Legislature(2023 - 2024)ADAMS 519
03/22/2024 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB219 | |
| HB115 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 115 | TELECONFERENCED | |
| *+ | HB 219 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE FINANCE COMMITTEE
March 22, 2024
1:35 p.m.
1:35:26 PM
CALL TO ORDER
Co-Chair Foster called the House Finance Committee meeting
to order at 1:35 p.m.
MEMBERS PRESENT
Representative Neal Foster, Co-Chair
Representative DeLena Johnson, Co-Chair
Representative Julie Coulombe
Representative Mike Cronk
Representative Alyse Galvin
Representative Sara Hannan
Representative Andy Josephson
Representative Dan Ortiz
Representative Frank Tomaszewski
MEMBERS ABSENT
Representative Bryce Edgmon, Co-Chair
Representative Will Stapp
ALSO PRESENT
Representative Dan Saddler, Sponsor; Representative Mike
Prax, Sponsor; Dr. Natalie Wiggins, Alaska Association of
Naturopathic Doctors, Juneau; Representative Justin
Ruffridge
PRESENT VIA TELECONFERENCE
Melodie Wilterdink, Staff, Representative Saddler,
Anchorage; Duane Mayes, Director, Division of Vocational
Rehabilitation, Department of Labor and Workforce
Development, Anchorage; Mystie Rail, Executive Director,
Assisted Technology of Alaska, Anchorage; Dr. Carrie
Baldwin-Sayre, Associate Vice President, Advancement and
Community Engagement, Alaska Naturopathic Doctors
Association, Portland, Oregon; Dr. Sean Higgins, Emergency
Room Doctor, Anchorage; Dr. Clyde Jensen, Professor of
Pharmacology, Naturopathic Association, St. George, Utah;
Dr. Robert Downey, Family Practice Physician, South
Peninsula Hospital, Homer; Dr. Roxanne Jones, Alaska
Academy of Family Physicians, Anchorage; Dr. Hillary
Johnson-Jahngir, American Society for Dermatologic Surgery,
Iowa; Dr. Kristin Mitchell, President Elect, Alaska State
Medical Association, Soldotna; Dr. Scott Ferguson, Board of
Trustees, American Medical Association, West Memphis,
Arkansas; Bruce Campbell, Self, Fairbanks; Bart Grabman,
Self, Anchorage; Karen Gonne-Harrell, Self, Anchorage; Dr.
Tim Birdsall, Alaska Association of Naturopathic Doctors,
Anchorage; Pam Ventgen, Executive Director, Alaska State
Medical Association, Anchorage;
SUMMARY
HB 219 REPEAL ASSISTIVE TECHNOLOGY LOAN PROGRAM
HB 219 was HEARD and HELD in committee for further
consideration.
HB 115 NATUROPATHS: LICENSING; PRACTICE
HB 115 was HEARD and HELD in committee for further
consideration.
Co-Chair Foster reviewed the meeting agenda.
HOUSE BILL NO. 219
"An Act repealing the assistive technology loan
guarantee and interest subsidy program; and providing
for an effective date."
1:38:00 PM
REPRESENTATIVE DAN SADDLER, SPONSOR, Introduced HB 219 //
he argued that the best part of living in Alaska was the
people // there was an assisted technology guarantee fund
// he was hoping to realize the original mission of the
grants
1:40:22 PM
MELODIE WILTERDINK, STAFF, REPRESENTATIVE SADDLER,
ANCHORAGE (via teleconference), offered the sectional
analysis of the bill (copy on file)
Section 1 Page 1, Line 4
Section 1 repeals AS 23.15.125 the assistive
technology loan guarantee and interest subsidy program
which established the "assistive technology loan
guarantee fund." The fund can be used to guarantee the
principal amount or subsidize the interest rate of a
loan for purchasing assistive technology that enables
an individual to obtain or maintain employment or live
more independently.
Section 2 Page 1, Lines 5-9
Section 2 adds conditional language to Alaska's
uncodified law stipulating that this act only takes
effect if the Legislature reappropriates the balance
of the assistive technology loan fund for the purpose
of improving access to assistive technology.
Section 3 Page 1, Line 10
Section 3 provides for an immediate effective date.
Co-Chair Foster asked //
Ms. Wilterdink // there was drafted language and the
amendment to the operating budget could happen in the
finance committee//
1:43:16 PM
Representative Josephson asked // how the fund avoided
being swept
Representative Saddler deferred the question to a member of
the department //
1:43:47 PM
DUANE MAYES, DIRECTOR, DIVISION OF VOCATIONAL
REHABILITATION, DEPARTMENT OF LABOR AND WORKFORCE
DEVELOPMENT, ANCHORAGE (via teleconference), responded //
Representative Saddler added that he was not sure if there
was evidence that //
Representative Hannan asked how much money was available.
Representative Saddler //
Mr. Mayes responded that the balance of the fund was
447,000 and the life experience with the fund // identified
that there may be
Representative Saddler// subside loans // there had been a
period of low interest rates //
Representative Hannan asked // the initial 291,000 was
federal money // she asked if there were any restrictions
or tied it from
Representative Saddler //
Mr. Mayes // with the change in statute work// there had
been discussion with federal partners // many states had
experienced the same thing //
1:49:09 PM
Representative Hannan asked if the leg wanted to move the
initial amount that was capitalized // she asked if there
was cart blanche
Mr. Mayes // responded that the implementing agency was //
the division had a set of rehabilitation counselors //
there were not other implementing agencies //
Representative Saddler responded that it was his
understanding that //
Co-Chair Foster asked //
Representative Galvin asked // appreciated that the sponsor
found money that needed to be spent // the letters were
similar // ATLA remains the // she asked if there were
others
Representative Saddler asked
Representative Galvin // Association of assisted technology
programs letter, paragraph 3
Representative Saddler // responded that ATLA// the
division of voc rehab// one of a few and not many //
1:54:42 PM
MYSTIE RAIL, EXECUTIVE DIRECTOR, ASSISTED TECHNOLOGY OF
ALASKA, ANCHORAGE (via teleconference), noted that atla was
the only agency in the state //
Representative Galvin // asked if the grant was single
sourced toward only one purpose, all of her questions were
answered
Mr. Mayes commented that he had been in the state system
for 35 years // he had used atla to identify technology
needs //
1:57:17 PM
Representative Hannan // there used to be an assisted
program for people who were deaf // could there be a person
dedicated //
Mr. Mayes responded that Ms. Rail would be a better
resource
Ms. Rail responded // she was not aware of // it was a
community rehab provider for the division // ~Mystie Rail,
Executive Director, Assisted Technology of Alaska,
Anchorage{
Representative Hannan // she had some active deaf
constituents and there used to //there was a group of
people who had continued to receive the same //
Co-Chair Foster //
Representative Saddler had some difficulty understanding
Ms. Rail //
2:01:07 PM
Ms. Rail responded that he was correct// ATLA could //
administer additional programs to provide specific types of
devices // looking for services beyond assistive technology
and beyond what ATLA did //
Co-Chair Foster //
Ms. Rail added that // the history of ATLA // became a
501c3 (?) in 1994 and became the implementing agency of //
under the direction of // the mission was to enhance the
quality of life for Alaskans through assisted technology //
"twinkle to wrinkle" // she supported the outline and
expanded upon Representative Saddler's comment on //
assisted technology was defined as any item, piece of
equipment // that was used to increase, maintain or improve
the functional capabilities of person with disabilities //
such as putting rubberized grips on a pen to as high tech
as technology like eye gaze, which allowed people to
control a computer with only their eyes // assisted
technology was not a one size fits all solution // unique
to every person // able to live, work and participate in
their communities indecently //
2:06:27 PM
Ms. Rail continued that ATLA // allowed Alaskans to become
familiar with the technologies that could help // also
allowed loans to // current funds did not begin to cover //
strengthen and maintain the gaps // needed to support //
Co-Chair Foster //
2:09:30 PM
Representative Saddler //
Representative Tomaszewski asked if any interest had been
collected //
Mr. Mayes responded that there was interest but he did not
have the specific numbers // he would follow up
Co-Chair Foster // am dead fri march 29 at 5pm
HB 219 was HEARD and HELD for further consideration.
2:11:21 PM
HOUSE BILL NO. 115
"An Act relating to the practice of naturopathy;
establishing the Naturopathy Advisory Board; relating
to the licensure of naturopaths; relating to
disciplinary sanctions for naturopaths; relating to
the Department of Commerce, Community, and Economic
Development; and providing for an effective date."
Co-Chair Foster
2:12:32 PM
REPRESENTATIVE MIKE PRAX, SPONSOR, reminded the committee
of the details of the bill //
2:14:38 PM
DR. CARRIE BALDWIN-SAYRE, ASSOCIATE VICE PRESIDENT,
ADVANCEMENT AND COMMUNITY ENGAGEMENT, ALASKA NATUROPATHIC
DOCTORS ASSOCIATION, PORTLAND, OREGON (via teleconference),
was supportive of the bill //
2:18:24 PM
Representative Josephson asked // naturopaths wanted to
practice medicine beyond // asked if naturopaths should be
held
Dr. Baldwin-Sayre responded // based on the board which
included a variety of physicians and public members //
Representative Josephson // it seemed like naturopaths
wanted to // he asked //
Dr. Baldwin-Sayre responded // there was only one way to do
certain things //
2:22:05 PM
DR. SEAN HIGGINS, EMERGENCY ROOM DOCTOR, ANCHORAGE (via
teleconference), allowing doctors to practice to the extent
of their training would increase // comparable to all other
education //
Co-Chair Foster noted that Representative Justin Ruffridge
was in the audience
Representative Josephson //
Dr. Sean Higgins responded curcumin//
Representative Josephson //
Dr. Sean Higgins responded
Representative Josephson //
Dr. Sean Higgins responded he was aware of
2:26:55 PM
Representative Galvin paramedic and now a physicain with
direct clinical care because his knowledge base was not
suffienciet // she asked if there needed to be a change //
the ability to prescribe medications sooner
Dr. Sean Higgins responded that once a person finished
frour years of medical school // he understood that // he
would challenge the question // he thought
Representative Galvin understood that the bill would give
doctors the authority to //
Dr. Sean Higgins responded//
Representative Galvin //
Dr. Sean Higgins responded
Representative Galvin // if there was enough background //
Dr. Sean Higgins responded it was part of the training to
// people were typically referred to specialists //
2:33:23 PM
DR. CLYDE JENSEN, PROFESSOR OF PHARMACOLOGY, NATUROPATHIC
ASSOCIATION, ST. GEORGE, UTAH (via teleconference), the
training was identical to that given to doctors // needed
to understand the relationship between drugs and // he
opined that naturopathic doctors were capable of
confidently and conservatively prescribing medications
commonly used in care practices //
Representative Josephson asked why the bill would //
Dr. Jensen responded //
Representative Josephson commented that he had not felt //
should be able to // asked why it was ok that naturopathy
// decades after a doctor was accredited,
Dr. Jensen responded // the reason was because residencies
were not available to naturopaths // privately funded by
hospitals//
Representative Josephson
Dr. Jensen responded that a collaborative relationship
between a new and prescribing // was not a bad idea// he
received a call earlier in the day // the inclusion of
pharmaceuticals // if a collaborative relationship were to
be established, there should be a finite time period //
would /
2:43:11 PM
Representative Coulombe asked /
Dr. Jensen responded // many naturopaths did not have
access //
Representative Galvin asked // if there was differce
between pharmacology and // she understood that it was an
ever evolving science and // continuing education given
that the options available for medicines chagned constatnly
/
Dr. Jensen responded / naturopaths had continuing medical
education requirements that were similar to // continuing
\\\
\
2:48:41 PM
Representative Hannan asked // the pharmacological exam
Dr. Jensen //
Representative Hannan //
Representative Ortiz //
Dr. Jensen //
2:54:42 PM
DR. ROBERT DOWNEY, FAMILY PRACTICE PHYSICIAN, SOUTH
PENINSULA HOSPITAL, HOMER (via teleconference), /// grant
doctors prescribing privileges // naturopaths would
prescribe the same way // important botanical without
downsides or safety concerns //
3:00:40 PM
Representative Galvin // she found // 15 hours of
continuing education over a five year period //
Dr. Downey responded // details beyond familiarity // any
perso who valued the power had a respect for what could go
awry // there were already prscriptions// he was //
separate issues around the pharmacutical industry //
3:05:17 PM
Co-Chair Foster //
3:06:26 PM
DR. ROXANNE JONES, ALASKA ACADEMY OF FAMILY PHYSICIANS,
ANCHORAGE (via teleconference), testified in opposition to
the bill // she pracitced medicine in the Norton sound
region // she had since transitioned to anchorage // she
worked in a primary care clinic where they accepted
Medicare and medicaid// she did not have intimate knowledge
of the training / she did not support full prescriptive
authority // formalize pathway to licensure // other
qualified individuals // accreditation was a good tool for
// not similar to the standards for physicians //
specifically noted that the goal was to train primary care
or general practice // same accrediting agency as
neurosurgery // pharmacology was included // thousands of
hours // the basement was // medical students had completed
300 horus //
3:14:08 PM
DR. HILLARY JOHNSON-JAHNGIR, AMERICAN SOCIETY FOR
DERMATOLOGIC SURGERY, IOWA (via teleconference), certified
in // worked with medical professional organizatrions and
weighed in on policy that impacted dermatology // was the
lesion benign or would it lead to // her parents moved to
iowa // her pre-diabetes went unnoticed // she reviewed the
patient's entire medical history //
Co-Chair Foster //
3:18:10 PM
DR. KRISTIN MITCHELL, PRESIDENT ELECT, ALASKA STATE MEDICAL
ASSOCIATION, SOLDOTNA (via teleconference), certified by
the board of internal medicine // her concern was about
patience safety // malpractice implication and // keep in
mind that any action was reviewed by the board // she would
expect that naturopaths be held to the same standard as
medical physicians // she was concerned that it was not//
circuim was a supplement // the bill would not change the
current ability of naturopaths to infuse circuim //it would
be difficutl for // it was unlawful for 3 states // there
should not be an equivilance //
3:26:21 PM
DR. SCOTT FERGUSON, BOARD OF TRUSTEES, AMERICAN MEDICAL
ASSOCIATION, WEST MEMPHIS, ARKANSAS (via teleconference),
noted that he was a previous legislator // naturopathic
education was different from a medical education // there
were crucial gaps in education // must complete clinical
training // credication expenditure // patients in any age
or condition // there was no // open up the door for
naturopaths to prescribe any medications // principals and
theraputics that lacked a foundation in medical evidence //
he urged that legislators take the risk of patients
seriously // there were fewer than 50 naturopathic doctors
in Alaska//
3:32:14 PM
Co-Chair Foster OPENED public testimony.
3:33:05 PM
DR. NATALIE WIGGINS, ALASKA ASSOCIATION OF NATUROPATHIC
DOCTORS, JUNEAU, was a naturopathic doctor in Anchorage //
had a scope of practice that reflected her level of
traingin // scheduled and non controlled medication // she
had heard comments in areas of concerns // annual req was
30 hours of cmes (?) which was the standard of practice //
broad prescriptive authority was not requested // the
request was for things like antibiotics // medicine was
constantly changing // could direct some of the concerns //
there are many possible situations // there was some //
safety was well illustrated //
Co-Chair Foster //
Dr. Wiggins //
3:37:28 PM
Representative Galvin thanked Dr. Wiggins for her time //
referred to a chart amendment a
Dr. Wiggins //
3:40:23 PM
Representative Ortiz had heard arguments that it would help
alleviate the shortage of access to primary care
physicians, however Medicaid and Medicare would not cover
naturopaths
Dr. Wiggins replied the need was extensive // she had kept
track of how many // the 12 patients had to get 12 more
medical care visits to have the needs taken care of//
Representative Tomaszewski noted that there had been prior
testimony that stated // the inference was that //
Dr. Wiggins responded in the affirmative //
Representative Tomaszewski // fill the prescriptions for
patients // create more need //
Dr. Wiggins responded //
3:44:06 PM
Representative Galvin there was significant correspondence
around the amount of continuing education not having parity
Dr. Wiggins responded // 50 hours every two years // other
states were in excess//
3:45:36 PM
BRUCE CAMPBELL, SELF, FAIRBANKS (via teleconference),
testified in support of HB 115 and he believed it was an
update // he was on medicare and his provider worked with
// had received care from nurse practicioners // he had to
go to another doctor // there would be a five week to six
week // it was an added cost and impediment to care // the
bottom line was that he determined /
3:48:28 PM
BART GRABMAN, SELF, ANCHORAGE (via teleconference), opposed
HB 115 // he was a resident physician // although it did
not address // school included 4000 hours of training and
hands on clinical education // by the time // required for
all MDs // still not allowed to // the bill would allow
naturopaths prescriptive authority // the focus and
training was different //
3:51:45 PM
KAREN GONNE-HARRELL, SELF, ANCHORAGE (via teleconference),
his medical doctor was a pediatrician // urged support of
the bill in a safe manner
3:54:39 PM
DR. TIM BIRDSALL, ALASKA ASSOCIATION OF NATUROPATHIC
DOCTORS, ANCHORAGE (via teleconference), relayed that
naturopaths were not asking to be considered the same as
MDs// increased both the scope of practice and
responsibility// proposed language that would require //
license would allow them to do brain surgery// one of the
leaders in the nation in granting nurse practioners
independent pracitce authority // the disciplinary
3:59:51 PM
PAM VENTGEN, EXECUTIVE DIRECTOR, ALASKA STATE MEDICAL
ASSOCIATION, ANCHORAGE (via teleconference), noted that the
association supported many sections in HB 115 // minor
surgery and prescribing authority // there were fewer than
50 practicing naturopaths // did not cover naturopathic
services // no federally endorsed training programs //
faulty argument// the other thing to consider was that most
insurance plans only covered what was in state statute //
if the scope of practice was expanded //increase the
overall cost of health care// urged not to pass 115 as
written //
4:04:00 PM
Co-Chair Foster CLOSED public testimony.
Representative Ortiz asked whether the bill had two
Representative Prax//
Representative Ortiz asked if there were //
Representative Prax responded that there were initially but
then the original intent
Representative Ortiz asked if the amendments were adopted
Representative Prax responded that the bill started all
over again // got away from the intent of the bill //
Representative Ortiz asked if the amendments dealt with
some of the concerns that had been raised //
Representative Prax responded in the affirmative //
4:07:38 PM
Representative Prax // it was difficult to cover a statute
that covers every situation //
4:11:23 PM
Co-Chair Foster reviewed the agenda for the following
meeting.
HB 115 was HEARD and HELD in committee for further
consideration.
ADJOURNMENT
4:12:00 PM
The meeting was adjourned at 4:11 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 219 Sponsor Statement 2.6.24.pdf |
HFIN 3/22/2024 1:30:00 PM |
HB 219 |
| HB 219 Sectional Analysis ver B 2.6.24.pdf |
HFIN 3/22/2024 1:30:00 PM |
HB 219 |
| HB219 NEW FN DOLWD-SP-03-15-24.pdf |
HFIN 3/22/2024 1:30:00 PM |
HB 219 |
| HB 219 Public Testimony Rec’d by 3.18.24.pdf |
HFIN 3/22/2024 1:30:00 PM |
HB 219 |
| HB 219 Responses to HFIN Questions 3.22.24.pdf |
HFIN 3/22/2024 1:30:00 PM |
HB 219 |
| HB 115 Additional Authorities and Responsibilities 4.3.24.pdf |
HFIN 3/22/2024 1:30:00 PM |
HB 115 |
| HB 115 Follow Up Answers from 3.22.24 (FIN) Mtg..pdf |
HFIN 3/22/2024 1:30:00 PM |
HB 115 |