federal jobs or switch jobs. While there is not a large number of these doctors, she suspected this is what created the issue. The Board did not expect this to be a very controversial topic, so it did not highlight it in their January newsletter. The Board did, however, ask for changes in training requirements. MS. REARDON said that the Department of Law also suggested that, when things like this have been contested in other states, the courts ruled the federal government, not the state government should determine who can work. The issue of training foreign medical graduates is a separate topic, because some of them could be U.S. citizens. They could be Americans who intentionally went outside the U.S. to get their medical training. The Board's figures indicate 43 other states require three years of training. MS. REARDON said initially, the Board thought there wasn't much concern about this issue because of the poor response to the newsletter. Now they are more aware of the issue and working on it. SENATOR LEMAN moved to pass CSSB29(L&C) with the accompanying zero fiscal note from committee with individual recommendations. There were no objections and it was so ordered.