Legislature(2003 - 2004)

04/27/2004 03:11 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                                                                         
                       STANDING COMMITTEE                                                                                     
                         April 27, 2004                                                                                         
                           3:11 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Peggy Wilson, Chair                                                                                              
Representative Carl Gatto, Vice Chair                                                                                           
Representative John Coghill                                                                                                     
Representative Paul Seaton                                                                                                      
Representative Kelly Wolf                                                                                                       
Representative Sharon Cissna                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Mary Kapsner                                                                                                     
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                              
CS FOR SENATE BILL NO. 179(FIN)                                                                                                 
"An  Act  relating to  criminal  history  records and  background                                                               
checks; allowing  persons to teach  in the public schools  for up                                                               
to five months  without a teaching certificate if  the person has                                                               
applied for a certificate and  the application has not been acted                                                               
upon by the Department of  Education and Early Development due to                                                               
a delay  in receiving criminal history  records; allowing teacher                                                               
certification  for certain  persons based  on a  criminal history                                                               
background  check  without  fingerprints; and  providing  for  an                                                               
effective date."                                                                                                                
                                                                                                                                
     - MOVED HCS CSSB 179(FIN) OUT OF COMMITTEE                                                                                 
                                                                                                                                
SENATE BILL NO. 274                                                                                                             
"An  Act relating  to the  housing  assistance loan  fund in  the                                                               
Alaska   Housing  Finance   Corporation;  creating   the  housing                                                               
assistance loan program; repealing  loans for teacher housing and                                                               
providing for  loans for multi-family housing;  making conforming                                                               
amendments; and providing for an effective date."                                                                               
                                                                                                                                
     - MOVED SB 274 OUT OF COMMITTEE                                                                                            
                                                                                                                                
HOUSE BILL NO. 84                                                                                                               
"An  Act  relating  to  a  curriculum  for  Alaska  history;  and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
     - MOVED HB 84 OUT OF COMMITTEE                                                                                             
                                                                                                                                
HOUSE BILL NO. 72                                                                                                               
"An  Act  relating  to  the  qualifications  and  appointment  of                                                               
members of the Board of Regents  of the University of Alaska; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
     - MOVED CSHB 72(HES) OUT OF COMMITTEE                                                                                      
                                                                                                                                
HOUSE BILL NO. 535                                                                                                              
"An  Act  relating to  liability  for  expenses of  placement  in                                                               
certain mental  health facilities; relating to  the mental health                                                               
treatment  assistance program;  and  providing  for an  effective                                                               
date."                                                                                                                          
                                                                                                                                
     - MOVED CSHB 535(HES) OUT OF COMMITTEE                                                                                     
                                                                                                                                
HOUSE BILL NO. 186                                                                                                              
"An  Act   establishing  the   Radiologic  Technology   Board  of                                                               
Examiners;  requiring   licensure  of  occupations   relating  to                                                               
radiologic  technology, radiation  therapy, and  nuclear medicine                                                               
technology; and providing for an effective date."                                                                               
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
HOUSE BILL NO. 434                                                                                                              
"An Act  relating to the  practice of naturopathic  medicine; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
HOUSE BILL NO. 239                                                                                                              
"An Act  directing the Department  of Public Safety  to establish                                                               
an Internet-based identification and  tracking system relating to                                                               
controlled  substances that  are  prescribed for  human use;  and                                                               
relating  to the  manner in  which  prescriptions for  controlled                                                               
substances may be filled by a pharmacist."                                                                                      
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
HOUSE BILL NO. 502                                                                                                              
"An Act relating to dispensing  opticians and dispensing optician                                                               
apprentices."                                                                                                                   
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 179                                                                                                                  
SHORT TITLE: CRIMINAL BACKGROUND CHECKS/TEACHERS                                                                                
SPONSOR(S): SENATOR(S) THERRIAULT                                                                                               
                                                                                                                                
04/08/03       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/08/03       (S)       HES, FIN                                                                                               
04/16/03       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
04/16/03       (S)       Moved CSSB 179(HES) Out of Committee                                                                   
04/16/03       (S)       MINUTE(HES)                                                                                            
05/10/03       (S)       HES RPT CS 2DP 1NR            NEW TITLE                                                                
05/10/03       (S)       DP: DYSON, WILKEN; NR: DAVIS                                                                           
05/13/03       (H)       FIN AT 8:00 AM SENATE FINANCE 532                                                                      
05/13/03       (S)       <Above Item Removed from Agenda>                                                                       
05/13/03       (S)       MINUTE(FIN)                                                                                            
03/08/04       (S)       FIN RPT CS  5DP 2NR       NEW TITLE                                                                    
03/08/04       (S)       DP: GREEN, WILKEN, DYSON, BUNDE,                                                                       
03/08/04       (S)       STEVENS B; NR: HOFFMAN, OLSON                                                                          
03/08/04       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
03/08/04       (S)       Moved CSSB 179(FIN) Out of Committee                                                                   
03/08/04       (S)       MINUTE(FIN)                                                                                            
03/15/04       (S)       TRANSMITTED TO (H)                                                                                     
03/15/04       (S)       VERSION: CSSB 179(FIN)                                                                                 
03/16/04       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/16/04       (H)       EDU, HES, JUD                                                                                          
03/23/04       (H)       EDU AT 11:00 AM CAPITOL 124                                                                            
03/23/04       (H)       Moved Out of Committee                                                                                 
03/23/04       (H)       MINUTE(EDU)                                                                                            
03/24/04       (H)       EDU RPT 4DP 1NR 1AM                                                                                    
03/24/04       (H)       DP: WILSON, OGG, SEATON, GATTO;                                                                        
03/24/04       (H)       NR: KAPSNER; AM: WOLF                                                                                  
04/20/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/20/04       (H)       Moved   HCS   CSSB   179(HES)   Out   of                                                               
                         Committee                                                                                              
04/20/04       (H)       MINUTE(HES)                                                                                            
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: SB 274                                                                                                                  
SHORT TITLE: HOUSING PROGRAMS                                                                                                   
SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
01/23/04       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/23/04       (S)       HES, FIN                                                                                               
02/20/04       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
02/20/04       (S)       -- Meeting Canceled --                                                                                 
02/25/04       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
02/25/04       (S)       Moved SB 274  Out of Committee                                                                         
02/25/04       (S)       MINUTE(HES)                                                                                            
02/27/04       (S)       HES RPT 3DP 1NR                                                                                        
02/27/04       (S)       DP: DYSON, GREEN, WILKEN; NR: GUESS                                                                    
03/08/04       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
03/08/04       (S)       Heard & Held                                                                                           
03/08/04       (S)       MINUTE(FIN)                                                                                            
03/22/04       (S)       FIN RPT 5DP 2NR                                                                                        
03/22/04       (S)       DP: GREEN, WILKEN, DYSON, HOFFMAN,                                                                     
03/22/04       (S)       STEVENS B; NR: OLSON, BUNDE                                                                            
03/22/04       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
03/22/04       (S)       Moved  SB 274 Out of Committee                                                                         
03/22/04       (S)       MINUTE(FIN)                                                                                            
03/31/04       (S)       TRANSMITTED TO (H)                                                                                     
03/31/04       (S)       VERSION: SB 274                                                                                        
04/01/04       (H)       READ THE FIRST TIME - REFERRALS                                                                        
04/01/04       (H)       HES, FIN                                                                                               
04/22/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/22/04       (H)       Scheduled But Not Heard                                                                                
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB  84                                                                                                                  
SHORT TITLE: ALASKA HISTORY CURRICULUM                                                                                          
SPONSOR(S): REPRESENTATIVE(S) KAPSNER                                                                                           
                                                                                                                                
02/07/03       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/07/03       (H)       EDU, HES, FIN                                                                                          
04/13/04       (H)       EDU AT 11:00 AM CAPITOL 124                                                                            
04/13/04       (H)       Moved CSHB  84(EDU) Out of Committee                                                                   
04/13/04       (H)       MINUTE(EDU)                                                                                            
04/14/04       (H)       EDU RPT CS(EDU) 2DP 2NR 2AM                                                                            
04/14/04       (H)       DP: SEATON, WILSON; NR: WOLF, GATTO;                                                                   
04/14/04       (H)       AM: GARA, KAPSNER                                                                                      
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB  72                                                                                                                  
SHORT TITLE: BOARD OF REGENTS QUALIFICATIONS                                                                                    
SPONSOR(S): REPRESENTATIVE(S) GUTTENBERG                                                                                        
                                                                                                                                
02/05/03       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/05/03       (H)       EDU, HES                                                                                               
03/25/03       (H)       EDU AT 11:00 AM CAPITOL 124                                                                            
03/25/03       (H)       Moved CSHB 72(EDU) Out of Committee                                                                    
03/25/03       (H)       MINUTE(EDU)                                                                                            
03/26/03       (H)       EDU RPT CS(EDU) 5DP 1DNP                                                                               
03/26/03       (H)       DP: KAPSNER, GARA, SEATON, WILSON,                                                                     
03/26/03       (H)       GATTO; DNP: OGG                                                                                        
04/01/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
04/01/04       (H)       Scheduled But Not Heard                                                                                
04/13/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/13/04       (H)       Scheduled But Not Heard                                                                                
04/22/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/22/04       (H)       Scheduled But Not Heard                                                                                
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 535                                                                                                                  
SHORT TITLE: LIMIT STATE AID FOR MENTAL HEALTH CARE                                                                             
SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
03/08/04       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/08/04       (H)       HES, JUD, FIN                                                                                          
03/25/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
03/25/04       (H)       Heard & Held                                                                                           
03/25/04       (H)       MINUTE(HES)                                                                                            
04/13/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/13/04       (H)       Scheduled But Not Heard                                                                                
04/22/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/22/04       (H)       Scheduled But Not Heard                                                                                
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 186                                                                                                                  
SHORT TITLE: LICENSING RADIOLOGIC TECHNICIANS                                                                                   
SPONSOR(S): REPRESENTATIVE(S) ANDERSON                                                                                          
                                                                                                                                
03/12/03       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/12/03       (H)       L&C, HES, FIN                                                                                          
03/26/03       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
03/26/03       (H)       -- Meeting Canceled --                                                                                 
03/28/03       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
03/28/03       (H)       Moved CSHB 186(L&C) Out of Committee                                                                   
03/28/03       (H)       MINUTE(L&C)                                                                                            
03/31/03       (H)       L&C RPT CS(L&C) 3DP 3NR                                                                                
03/31/03       (H)       DP: CRAWFORD, DAHLSTROM, ANDERSON;                                                                     
03/31/03       (H)       NR: GATTO, GUTTENBERG, ROKEBERG                                                                        
04/22/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/22/04       (H)       Scheduled But Not Heard                                                                                
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 434                                                                                                                  
SHORT TITLE: NATUROPATHIC MEDICINE                                                                                              
SPONSOR(S): REPRESENTATIVE(S) HOLM                                                                                              
                                                                                                                                
02/04/04       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/04/04       (H)       L&C, JUD                                                                                               
02/04/04       (H)       HES REFERRAL ADDED AFTER L&C                                                                           
02/18/04       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
02/18/04       (H)       Heard & Held <Assigned to Subcmte>                                                                     
02/18/04       (H)       MINUTE(L&C)                                                                                            
03/03/04       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
03/03/04       (H)       <Bill Hearing Postponed>                                                                               
03/24/04       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
03/24/04       (H)       Moved CSHB 434(L&C) Out of Committee                                                                   
03/24/04       (H)       MINUTE(L&C)                                                                                            
03/29/04       (H)       L&C RPT CS(L&C) 2DP 2NR 3AM                                                                            
03/29/04       (H)       DP: CRAWFORD, GUTTENBERG; NR: LYNN,                                                                    
03/29/04       (H)       DAHLSTROM; AM: GATTO, ROKEBERG,                                                                        
03/29/04       (H)       ANDERSON                                                                                               
04/13/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/13/04       (H)       Heard & Held                                                                                           
04/13/04       (H)       MINUTE(HES)                                                                                            
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 239                                                                                                                  
SHORT TITLE: ID SYSTEM FOR PRESCRIPTIONS                                                                                        
SPONSOR(S): REPRESENTATIVE(S) CHENAULT                                                                                          
                                                                                                                                
04/04/03       (H)       READ THE FIRST TIME - REFERRALS                                                                        
04/04/03       (H)       HES, STA, FIN                                                                                          
03/30/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
03/30/04       (H)       Scheduled But Not Heard                                                                                
04/01/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
04/01/04       (H)       Scheduled But Not Heard                                                                                
04/08/04       (H)       STA AT 8:00 AM CAPITOL 102                                                                             
04/08/04       (H)       <Bill Hearing Postponed>                                                                               
04/22/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/22/04       (H)       Scheduled But Not Heard                                                                                
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 502                                                                                                                  
SHORT TITLE: DISPENSING OPTICIANS: BOARD & REGULATION                                                                           
SPONSOR(S): REPRESENTATIVE(S) HOLM                                                                                              
                                                                                                                                
02/16/04       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/16/04       (H)       L&C, HES                                                                                               
03/31/04       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
03/31/04       (H)       Heard & Held                                                                                           
03/31/04       (H)       MINUTE(L&C)                                                                                            
04/02/04       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
04/02/04       (H)       Moved Out of Committee                                                                                 
04/02/04       (H)       MINUTE(L&C)                                                                                            
04/05/04       (H)       L&C RPT 2DP 4NR                                                                                        
04/05/04       (H)       DP: GATTO, GUTTENBERG; NR: CRAWFORD,                                                                   
04/05/04       (H)       LYNN, DAHLSTROM, ANDERSON                                                                              
04/06/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
04/06/04       (H)       Scheduled But Not Heard                                                                                
04/22/04       (H)       HES AT 2:00 PM CAPITOL 106                                                                             
04/22/04       (H)       Heard & Held                                                                                           
04/22/04       (H)       MINUTE(HES)                                                                                            
04/27/04       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ZACK WARWICK, Staff                                                                                                             
to Senator Gene Therriault                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on SB 179 on behalf of Senator                                                                   
Therriault, sponsor of SB 179.                                                                                                  
                                                                                                                                
DAN FAUSKE, CEO/Executive Director                                                                                              
Alaska Housing Finance Corporation                                                                                              
Department of Revenue                                                                                                           
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of SB 274 and answered                                                                
questions from the members.                                                                                                     
                                                                                                                                
JOE DUBLER, Chief Financial Officer                                                                                             
Alaska Housing Finance Corporation                                                                                              
Department of Revenue                                                                                                           
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on SB 274 and answered questions                                                                 
from the committee.                                                                                                             
                                                                                                                                
PAT JACKSON, Staff                                                                                                              
to Representative Mary Kapsner                                                                                                  
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 84 on behalf of Representative                                                                
Kapsner, sponsor of HB 84.                                                                                                      
                                                                                                                                
REPRESENTATIVE DAVID GUTTENBERG                                                                                                 
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As sponsor of HB 72, presented the bill and                                                                
answered questions from the committee.                                                                                          
                                                                                                                                
BILL HOGAN, Director                                                                                                            
Division of Behavioral Health                                                                                                   
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on HB 535 and answered questions                                                                 
from the committee.                                                                                                             
                                                                                                                                
RICHARD RAINERY, Executive Director                                                                                             
Alaska Mental Health Board                                                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on HB 535 and answered questions                                                                 
from the members.                                                                                                               
                                                                                                                                
JEFF JESSEE, Executive Director                                                                                                 
Alaska Mental Health Trust Authority                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified on HB 535 and answered questions                                                                 
from the members.                                                                                                               
                                                                                                                                
ROD BETIT, President                                                                                                            
Alaska State Hospital and Nursing Home Association                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 535 and answered                                                                
questions from the members.                                                                                                     
                                                                                                                                
JIM SHINE, Staff                                                                                                                
to Representative Tom Anderson                                                                                                  
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on behalf of Representative                                                                      
Anderson, sponsor of HB 186, and answered questions from the                                                                    
committee.                                                                                                                      
                                                                                                                                
CHRISTINE LUNG, Director                                                                                                        
Government Relations                                                                                                            
American Society of Radiologic Technologists (ASRT)                                                                             
Address Unknown                                                                                                                 
POSITION STATEMENT:  Testified in support of HB 186.                                                                            
                                                                                                                                
ANN DAILEY, President                                                                                                           
Alaska Academy of Physician's Assistants                                                                                        
Iliamna, Alaska                                                                                                                 
POSITION STATEMENT:  Testified on HB 186.                                                                                       
                                                                                                                                
CLYDE PEARCE, Chief, Radiological Physicist                                                                                     
Radiological Health                                                                                                             
Division of Public Health                                                                                                       
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified on HB 186.                                                                                       
                                                                                                                                
DONNA RUFSHOLM, Chair, Licensure Committee, and Board Member                                                                    
Alaska Society of Radiology Technologists                                                                                       
Homer, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 186.                                                                            
                                                                                                                                
ED HALL                                                                                                                         
Physician's Assistant and Member                                                                                                
Alaska Academy of Physician Assistants                                                                                          
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 186.                                                                         
                                                                                                                                
ERIKA WHITE, Program Director                                                                                                   
University of Alaska Anchorage                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 186.                                                                            
                                                                                                                                
JOHN BRINGHURST, Administrator                                                                                                  
Petersburg Hospital                                                                                                             
Petersburg, Alaska                                                                                                              
POSITION STATEMENT:  Testified in opposition to HB 186.                                                                         
                                                                                                                                
B. J. ANDERSON                                                                                                                  
Laboratory and X-Ray Manager                                                                                                    
Anchorage Neighborhood Health Center                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified on HB 186.                                                                                       
                                                                                                                                
VERA JAMES, Program Manager                                                                                                     
Alaska Native Health Board                                                                                                      
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 186.                                                                         
                                                                                                                                
BARBARA HUFFTUCKNESS, Director                                                                                                  
Governmental and Legislative Affairs                                                                                            
Teamsters Local 959                                                                                                             
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 186.                                                                            
                                                                                                                                
ALEX MALTER, M.D., President                                                                                                    
Alaska State Medical Association                                                                                                
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on HB 434, and answered questions                                                                
from the members.                                                                                                               
                                                                                                                                
SUE WRIGHT, Staff                                                                                                               
to Representative Mike Chenault                                                                                                 
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION   STATEMENT:      Presented   HB  239   on   behalf   of                                                               
Representative  Chenault,   sponsor  of  HB  239,   and  answered                                                               
questions from the members.                                                                                                     
                                                                                                                                
MARGARET SODEN, Chair                                                                                                           
Alaska Board of Pharmacy                                                                                                        
Division of Occupational Licensing                                                                                              
Department of Community and Economic Development                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified on HB 239.                                                                                       
                                                                                                                                
MATT RUDIG, Staff                                                                                                               
to Representative Jim Holm                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:     Testified  on   HB  502  on   behalf  of                                                               
Representative  Jim  Holm,  sponsor   of  HB  502,  and  answered                                                               
questions from the members.                                                                                                     
                                                                                                                                
RANDALL DAHL                                                                                                                    
Opticians Association of Alaska                                                                                                 
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in  support of HB 502 and answered                                                               
questions from the members.                                                                                                     
                                                                                                                                
CHRISTI BRAND, President                                                                                                        
Optician Association of Alaska                                                                                                  
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in  support of HB 502 and answered                                                               
questions from the members.                                                                                                     
                                                                                                                                
JAMES ROTHMEYER, Chair                                                                                                          
Board of Dispensing Opticians                                                                                                   
Division of Occupational Licensing                                                                                              
Department of Community and Economic Development                                                                                
Paxson, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in  support of HB 502 and answered                                                               
questions from the members.                                                                                                     
                                                                                                                                
FRANKLIN ROZAK, Secretary-Treasurer                                                                                             
National Association of Optometrists and Opticians                                                                              
Marblehead, Ohio                                                                                                                
POSITION STATEMENT:   Testified on HB 502  and answered questions                                                               
from the members.                                                                                                               
                                                                                                                                
BARBARA COTTING, Staff                                                                                                          
to Representative Jim Holm                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on  behalf of Representative Holm,                                                               
sponsor of HB 434.                                                                                                              
                                                                                                                                
LINDA ANDERSON, Lobbyist                                                                                                        
Naturopaths Association of Alaska                                                                                               
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on HB 434.                                                                                       
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
TAPE 04-37, SIDE A                                                                                                            
Number 0001                                                                                                                     
                                                                                                                                
CHAIR PEGGY WILSON called the  House Health, Education and Social                                                             
Services  Standing  Committee  meeting  to  order  at  3:11  p.m.                                                               
Representatives Wilson,  Wolf, Coghill,  and Seaton  were present                                                               
at the call  to order.  Representatives Gatto  and Cissna arrived                                                               
as  the meeting  was  in progress.    Representative Kapsner  was                                                               
excused.                                                                                                                        
                                                                                                                                
CHAIR  WILSON  announced  that   the  confirmation  hearings  are                                                               
cancelled.                                                                                                                      
                                                                                                                                
SB 179-CRIMINAL BACKGROUND CHECKS/TEACHERS                                                                                    
                                                                                                                                
CHAIR WILSON announced that the  first order of business would be                                                               
CS FOR  SENATE BILL  NO. 179(FIN), "An  Act relating  to criminal                                                               
history records and background checks;  allowing persons to teach                                                               
in the  public schools for up  to five months without  a teaching                                                               
certificate if the  person has applied for a  certificate and the                                                               
application  has  not  been  acted  upon  by  the  Department  of                                                               
Education  and Early  Development  due to  a  delay in  receiving                                                               
criminal  history  records;  allowing teacher  certification  for                                                               
certain  persons based  on a  criminal  history background  check                                                               
without fingerprints; and providing for an effective date."                                                                     
                                                                                                                                
CHAIR WILSON announced that the  committee decided not to proceed                                                               
with  motions  made  at  the  last  meeting  on  SB  179  because                                                               
additional information came to the  committee's attention.  There                                                               
was consensus  from the committee  that version V  was preferable                                                               
over version W.                                                                                                                 
                                                                                                                                
Number 0117                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON moved to rescind  previous action to report                                                               
HCS CSSB 179(HES), version W,  out of the House Health, Education                                                               
and Social Services Standing Committee  on April 20, 2004.  There                                                               
being no  objection, the previous  action to report out  HCS CSSB                                                               
179(HES) was rescinded.                                                                                                         
                                                                                                                                
REPRESENTATIVE SEATON  moved to  rescind House  Health, Education                                                               
and Social Services  Standing Committee action in  adopt HCS CSSB                                                               
179(HES), version  W, as  the working document.   There  being no                                                               
objection, the motion to adopt  HCS CSSB 179(HES), version W, was                                                               
rescinded.                                                                                                                      
                                                                                                                                
Number 0389                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON  moved to  adopt CSSB 179(FIN),  version V,                                                               
as  the  working  document.    There  being  no  objection,  CSSB                                                               
179(FIN), version  V is  before the  House Health,  Education and                                                               
Social Services Standing Committee.                                                                                             
                                                                                                                                
Number 0402                                                                                                                     
                                                                                                                                
ZACK  WARWICK, Staff  to Senator  Gene  Therriault, Alaska  State                                                               
Legislature, testified on SB 179  for Senator Therriault, sponsor                                                               
of SB 179.   He explained that version V of  this bill allows the                                                               
Department of  Education and Early Development  the authorization                                                               
to grant  the 60-day extension  in the case  of a backlog  at the                                                               
U.S. Department  of Justice.   He emphasized that  the department                                                               
has given  assurances that  this is  an authorization  that would                                                               
not be taken lightly.                                                                                                           
                                                                                                                                
MR.  WARWICK asked  if the  committee would  need to  rescind its                                                               
action on the title change resolution.                                                                                          
                                                                                                                                
CHAIR WILSON  said no.   The title  change resolution  only dealt                                                               
with version W which will not be heard.                                                                                         
                                                                                                                                
REPRESENTATIVE  SEATON  asked if  there  is  a fiscal  note  with                                                               
version V.                                                                                                                      
                                                                                                                                
MR. WARWICK replied no.                                                                                                         
                                                                                                                                
Number 0426                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON  moved to report CSSB  179(FIN), version V,                                                               
out  of   committee  with  individual  recommendations   and  the                                                               
accompanying  fiscal  notes.   There  being  no  objection,  CSSB                                                               
179(FIN),  version  V, was  reported  out  of the  House  Health,                                                               
Education and Social Services Standing Committee.                                                                               
                                                                                                                                
SB 274-HOUSING PROGRAMS                                                                                                       
                                                                                                                                
Number 0488                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
SENATE BILL NO.  274, "An Act relating to  the housing assistance                                                               
loan  fund in  the Alaska  Housing Finance  Corporation; creating                                                               
the housing assistance loan program;  repealing loans for teacher                                                               
housing and providing for loans  for multi-family housing; making                                                               
conforming amendments; and providing for an effective date."                                                                    
                                                                                                                                
Number 0545                                                                                                                     
                                                                                                                                
DAN  FAUSKE, Chief  Executive Officer/Executive  Director, Alaska                                                               
Housing Finance Corporation, Department  of Revenue, testified in                                                               
support of  SB 274 and answered  questions from the members.   He                                                               
read a statement into the record as follows:                                                                                    
                                                                                                                                
     SB  274  will  make  two  changes  to  the  rural  loan                                                                    
     program.   It will replace the  Housing Assistance Loan                                                                    
     Fund with  the Housing  Assistance Loan Program.   This                                                                    
     bill will  also replace the Rural  Teacher Housing Loan                                                                    
     Program with the Rural Multi-Family  Loan Program.  The                                                                    
     changing  of the  Housing Assistance  Loan Fund  from a                                                                    
     fund  to a  program is  necessary  as a  result of  the                                                                    
     liquidity  concerns at  the corporation.   The  current                                                                    
     revolving nature of  the fund limits the  fund to being                                                                    
     used  only to  purchase new  loans under  this program.                                                                    
     For fiscal year 2003 over  a third of the corporation's                                                                    
     net  income was  in this  fund.   With the  corporation                                                                    
     paying  a dividend  of $103  million to  the state  the                                                                    
     funds  paid  to  the  state   have  continued  to  come                                                                    
     entirely  out of  our working  capital  because of  the                                                                    
     restrictions  of  the  Rural   Loan  Fund.    This  has                                                                    
     resulted  in  the  liquid  assets  of  the  corporation                                                                    
     declining  at an  accelerated rate.    In addition  the                                                                    
     revolving  fund has  not  really  revolved for  several                                                                    
     years and  new loans in  the program have  exceeded the                                                                    
     cash available  in the fund causing  the corporation to                                                                    
     use its working capital to  purchase and hold loans for                                                                    
     reimbursement from the fund.                                                                                               
                                                                                                                                
     This legislation  will allow the program  to operate in                                                                    
     the  same way  our other  programs do,  and other  than                                                                    
     this change  the program will  continue to  operate the                                                                    
     same way.                                                                                                                  
                                                                                                                                
     The  other phase  would change  the Rural  Teacher Loan                                                                    
     Program to  the Rural  Multi-Family Loan Program.   The                                                                    
     passage  of SB  181 in  2002 changed  the Rural  Multi-                                                                    
     Family non-owner  occupied loan program into  the Rural                                                                    
     Teacher  Loan Program.    This  change required  anyone                                                                    
     using the  program to fill their  duplex, four-plex, or                                                                    
     any  other  multi-family  building with  at  least  one                                                                    
     teacher  in   every  unit.     As  a  result   of  this                                                                    
     restriction in  the year  and a  half that  the program                                                                    
     has  existed there  has not  been a  single loan  made.                                                                    
     Before  this change  the multi-family  program made  up                                                                    
     between 2 percent and 3  percent of our rural business.                                                                    
     This bill will  change the program back  into the Rural                                                                    
     Multi-Family  Program  available  to  anyone  including                                                                    
     teachers.   It will also  allow an owner to  occupy one                                                                    
     of the units if they so choose.                                                                                            
                                                                                                                                
MR.  FAUSKE  reminded the  members  that  Alaska Housing  Finance                                                               
Corporation (AHFC)  is also  in the process  of putting  in place                                                               
the Teacher  Housing Loan  Program and  the General  Agreement on                                                               
Tariffs  and Trade  (GATT) Program  that are  applied across  the                                                               
state.  There are applications and  work in progress in a variety                                                               
of areas around the state, he added.   He said he did not want to                                                               
mislead the committee that AHFC is going backwards.                                                                             
                                                                                                                                
Number 0680                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON moved to adopt  SB 274, 23-GS2095\A, as the                                                               
working  document.   There  being  no  objection, version  A  was                                                               
before the committee.                                                                                                           
                                                                                                                                
Number 0760                                                                                                                     
                                                                                                                                
REPRESENTATIVE  COGHILL asked  for  clarification  on the  change                                                               
between the fund and the program.                                                                                               
                                                                                                                                
MR. FAUSKE  replied that he will  have Joe Dubler speak  to this,                                                               
but  offered a  brief  explanation of  the  difference between  a                                                               
program and  a fund.   He explained  that it has  to do  with the                                                               
intricacies  of  how AHFC  buys  and  sells bonds,  and  recycles                                                               
loans.    There are  restrictions  on  co-mingling funds  between                                                               
programs  and  funds.    With   the  exception  of  the  [Housing                                                               
Assistance Loan Fund] all of  AHFC loans are administered through                                                               
programs.  He explained that  the fund was created under statute.                                                               
Alaska  Housing Finance  Corporation has  a hard  time purchasing                                                               
loans from  this fund with  monies from other programs,  with the                                                               
exception of  cash placements from  AHFC's general fund  into the                                                               
fund, he clarified.                                                                                                             
                                                                                                                                
Number 0769                                                                                                                     
                                                                                                                                
JOE  DUBLER,  Chief  Financial   Officer  (CFO),  Alaska  Housing                                                               
Finance Corporation,  Department of Revenue, testified  on SB 274                                                               
and  answered   questions  from  the  committee.     The  Housing                                                               
Assistance Loan  Fund that  is being  discussed is  the revolving                                                               
loan fund  that came  to AHFC  when there was  a merger  with the                                                               
then Department  of Community  and Regional  Affairs in  1992, he                                                               
explained.   The fund was set  up as a revolving  fund to protect                                                               
the  assets so  it could  only be  used statutorily  to make  new                                                               
loans under that  program.  The corporation administers  a lot of                                                               
different loan  programs very successfully throughout  the state,                                                               
Mr. Dubler  said.  It  is AHFC wish to  make this another  one of                                                               
those programs so  it is not restricted to using  only the assets                                                               
in that fund  for that specific program.  It  will mean that AHFC                                                               
will be able to sell bonds to  back loans that are now pledged to                                                               
a fund that cannot be used  now, he added.  Mr. Dubler emphasized                                                               
that there is  about $515 million, about one-third  of AHFC's net                                                               
assets, which is locked up in the fund and that cannot be used.                                                                 
                                                                                                                                
REPRESENTATIVE COGHILL  commented that  he believes  the original                                                               
policy call  that occurred was  to have  a fund where  the assets                                                               
would build up.  He asked  if changing the fund to a multi-family                                                               
loan program  will mean the original  intent of the fund  will be                                                               
superceded.                                                                                                                     
                                                                                                                                
MR. DUBLER responded:                                                                                                           
                                                                                                                                
     It is  a dual-purpose  bill.   The only  part of  it is                                                                    
     related  to  the multi-family  aspect  of  it, of  this                                                                    
     program.   The rest will  just take the  whole program,                                                                    
     the  majority of  it are  single-family loans  in Rural                                                                    
     Alaska and  that will remain  the same it will  just be                                                                    
     shifted out  of a  revolving fund so  we can  use those                                                                    
     assets for...leverage those assets basically.                                                                              
                                                                                                                                
Number 0899                                                                                                                     
                                                                                                                                
MR. FAUSKE  added that  the other  feature of  the bill  that was                                                               
referred to, the multi-family [loan  program], was created to fix                                                               
the problem that was created a  couple of years ago which has not                                                               
resulted in any loan activity.   It is important to get back into                                                               
a mode where  AHFC has access to these funds,  he commented.  Mr.                                                               
Fauske  told the  committee that  negotiations  took placed  over                                                               
many years and there was finally  a compromise to get the bill to                                                               
move.   He explained that  at a time when  AHFC is trying  to get                                                               
investments out  for rural and  teacher housing it does  not make                                                               
sense to  restrict loans by  saying the housing must  be occupied                                                               
only by teachers.  The intent is  not a bad idea, but in practice                                                               
it  has not  worked.   For example,  in many  of the  small rural                                                               
areas where  there will be an  individual who has some  money and                                                               
wants  to build  a four-plex,  live in  one unit  and rent  three                                                               
others  out to  teachers, this  program restricted  that kind  of                                                               
loan  and denies  access  to  some capital  investments.   It  is                                                               
important to get this program fixed, he summarized.                                                                             
                                                                                                                                
CHAIR   WILSON  recalled   that   originally   the  program   was                                                               
established to  provide teachers  with decent housing.   However,                                                               
the program just did not work.                                                                                                  
                                                                                                                                
MR. FAUSKE  agreed that the program  did not work.   The revision                                                               
in  SB 274  will  put the  program  back in  an  arena that  will                                                               
attract  investors   and  make  it  easier   for  individuals  to                                                               
participate.                                                                                                                    
                                                                                                                                
CHAIR  WILSON commented  that it  was the  legislature's goal  to                                                               
provide  decent housing  for  teachers in  Rural  Alaska so  they                                                               
would  be more  likely  to remain  there.   She  stated that  she                                                               
believes  the original  goals can  be achieved  with the  changes                                                               
provided in the bill.                                                                                                           
                                                                                                                                
Number 1013                                                                                                                     
                                                                                                                                
REPRESENTATIVE  SEATON referred  to Section  3, page  3, line  28                                                               
through 31, where  it refers to the mortgage  interest rate being                                                               
one percent less.  He commented  that the lower interest rate use                                                               
to be for small community  housing for teachers; however, in this                                                               
bill the  lower interest rate  will be for  multi-family housing.                                                               
Representative  Seaton  asked  if  there  is  any  leverage  that                                                               
ensures  the  housing   is  focused  on  teacher   housing.    He                                                               
interprets this  language as  saying that no  one in  the housing                                                               
needs to be a teacher.                                                                                                          
                                                                                                                                
Number 1057                                                                                                                     
                                                                                                                                
MR.  FAUSKE  replied  that  there is  a  distinct  advantage  for                                                               
someone to  build a unit  that houses teachers because  there are                                                               
some financing  programs available to  offset some of  the costs,                                                               
such as the  GATT program that is being done  in conjunction with                                                               
the  AHFC,   Denali  Commission,  Rasmuson,  and   United  States                                                               
Department  of  Agriculture  (USDA).   Aside  from  the  on-going                                                               
program  that the  corporation offers  for energy-efficiency  and                                                               
interest  rate  reductions, there  is  another  avenue that  adds                                                               
another layer of possibilities for  individuals.  This would also                                                               
allow an  investor that  wanted to  approach the  school district                                                               
and offer  a long-term agreement  to provide housing  to teachers                                                               
and  the financing  would then  be  there to  provide housing  to                                                               
teachers and  health professionals.   Mr.  Fauske said  that AHFC                                                               
will do  its part to provide  the marketing to make  sure lenders                                                               
are  aware of  it  so when  someone  walks off  the  street to  a                                                               
lending  institution  they will  be  aware  of all  the  programs                                                               
available to the borrower.                                                                                                      
                                                                                                                                
REPRESENTATIVE SEATON emphasized that he  just wants to make sure                                                               
there is some context in providing teacher housing.                                                                             
                                                                                                                                
Number 1153                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON  moved to  report SB 274,  23-GS2095\A, out                                                               
of   committee   with    individual   recommendations   and   the                                                               
accompanying fiscal  notes.   There being  no objection,  SB 274,                                                               
version A,  was reported out  of the House Health,  Education and                                                               
Social Services Standing Committee.                                                                                             
                                                                                                                                
HB  84-ALASKA HISTORY CURRICULUM                                                                                              
                                                                                                                                
Number 1203                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL  NO. 84, "An Act  relating to a curriculum  for Alaska                                                               
history; and providing for an effective date."                                                                                  
                                                                                                                                
PAT JACKSON,  Staff to Representative Mary  Kapsner, Alaska State                                                               
Legislature,  presented   HB  84  on  behalf   of  Representative                                                               
Kapsner, sponsor of HB 84.  She  said that she will be very brief                                                               
in her explanation  of the bill because she is  aware of the fact                                                               
that the members  are familiar with it.  Ms.  Jackson shared that                                                               
when  researching the  bill it  was discovered  that in  1981 the                                                               
state board  of education  had looked at  the issue  of requiring                                                               
Alaska history for high school  seniors because of the importance                                                               
of  knowing one's  history in  order  to become  active in  state                                                               
affairs.   In 1988  the then Senator  Willie Hensley  sponsored a                                                               
resolution which passed the legislature  with strong support, 18-                                                               
0 in the Senate and 35-1 in the House.                                                                                          
                                                                                                                                
MS. JACKSON told the members  when Representative Kapsner started                                                               
working on the issue she  worked with a dedicated, broad-ranging,                                                               
group of  people from Commonwealth  North, the  Humanities Forum,                                                               
the Alaska Historical Society, the  [Alaska Association of School                                                               
Administrators], and NEA-Alaska.  There  was agreement that it is                                                               
important   that  high   school  students   have  that   base  of                                                               
information.                                                                                                                    
                                                                                                                                
MS. JACKSON commented  that in the previous  legislature the bill                                                               
passed the  House with really strong  support by a vote  of 36-0,                                                               
but  hit  a roadblock  in  the  Senate.   Representative  Kapsner                                                               
reintroduced  the  legislation this  year  and  has continued  to                                                               
receive a  lot of positive  support from people around  the state                                                               
from policy makers who wear a lot of hats.                                                                                      
                                                                                                                                
Number 1353                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON moved to  report CSHB 84(EDU), 23-LS0116\I,                                                               
out  of   committee  with  individual  recommendations   and  the                                                               
accompanying  fiscal  notes.   There  being  no  objection,  CSHB                                                               
84(EDU),  version  I,  was  reported out  of  the  House  Health,                                                               
Education and Social Services Standing Committee.                                                                               
                                                                                                                                
HB  72-BOARD OF REGENTS QUALIFICATIONS                                                                                        
                                                                                                                                
Number 1379                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL  NO. 72,  "An Act relating  to the  qualifications and                                                               
appointment of members of the  Board of Regents of the University                                                               
of Alaska; and providing for an effective date."                                                                                
                                                                                                                                
Number 1389                                                                                                                     
                                                                                                                                
REPRESENTATIVE  DAVID   GUTTENBERG,  Alaska   State  Legislature,                                                               
sponsor of HB 72, presented  the bill and answered questions from                                                               
the committee.  He explained that  at the end of the 2002 session                                                               
a situation occurred in joint  session where a student regent did                                                               
not  get confirmed.   As  a  result of  that university  students                                                               
across the  state wanted to come  up with a fix  that presented a                                                               
solution to that problem.  There  has been a lot discussion about                                                               
what that  would be  and suggestions  ranged from  adding another                                                               
student  regent  to  possibly  allowing the  Governor  to  add  a                                                               
student   regent   without    going   through   the   legislative                                                               
confirmation process.                                                                                                           
                                                                                                                                
REPRESENTATIVE  GUTTENBERG  said  that   the  consensus  of  that                                                               
discussion is before the members now  in HB 72.  This bill allows                                                               
for a second  student regent, who serves in  a non-voting student                                                               
regent capacity  for one  year and  then moves  up to  the voting                                                               
student regent position the next  year.  The student regent would                                                               
serve a two-year term with  alternating appointments.  He said he                                                               
believes it is  important to always have a student  regent on the                                                               
board.    This also  serves  as  an educational  opportunity  for                                                               
another student, he added.                                                                                                      
                                                                                                                                
REPRESENTATIVE  GUTTENBERG explained  that  students are  elected                                                               
from the  student body and  a list of  names from each  campus is                                                               
submitted to  the governor  for appointment.   He  commented that                                                               
the issue on  the even number of members on  the board of regents                                                               
does not  seem to be  a problem because of  the way the  board of                                                               
regents'  works.    It  works through  a  committee  process  and                                                               
divisive issues do  not come before the full board  until all the                                                               
problems are worked out.                                                                                                        
                                                                                                                                
Number 1542                                                                                                                     
                                                                                                                                
CHAIR WILSON asked  if she understands correctly  that the second                                                               
student regent would serve by  watching and learning and not have                                                               
a vote.                                                                                                                         
                                                                                                                                
REPRESENTATIVE GUTTENBERG replied that  the second student regent                                                               
would not  be able to vote  on official business at  a full board                                                               
of regents meeting.  However,  the second student regent could be                                                               
participate in other  meetings.  He explained that  when an issue                                                               
comes before  the regents it is  assigned to a working  group who                                                               
works through the process.   The second student regent could work                                                               
on an issue; however, at a  full regent meeting the student could                                                               
speak, but not vote.                                                                                                            
                                                                                                                                
Number 1579                                                                                                                     
                                                                                                                                
CHAIR WILSON commented  that the state school board  has the same                                                               
arrangement with  two student representatives.   She  shared that                                                               
when she  asked them  how it  was working  out the  students were                                                               
very happy with it.                                                                                                             
                                                                                                                                
REPRESENTATIVE  SEATON referred  to page  3, lines  3 through  5,                                                               
where it says:                                                                                                                  
                                                                                                                                
       The term "campus" used in this subsection means a                                                                        
      portion of the University of Alaska designated as a                                                                       
     "campus" by the Board of Regents.                                                                                          
                                                                                                                                
REPRESENTATIVE  SEATON asked  whether  there is  language in  the                                                               
bill that  makes the  distinction that  the student  regents will                                                               
come from different campuses.                                                                                                   
                                                                                                                                
REPRESENTATIVE GUTTENBERG responded that  it is not his intention                                                               
to  have two  people from  the  same campus.   He  added that  he                                                               
believes  there  would  be  enough   political  pressure  on  the                                                               
governor  to  ensure  that  the two  student  regents  come  from                                                               
different campuses.                                                                                                             
                                                                                                                                
REPRESENTATIVE  SEATON pointed  to page  2, lines  25 through  27                                                               
which reads as follows:                                                                                                         
                                                                                                                                
       The list must [SHALL] consist of the names of two                                                                    
     students from each campus of the University of Alaska                                                                      
     after an election is held at each campus.                                                                                  
                                                                                                                                
REPRESENTATIVE  SEATON  asked  Representative  Guttenberg  if  he                                                               
intended  for that  language to  specify that  one nominee  would                                                               
come from each campus.                                                                                                          
                                                                                                                                
REPRESENTATIVE GUTTENBERG  replied yes.   The possibility  of the                                                               
governor appointing  two regents  from the  same campus  would be                                                               
the governor's political  decision.  He said he  hopes that would                                                               
not happen.                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON commented that it is not specified.                                                                       
                                                                                                                                
REPRESENTATIVE GUTTENBERG agreed it is not specified.                                                                           
                                                                                                                                
Number 1693                                                                                                                     
                                                                                                                                
REPRESENTATIVE COGHILL asked if  the student regent positions are                                                               
staggered.   He said it appears  that the terms could  both begin                                                               
at the same time.                                                                                                               
                                                                                                                                
REPRESENTATIVE  GUTTENBERG replied  that it  is his  intention to                                                               
have the terms staggered.  It  would not be practical to have the                                                               
terms start at the  same time.  The point is  to have one student                                                               
regent that  watches for a  year and  moves up into  the [voting]                                                               
regent position when a regent is appointed behind him/her.                                                                      
                                                                                                                                
REPRESENTATIVE  COGHILL commented  that  he is  looking for  that                                                               
clarification   in  the   language.      He  questioned   whether                                                               
Representative  Guttenberg  would  want  to  amend  the  bill  to                                                               
specify that.                                                                                                                   
                                                                                                                                
REPRESENTATIVE GUTTENBERG  responded that  he has  discussed that                                                               
possibility.                                                                                                                    
                                                                                                                                
REPRESENTATIVE COGHILL  noted that the qualifications  refer to a                                                               
regent  having  a  graduate  or  undergraduate  degree  from  the                                                               
University of Alaska on page 2, lines  5 and 6.  He asked if that                                                               
is a current requirement or is it new language.                                                                                 
                                                                                                                                
REPRESENTATIVE GUTTENBERG  explained that while this  is a change                                                               
in the language,  it is really directed at the  board of regents,                                                               
not student regents.  Currently  there is no requirement that any                                                               
member of  the board of regents  be a graduate of  the University                                                               
of Alaska.                                                                                                                      
                                                                                                                                
REPRESENTATIVE  COGHILL  commented that  it  sounds  like a  good                                                               
idea.                                                                                                                           
                                                                                                                                
CHAIR WILSON  asked for Representative Guttenberg  to clarify how                                                               
the student regent is appointed.                                                                                                
                                                                                                                                
REPRESENTATIVE   GUTTENBERG  explained   that  the   governor  is                                                               
presented with a  list of two students from each  campus and from                                                               
that  list  the governor  selects  one  to  be  on the  board  of                                                               
regents.                                                                                                                        
                                                                                                                                
CHAIR WILSON commented  that the bill does say that  the "term of                                                               
office  begin June  1 of  the year  in which  the appointment  is                                                               
made."  She asked how the student regents' terms are designated.                                                                
                                                                                                                                
Number 1833                                                                                                                     
                                                                                                                                
REPRESENTATIVE GUTTENBERG commented  that the university believed                                                               
the  terms of  the  regents  could be  accomplished  by having  a                                                               
staggered term.   When meeting with the regents he  was told that                                                               
they do not believe it is  their role to tell the legislature how                                                               
they will be governed.                                                                                                          
                                                                                                                                
REPRESENTATIVE SEATON moved conceptual Amendment 1 as follows:                                                                  
                                                                                                                                
     On Page 2, Line 28, after "Governor."                                                                                      
      Insert "The Governor shall appoint one student from                                                                       
        each of two different campuses having staggered                                                                         
     terms."                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  he  said   he  believes  this  conceptual                                                               
amendment would take care of both problems.                                                                                     
                                                                                                                                
There being no objection, Conceptual Amendment 1 was adopted.                                                                   
                                                                                                                                
REPRESENTATIVE COGHILL asked Representative  Guttenberg if any of                                                               
the regents have express an objection to the bill.                                                                              
                                                                                                                                
REPRESENTATIVE GUTTENBERG commented that  the two regents that he                                                               
spoke to were Representatives Fate  and Ogg.  Representative Ogg,                                                               
when speaking  only for  himself, and  not as  a regent,  said he                                                               
believes  the  current  arrangement  is   fine  the  way  it  is.                                                               
Representative Guttenberg  told the  members that  he did  have a                                                               
conversation with Chip  Wagoner who was involved  in the creation                                                               
of  a student  regent  position.   He  had  some opposition,  but                                                               
decided that if  the students wanted another regent  he would not                                                               
stand in their way.                                                                                                             
                                                                                                                                
REPRESENTATIVE  COGHILL  said  he  believes  having  one  student                                                               
regent  as a  non-voting member  is  a good  idea.   He told  the                                                               
members he supports the bill.                                                                                                   
                                                                                                                                
Number 1975                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON moved to  report CSHB 72(EDU), 23-LS0112\Q,                                                               
as amended, out of committee  with individual recommendations and                                                               
the accompanying  fiscal notes.   There being no  objection, CSHB                                                               
72(HES)  was reported  out  of the  House  Health, Education  and                                                               
Social Services Standing Committee.                                                                                             
                                                                                                                                
HB 535-LIMIT STATE AID FOR MENTAL HEALTH CARE                                                                                 
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL  NO. 535, "An  Act relating to liability  for expenses                                                               
of  placement in  certain mental  health facilities;  relating to                                                               
the  mental health  treatment assistance  program; and  providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
Number 2066                                                                                                                     
                                                                                                                                
BILL HOGAN,  Director, Division of Behavioral  Health, Department                                                               
of Health and  Social Services, testified on HB  535 and answered                                                               
questions  from  the  committee.   He  explained  that  the  bill                                                               
relates to statutes  which requires the state to  cover the costs                                                               
of  diagnosis  and treatment  services  for  individuals who  are                                                               
financially eligible, and who need  to be involuntarily committed                                                               
to non-state  operated hospitals.   Mr. Hogan told  the committee                                                               
that the costs  of both the services  and transportation expenses                                                               
have  increased  dramatically over  the  last  four years.    The                                                               
intent of HB 535 is to  clarify that the costs incurred will only                                                               
be  covered up  to the  amount appropriated  by the  legislature.                                                               
The bill also requires hospitals  to notify the department within                                                               
24  hours  of admission  of  a  potentially eligible  individual.                                                               
This  would  allow the  department  to  assist  in a  timely  and                                                               
appropriate  discharge to  a  community-based  program, and  also                                                               
ensure  that the  funding is  actually decreasing  between fiscal                                                               
year  04  and  05.    The  bill  does  give  the  department  the                                                               
capability  of containing  costs on  an annual  basis, he  added.                                                               
Mr.  Hogan   reiterated  that  this   bill  limits   the  state's                                                               
responsibility to funds appropriated by the legislature.                                                                        
                                                                                                                                
MR. HOGAN  told the committee  that there are currently  10 sites                                                               
that can  provide mental health  care throughout the state.   The                                                               
two most  prominent sites are  at Bartlett Regional  Hospital and                                                               
Fairbanks Memorial  Hospital.  There  are smaller  sites, usually                                                               
comprised  of one  or two  beds, in  Palmer, Ketchikan,  Cordova,                                                               
Homer, Valdez, Sitka, Bethel, and Kodiak, he said.                                                                              
                                                                                                                                
MR. HOGAN  reminded the members that  the last time the  bill was                                                               
heard before  the committee Chair Wilson  directed the department                                                               
to  work  with  the  various stakeholders  including  the  Alaska                                                               
Mental Health  Trust Authority, the  Alaska Mental  Health Board,                                                               
and the  Alaska State  Hospital and  Nursing Home  Association to                                                               
come up  with an agreement  as to what  the language in  the bill                                                               
should ultimately  look like.   The group  agreed to a  number of                                                               
modifications to  the bill, he  said.   He told the  members that                                                               
version H of  HB 535 includes language in Section  2 of the bill,                                                               
lines 28  through 30, which  stipulates that the  department will                                                               
assist hospital-based  facilities in moving individuals  from its                                                               
hospitals when there  are no longer dollars available  to pay for                                                               
diagnosis, evaluation, and  treatment (DET) services.   It is not                                                               
the  department's intent  to have  hospitals bare  the burden  of                                                               
having individuals  in their facility without  having appropriate                                                               
compensation, he explained.  In  these circumstances, it would be                                                               
the  department's  intent  to have  these  individuals  moved  to                                                               
Alaska  Psychiatric  Institute  (API) if  individuals  are  still                                                               
involuntarily committed.   However,  if the individual  no longer                                                               
meets  the involuntary  commitment criteria  the department  will                                                               
work to find alternatives in the community, Mr. Hogan said.                                                                     
                                                                                                                                
MR. HOGAN told the members that  Section 2 is still the "sticking                                                               
point" in  general.   The stipulation that  the state  would only                                                               
pay  for the  program up  to the  level of  appropriation by  the                                                               
legislature  is   the  primary  point  of   disagreement  by  the                                                               
stakeholders, he stated.                                                                                                        
                                                                                                                                
Number 2188                                                                                                                     
                                                                                                                                
CHAIR WILSON commented that the  mental health community has been                                                               
working hard to  downsize API and find ways for  patients to stay                                                               
in their communities.   Because of the lack of  funding and cost-                                                               
containing  measures it  appears there  will be  more individuals                                                               
going to API,  she added.  Chair  Wilson said she sees  this as a                                                               
philosophical tug-of-war.                                                                                                       
                                                                                                                                
Number 2300                                                                                                                     
                                                                                                                                
RICHARD RAINERY, Executive Director,  Alaska Mental Health Board,                                                               
testified on HB 535 and answered  questions from the members.  He                                                               
said that  as an advocate for  Alaska's mentally ill he  has real                                                               
discomfort with Section 2 of the  bill.  There has been a process                                                               
that has  gone on over a  dozen years in designing  a system that                                                               
diverts individuals from API, he  explained.  Mr. Rainery said he                                                               
believes this system will threaten  that progress.  He noted that                                                               
while the  members are  aware of  the fact that  the new  API has                                                               
been downsized,  they may not  be aware of  the fact that  it has                                                               
been  designed  to be  a  national  model.   It  will  be a  very                                                               
different facility therapeutically  speaking.  The old  API was a                                                               
converted  medical/surgical hospital.    The new  API  will be  a                                                               
state of  the art psychiatric  facility with one and  two patient                                                               
rooms.   When the new  API goes over  census the therapy  will be                                                               
altered  substantially,  he  said.    Mr.  Rainery  reminded  the                                                               
members  that  this  is  in  addition  to  the  fact  that  these                                                               
individuals will be removed from their home communities.                                                                        
                                                                                                                                
Number 2361                                                                                                                     
                                                                                                                                
CHAIR  WILSON  asked  Mr.  Rainery to  tell  the  committee  what                                                               
happens when a patient is  removed from his/her community because                                                               
he/she has  been harmful to  himself or herself or  someone else.                                                               
For  example,  what  would  happen to  an  individual  living  in                                                               
Wrangell that has to be sent to API, she asked.                                                                                 
                                                                                                                                
MR.  RAINERY   responded  that  under  normal   circumstances  an                                                               
individual in Wrangell would be  transported to Bartlett Regional                                                               
Hospital.   If  there was  a  scenario where  Bartlett could  not                                                               
accept  the patient,  then  the  person would  be  escorted by  a                                                               
security service, often in handcuffs on public transportation.                                                                  
                                                                                                                                
TAPE 04-37, SIDE B                                                                                                            
                                                                                                                                
Number 2365                                                                                                                     
                                                                                                                                
MR. RAINERY commented that has been  an issue at the top of radar                                                               
screen for  quite a  while, because  it is  a very  demeaning and                                                               
stigmatizing experience.   Not only is the  individual taken away                                                               
from his/her home and family,  but dehumanized in the process, he                                                               
added.  The  individual is treated in a  separate environment and                                                               
then  sent  back to  his/her  home  community where  the  reentry                                                               
situation is complicated.                                                                                                       
                                                                                                                                
REPRESENTATIVE CISSNA  asked if  there have  been studies  on the                                                               
outcomes of different treatment options.                                                                                        
                                                                                                                                
MR. RAINERY replied that he could  not cite any studies.  In some                                                               
parts of the  mental health community it is  accepted wisdom that                                                               
it  is always  a  problem  to have  an  individual  taken out  of                                                               
his/her home  community and treated  in an institution.   It does                                                               
not matter  whether it is  in Anchorage or Colorado,  the reentry                                                               
to  the community  is  difficult.   At  least  when  a person  is                                                               
treated  at  Bartlett Memorial  Hospital  mental  health unit  or                                                               
Fairbanks Memorial  Hospital mental health unit  the individual's                                                               
family is  there and able  to interact  with the individual  on a                                                               
daily basis.   Additionally, the people who will  be working with                                                               
the individual  as he/she  goes back to  the community  are there                                                               
and able to work with the individual, he added.                                                                                 
                                                                                                                                
Number 2268                                                                                                                     
                                                                                                                                
CHAIR WILSON commented  that she tried to imagine  herself in the                                                               
place of  an individual who  was seen  by people she  knows being                                                               
transported in handcuffs.  That would be very embarrassing.                                                                     
                                                                                                                                
MR. RAINERY  told the committee  that very thing has  happened to                                                               
members  of  the  Alaska  Mental Health  Board  while  they  were                                                               
members.                                                                                                                        
                                                                                                                                
REPRESENTATIVE  SEATON posed  a  hypothetical  question where  an                                                               
individual  from  Wrangell  were  to  be  transported  to  either                                                               
Bartlett  Regional Hospital  or a  state of  the art  facility at                                                               
API, would the  outcome be the same.  Are  the treatment programs                                                               
the same at both facilities, he asked.                                                                                          
                                                                                                                                
MR.  RAINERY responded  that there  are definitely  not the  same                                                               
programs available at Bartlett Regional  Hospital as that at API.                                                               
He explained that API is a  specialty hospital.  If the committee                                                               
were to look at the mental  health system as a pyramid, API would                                                               
be considered the  very apex.  Local hospital  treatments are for                                                               
a maximum of 30  days, but most patients are only  there for 6 to                                                               
8 days,  he commented.   A  course of treatment  at API  could be                                                               
months long, although most are not there for months.                                                                            
                                                                                                                                
CHAIR  WILSON pointed  out that  the Alaska  Mental Health  Board                                                               
still prefers that individuals be treated at local hospital.                                                                    
                                                                                                                                
MR.  RAINERY agreed  that is  correct.   Most people  admitted to                                                               
local hospitals  do not need to  go to a specialty  hospital like                                                               
API, he said.                                                                                                                   
                                                                                                                                
Number 2179                                                                                                                     
                                                                                                                                
JEFF  JESSEE,  Executive  Director, Alaska  Mental  Health  Trust                                                               
Authority, testified  on HB 535  and answered questions  from the                                                               
members.  He told the members  that the problem with this bill is                                                               
in Section 2  which allows the department to stop  paying for DET                                                               
when the state  has reached the end of the  appropriation.  There                                                               
are other parts  of the bill that the Alaska  Mental Health Trust                                                               
Authority  supports, such  as those  provisions  which gives  the                                                               
department more management tools to  bring the program under some                                                               
active management.                                                                                                              
                                                                                                                                
MR. JESSEE  pointed to  the provision  that the  commissioner and                                                               
the governor have decided that  in this particular arena if there                                                               
is a  cost overrun on  DETs, a supplemental appropriation  is not                                                               
an  option.   Either the  money must  be found  elsewhere in  the                                                               
budget or the state will stop  paying, he said.  Mr. Jessee noted                                                               
that  there is  intent language  in  the bill  testifying to  the                                                               
state's good  intentions to try to  find other funding.   He said                                                               
he does  not doubt  their sincerity in  these efforts,  but there                                                               
are a  lot of discussions  going on  in the state  in determining                                                               
what  constitutes  essential services.    This  is one  of  those                                                               
things the state absolutely has to  do, he stated.  By definition                                                               
all people  who have been found  to be a danger  to themselves or                                                               
others and are  in the care and custody of  the commissioner, who                                                               
then  designates  the  different   facilities  to  provide  these                                                               
services.  The  administration is asking the committee  to make a                                                               
policy decision.   He said he  believes the question is  who will                                                               
bare  the burden  if  a  shortfall in  funding  for this  program                                                               
occurs.  Mr.  Jessee asked if it will be  the department who will                                                               
have to ask for a supplemental,  the local hospitals who could be                                                               
asked provide  uncompensated care, or the  beneficiaries who have                                                               
to bare the stigma of being  transported in handcuffs to API.  He                                                               
shared  that  during  territorial  days  patients  were  sent  to                                                               
Oregon.   For  many people  in the  outlying portions  of Alaska,                                                               
being  sent to  Anchorage  is about  the same  as  being sent  to                                                               
Oregon, he commented.  Mr. Jessee  said the policy call is pretty                                                               
straightforward,   and   if   approved   would   mean   partially                                                               
dismantling the  mental health system  by transporting  people to                                                               
API.  In closing, he commented  that he does not believe the cost                                                               
of  transporting individuals  to  API has  been  included in  the                                                               
fiscal note.                                                                                                                    
                                                                                                                                
Number 2043                                                                                                                     
                                                                                                                                
REPRESENTATIVE  SEATON  moved  to adopt  CSHB  535,  23-GH2080\H,                                                               
Mischel,  4/26/04,  as the  working  document.   There  being  no                                                               
objection,  CSHB 535,  version  H was  before  the House  Health,                                                               
Education and Social Services Standing Committee.                                                                               
                                                                                                                                
Number 1971                                                                                                                     
                                                                                                                                
ROD  BETIT, President,  Alaska State  Hospital  and Nursing  Home                                                               
Association,  testified  in  support   of  HB  535  and  answered                                                               
questions  from the  members.   He told  the members  he believes                                                               
this is a good bill in  its present form and appreciated the time                                                               
that was  given to  work through  the details of  it.   Mr. Betit                                                               
explained  that  he supports  the  bill  because  there is  a  $1                                                               
million hole in the department's  budget that the legislature has                                                               
not said will  go away; the commissioner has stated  that he will                                                               
not seek  a supplemental [appropriation];  and the  department is                                                               
seeking   additional  funding   through  disproportionate   share                                                               
hospital funding (DSH) that may help  to fill that hole.  He told                                                               
the members  that some  people are concerned  about Section  2 of                                                               
the bill, however, if the  department has a funding shortfall and                                                               
cannot make up the $1  million, the commissioner must balance his                                                               
budget.   It  will be  necessary to  act, and  something akin  to                                                               
Section 2  will happen  if there  is not enough  money.   If this                                                               
occurs   there  will   be   statutory   language  directing   the                                                               
commissioner  to  move  these unfunded  patients  from  community                                                               
hospitals  to  API,   he  said.    While  the   patient  will  be                                                               
transported  under embarrassing  conditions, he/she  will receive                                                               
excellent care, and the community  hospitals will not end up with                                                               
an unfunded mandate  that it cannot afford, he added.   Mr. Betit                                                               
commented that  there will still  be costs to local  hospitals in                                                               
that patients  must be stabilized  before being  transported, but                                                               
at least  there is the  expectation that cost will  be minimized.                                                               
If there is  an overflow that API cannot handle,  then he said he                                                               
believes there will  be tremendous pressure to  divert money from                                                               
other areas  or ask for  a supplemental.  Mr.  Betit acknowledged                                                               
that this  arrangement is  not ideal  for patients,  families, or                                                               
community hospitals that have made  a philosophical and financial                                                               
commitment to the DET program,  but the future is muddier without                                                               
this bill.   He summarized that if there were  enough money, this                                                               
bill would not  even be on the table, and  asked that the members                                                               
move this bill out of committee.                                                                                                
                                                                                                                                
Number 1898                                                                                                                     
                                                                                                                                
REPRESENTATIVE COGHILL agreed with  Mr. Betit's comment that when                                                               
there is  not enough money  there needs to  be a plan  of action.                                                               
He shared a  personal experience where he  escorted an individual                                                               
to a treatment  facility.  It was not possible  to get the person                                                               
into the  hospital so he/she was  required to stay in  jail for a                                                               
day and a half.  It was very  difficult, he said.  When the money                                                               
is not there  to pay for care,  this is probably the  best way to                                                               
handle the  problem.  Representative  Coghill commented  that the                                                               
average stay is between three to  four days, so there will likely                                                               
not be a huge number of  individuals transported to API.  He said                                                               
he would be comfortable moving the bill.                                                                                        
                                                                                                                                
REPRESENTATIVE CISSNA  asked how many people  will be transported                                                               
to API.                                                                                                                         
                                                                                                                                
MR. HOGAN  responded in  FY03 there  were 244  individuals served                                                               
statewide, 178  in Fairbanks,  57 in  Bartlett, 8  Mt. Edgecumbe,                                                               
and 1  in Kodiak.   The  great majority  are served  at Fairbanks                                                               
[Memorial  Hospital]  and  Bartlett   [Regional  Hospital].    He                                                               
commented that Representative Coghill made  a good point, in that                                                               
it  is the  department's  intention to  stabilize individuals  as                                                               
quickly as possible.  In a  worse case scenario if the department                                                               
had  no  money  there  could  be  approximately  240  individuals                                                               
impacted by  this change in  law, he  said.  Mr.  Hogan commented                                                               
that he believes  the number would actually be  much smaller than                                                               
that.    Probably  the  number  would  be  closer  to  40  or  50                                                               
individuals.                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  shared that she  has been involved  in the                                                               
mental health field for many years  and has seen great strides in                                                               
deinstitutionalization of individuals.   She commented that there                                                               
is  a systemic  problem.   Many of  these individuals  could have                                                               
been identified  at a much  earlier point thereby  eliminating or                                                               
minimizing the  need to  be hospitalized, she  added.   Are these                                                               
services being cut, Representative Cissna asked.                                                                                
                                                                                                                                
MR.  HOGAN responded  that he  is a  firm believer  in community-                                                               
based mental  health services  and has  spent the  last 25  to 30                                                               
years of his  life working in that area.   He said he understands                                                               
that  there needs  to be  a  solid comprehensive  community-based                                                               
mental  health   system  to   make  things   work.     Mr.  Hogan                                                               
acknowledged that  there are  some reductions  in community-based                                                               
services  and   prevention  services.     These   were  difficult                                                               
decisions,  he added.    Mr.  Hogan said  that  he  has tried  to                                                               
maintain  the integrity  of the  system that's  been built  while                                                               
recognizing the current fiscal realities that face the state.                                                                   
                                                                                                                                
Number 1995                                                                                                                     
                                                                                                                                
The committee took an at-ease from 4:18 p.m. to 4:20 p.m.                                                                       
                                                                                                                                
Number 1586                                                                                                                     
                                                                                                                                
REPRESENTATIVE  COGHILL moved  to report  CSHB 535,  23-GH2080\H,                                                               
Mischel,    4/26/04,   out    of   committee    with   individual                                                               
recommendations and  the accompanying fiscal notes.   There being                                                               
no objection,  CSHB 535(HES)  was reported  out of  House Health,                                                               
Education and Social Services Standing Committee.                                                                               
                                                                                                                                
REPRESENTATIVE  SEATON  said  for  the record  that  he  supports                                                               
funding these obligations, but believes  the state will be better                                                               
off statutorily setting up a process  in the event the state runs                                                               
out of money, rather than leaving it to the department to do it.                                                                
                                                                                                                                
CHAIR WILSON commented  that there are two  further committees of                                                               
referral  including the  House Judiciary  Standing Committee  and                                                               
House Finance Committee.                                                                                                        
                                                                                                                                
HB 186-LICENSING RADIOLOGIC TECHNICIANS                                                                                       
                                                                                                                                
Number 1496                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE  BILL   NO.  186,  "An  Act   establishing  the  Radiologic                                                               
Technology   Board   of   Examiners;   requiring   licensure   of                                                               
occupations   relating   to  radiologic   technology,   radiation                                                               
therapy, and  nuclear medicine technology;  and providing  for an                                                               
effective date."                                                                                                                
                                                                                                                                
Number 1492                                                                                                                     
                                                                                                                                
JIM  SHINE, Staff  to Representative  Tom Anderson,  Alaska State                                                               
Legislature,  presented  HB   186  for  Representative  Anderson,                                                               
sponsor of  HB 186,  and answered  questions from  the committee.                                                               
He read the following statement into the record:                                                                                
                                                                                                                                
     The  unregulated  practice  of  Radiologic  Technology,                                                                    
     Nuclear  Medicine Technology  and Radiation  Therapy by                                                                    
     unqualified  individuals  represents a  serious  health                                                                    
     risk to the citizens of  Alaska.  HB 186 will establish                                                                    
     educational  and  certification  standards  for  health                                                                    
     care personnel  in Alaska  who perform  medical imaging                                                                    
     and  radiation  procedures.     The  Radiologic  Health                                                                    
     Science Professionals  in Alaska  are dedicated  to the                                                                    
     preservation  of  life  and  health,  as  well  as  the                                                                    
     prevention and  treatment of  disease.   The use  of x-                                                                    
     rays and other medical  imaging disciplines is the most                                                                    
     acceptable  method for  discovering  and treating  many                                                                    
     conditions that  might not otherwise be  observed until                                                                    
     it is too late for  treatment.  Any radiology procedure                                                                    
     is only as  effective as the person performing  it.  An                                                                    
     underexposed chest  x-ray cannot reveal pneumonia  or a                                                                    
     malignant  lesion, just  as  an inadequate  mammography                                                                    
     technique cannot detect breast  cancer.  No matter what                                                                    
     the procedure, the  radiologic technologist's knowledge                                                                    
     of  anatomy,  careful   application  of  radiation  and                                                                    
     skillful operation  of sophisticated  medical equipment                                                                    
     are the keys  to its success.  To  be clinically useful                                                                    
     diagnostic-imaging exams must be accurate.                                                                                 
                                                                                                                                
     The  Alaska  Society  of  Radiologic  Technologist  has                                                                    
     consistently   supported   the   enactment   of   state                                                                    
     standards  for  the   education  and  credentialing  of                                                                    
     radiologic  technologists,   radiation  therapists  and                                                                    
     nuclear   medicine   technologists   as  a   means   of                                                                    
     protecting  Alaskans   from  the  harmful   effects  of                                                                    
     excessive   and   unnecessary   exposure   to   medical                                                                    
     radiation.      Thirty-eight    states   have   adopted                                                                    
     recommendations  for   state  licensure   of  radiology                                                                    
     personnel,  while  Alaska  is  not  one  of  those  38.                                                                    
     Establishing these standards  will ensure that Alaskans                                                                    
     will have  access to safe  and high  quality radiologic                                                                    
     care.   Licensure  will establish  radiation protection                                                                    
     measures,  as  well   as  education  and  credentialing                                                                    
     standards that  will ensure  the competency  of persons                                                                    
     operating  medical equipment  emitting  radiation.   To                                                                    
     ensure  that the  citizens  of  Alaska receive  maximum                                                                    
     protection from  the harmful  effects of  excessive and                                                                    
       improper exposure to radiation, licensure must be                                                                        
     passed to establish standards.                                                                                             
                                                                                                                                
                                                                                                                                
Number 1429                                                                                                                     
                                                                                                                                
MR. SHINE  commented that  there are a  number of  people on-line                                                               
that would like to testify on the bill.                                                                                         
                                                                                                                                
Number 1329                                                                                                                     
                                                                                                                                
REPRESENTATIVE  SEATON  moved  to adopt  CSHB  186,  23-LS0380\E,                                                               
Mischel,  4/20/04,  as the  working  document.   There  being  no                                                               
objection,  CSHB 186,  version  E, is  before  the House  Health,                                                               
Education and  Social Services Standing Committee  as the working                                                               
document.                                                                                                                       
                                                                                                                                
Number 1258                                                                                                                     
                                                                                                                                
CHRISTINE LUNG, Director,  Government Relations, American Society                                                               
of Radiologic  Technologists (ASRT),  testified in support  of HB                                                               
186.   She  told the  members that  ASRT represents  over 112,000                                                               
radiology  technologists practicing  in all  states.   The Alaska                                                               
Society of  Radiologic Technologists is an  affiliated chapter of                                                               
the ASRT.   Ms. Lung said  that ASRT supports HB  186 which would                                                               
set down  education and  credential standards  for radiographers,                                                               
radiation   therapists,  nuclear   medicine  technologists,   and                                                               
limited  radiologic technologists.    Currently patients  believe                                                               
that everyone that  they see in a physician's  office or hospital                                                               
is  an  educated  and   credentialed  health  care  practitioner.                                                               
However,  in 11  states that  is not  necessarily the  case.   In                                                               
those states  anyone can  be hired by  a hospital  or physician's                                                               
office to perform critical medical  imaging and radiation therapy                                                               
procedures   on  patients   without  any   formal  education   or                                                               
certification of their capability to do so, she said.                                                                           
                                                                                                                                
Number 1187                                                                                                                     
                                                                                                                                
MS. LUNG pointed out that  currently there are 235,000 radiologic                                                               
technologists  who are  voluntarily  registered  by the  American                                                               
Registry  of  Radiological  Technologists.    It  is  hoped  that                                                               
technologists in Alaska  will have the opportunity  to present to                                                               
their  patients  credentials  that   would  show  that  they  are                                                               
educated  to  perform  these procedures.    The  educational  and                                                               
credentialing standards  that are in  HB 186 reflect  the current                                                               
professional   standards   of   graduation   from   an   approved                                                               
educational program.   These programs  are approved by  the Joint                                                               
Review Committee  on the Education  on Radiologic  Technology and                                                               
national certification  by the American Registry  of Radiological                                                               
Technologists.   Ms. Lung told  the members that  currently there                                                               
are  over  400 technologists  in  the  state that  possess  these                                                               
credentials.                                                                                                                    
                                                                                                                                
MS.  LUNG explained  that the  credentials are  important because                                                               
medical  imaging accounts  for 90  percent of  human exposure  to                                                               
manmade  radiation.   It  encompasses 40  percent  of acute  care                                                               
health care  costs, she  added.   In summary,  Ms. Lung  told the                                                               
committee that  HB 186  would ensure a  reduction in  exposure to                                                               
radiation, reduced  health care costs, and  improved radiological                                                               
health care to all patients.                                                                                                    
                                                                                                                                
Number 1089                                                                                                                     
                                                                                                                                
ANN DAILEY, President, Alaska  Academy of Physician's Assistants,                                                               
testified in  opposition to  HB 186.   She shared  that she  is a                                                               
physician's  assistant in  Iliamna and  previously worked  in the                                                               
rural community of St. Paul.   Ms. Daily explained that there are                                                               
no radiologic  technicians available  in the remote  villages and                                                               
for this reason  oppose HB 186.  In remote  villages only limited                                                               
radiography is  performed as it  is described  in the bill.   The                                                               
provision of  limited radiographic  services to patients  is well                                                               
within  physician's  assistant's  scope   of  practice  which  is                                                               
regulated  by  Alaska  statute and  supervised  by  collaborative                                                               
physicians.   Radiologists over  read our  images and  report any                                                               
suspicions  concerning  quality,  appropriateness, and  over  and                                                               
under radiation levels to our  supervisors.  The equipment itself                                                               
reads  the amount  of  radiation  a patient  is  exposed to,  she                                                               
explained.   Quality checks and  calibrations are done  every six                                                               
months by certified personnel, she added.                                                                                       
                                                                                                                                
MS. DAILEY told the members that  HB 186 will impose an untenable                                                               
burden to  the provision  of health care  to our  most vulnerable                                                               
patients in Rural  Alaska.  It will also erect  a barrier to care                                                               
by   unreasonably   and   unnecessarily  adding   an   additional                                                               
bureaucratic  administration, licensing  requirements, fees,  and                                                               
examination to  those already imposed,  she stated.  In  areas of                                                               
Alaska  where tuberculosis,  emphysema,  asthma,  and trauma  are                                                               
commonplace  the   ability  to  differentiate   these  conditions                                                               
radiographically is key to  prompt diagnosis, targeted treatment,                                                               
and prevention of public health  emergencies and loss of life and                                                               
limb.    She urged  the  members  to hold  HB  186  as it  is  an                                                               
impediment to the underserved people in Rural Alaska.                                                                           
                                                                                                                                
Number 0869                                                                                                                     
                                                                                                                                
CLYDE   PEARCE,  Chief,   Radiological  Physicist,   Radiological                                                               
Health,  Division  of Public  Health,  Department  of Health  and                                                               
Social Services, testified on HB  186 and answered questions from                                                               
the members.   He told  the members that he  performs inspections                                                               
at  facilities throughout  the state  including 23  hospitals and                                                               
137  medical  facilities.    Mr.  Pearce  explained  that  he  is                                                               
supportive of the bill because  it addresses some of the concerns                                                               
he  has   with  the  supervision  of   professional  health  care                                                               
providers   because  these   professionals   do  not   understand                                                               
radiology.  He said his greatest  concern is that the exposure to                                                               
radiation in  general is increasing  with new technologies.   For                                                               
example,  the  exposure  to  radiation  through  mammography  has                                                               
increased  even though  the  exposure time  has  decreased.   The                                                               
increased  speed  of the  exposure  makes  the margin  for  error                                                               
narrower, he explained.                                                                                                         
                                                                                                                                
MR.  PEARCE told  the members  that Alaska  has a  unique problem                                                               
where there  is new technology  and old equipment.   For example,                                                               
in Southeast  the blue light used  in x-rays are to  be used with                                                               
blue  sensitive  film;  however,  new green  film  was  used  and                                                               
unfortunately green  film cannot see  blue light.   The automatic                                                               
machines  cannot  detect  those kinds  of  incompatibilities,  he                                                               
said.   As a  result patients  have received  increased radiation                                                               
exposure, rather than correcting the problem.                                                                                   
                                                                                                                                
Number 0788                                                                                                                     
                                                                                                                                
CHAIR  WILSON asked  Mr.  Pearce  to clarify  the  point he  made                                                               
concerning the blue and green film.                                                                                             
                                                                                                                                
MR. PEARCE  explained that  it takes  a lot of  x-rays to  get an                                                               
image if the film is exposed in  an open manner, so what has been                                                               
used for  100 years is  an intensifying screen which  converts x-                                                               
rays  into  (indisc.) light  and  the  film  is exposed  to  that                                                               
(indisc.) light.  An x-ray film  is designed to be most sensitive                                                               
to a  particular color of light,  rather than a full  spectrum of                                                               
light.   The old  screens use  a blue light,  and x-ray  film was                                                               
made to  be sensitive to  the blue light.   The new  screens emit                                                               
green light,  so the  new film is  especially sensitive  to green                                                               
light, which  is the standard now.   Mr. Pearce said  he has seen                                                               
two  facilities using  the old  obsolete screen  x-rays with  new                                                               
green sensitive film and as a  result the patients were getting 6                                                               
to 10 times the amount of  radiation exposure.  The staff did not                                                               
even know it, he added.                                                                                                         
                                                                                                                                
CHAIR WILSON  surmised that higher amounts  of radiation exposure                                                               
was  due  to the  fact  that  the film  didn't  come  out so  the                                                               
technician would turn up the machine and do it again.                                                                           
                                                                                                                                
MR. PEARCE replied that is exactly right.                                                                                       
                                                                                                                                
Number 0646                                                                                                                     
                                                                                                                                
REPRESENTATIVE  SEATON asked  Mr.  Pearce to  comment on  digital                                                               
equipment.  He  asked if this equipment requires  a lesser dosage                                                               
of radiation.                                                                                                                   
                                                                                                                                
MR. PEARCE replied  that digital imaging is  designed for safety.                                                               
This process  gets away  from film processing.   An  advantage to                                                               
digital  imaging  is  that  the   image  can  be  manipulated  by                                                               
increasing  contrast or  brightness.   He commented  that digital                                                               
equipment  does not  guarantee lower  dosages because  it largely                                                               
depends on  who is operating  the machine.   In fact, he  said he                                                               
believes  technicians  can  get  a   little  lazy  and  add  more                                                               
radiation  exposure to  ensure  that  a good  amount  of data  is                                                               
obtain so  that it  can be manipulated,  he added.   Potentially,                                                               
digital equipment could  reduce exposures, but in  practice it is                                                               
often doubled or more depending on the operator.                                                                                
                                                                                                                                
CHAIR WILSON commented  that whenever a facility  purchases a new                                                               
digital imaging machine training is provided to the staff.                                                                      
                                                                                                                                
Number 0541                                                                                                                     
                                                                                                                                
MR. PEARCE  agreed that  training is provided.   He  compared the                                                               
training of  staff to a  person who has  a car with  an automatic                                                               
transmission  and   then  buys   a  new   car  with   a  standard                                                               
transmission.   The trainer may  teach the individual to  use the                                                               
stick shift,  but will not teach  the rules of the  road and help                                                               
the driver get  a driving license.  The trainer  will be teaching                                                               
staff the  unique aspects  of that digital  imaging machine.   It                                                               
will not be a replacement for  learning how to do radiography, he                                                               
added.                                                                                                                          
                                                                                                                                
Number 0472                                                                                                                     
                                                                                                                                
DONNA  RUFSHOLM, Chair,  Licensure Committee,  and Board  Member,                                                               
Alaska   Society  of   Radiology   Technologists  Board   Member,                                                               
testified in  support of HB  186.  She  told the members  that in                                                               
1991  the  U.S. Congress  recognized  the  need to  regulate  the                                                               
operators of  radiology equipment.  It  passed legislation saying                                                               
that all states would have  in place licensure programs for those                                                               
individuals   who  perform   radiology   procedures,  she   said.                                                               
Unfortunately, there  were no repercussions  for the  states that                                                               
did not comply  with the law.  She explained  that today there is                                                               
legislation that  would make licensure mandatory  for all states.                                                               
If states do  not comply the Medicare and  Medicaid funding could                                                               
be cut.   Of the 50 states  38 have licensure laws  in place, but                                                               
Alaska is not one of them,  she pointed out.  Deficiencies in the                                                               
use  of radiation  have  been  witnessed all  over  the state  of                                                               
Alaska  which  has  prompted  the  Alaska  Society  of  Radiology                                                               
Technologists to  write regulations  for those who  perform those                                                               
procedures.                                                                                                                     
                                                                                                                                
MS. RUFSHOLM told  the members that HB 186 was  written to ensure                                                               
quality patient care,  as well as protecting  those operating the                                                               
radiology devices.  She emphasized that  it was not the intent of                                                               
the  Alaska  Society of  Radiology  Technologists  to deny  rural                                                               
residents  of radiology  services,  but to  provide training  and                                                               
education to staff who operate the equipment.                                                                                   
                                                                                                                                
Number 0276                                                                                                                     
                                                                                                                                
ED HALL,  Physician's Assistant (PA),  Member, Alaska  Academy of                                                               
Physician  Assistants, testified  in opposition  to HB  186.   He                                                               
told the members  that he has been a practicing  PA for ten years                                                               
and a member  of the academy for nine years.   Mr. Hall explained                                                               
that in  his discussions with PAs  across the state he  has found                                                               
that there is great concern about  the ability to provide care to                                                               
patients, particularly in the rural  areas of the state, but also                                                               
in  the urban  areas of  Alaska as  well.   He acknowledged  that                                                               
there  are  providers  out   there  using  antiquated  equipment;                                                               
however, this bill is directed  toward those using the equipment,                                                               
not to  the highest technology  or inappropriate equipment.   Mr.                                                               
Hall said  he would hope  anyone using radiology  equipment would                                                               
stay  current.   All providers  that he  knows have  been through                                                               
extensive anatomy courses,  he stated.  Mr.  Hall reiterated that                                                               
this appears  to be another self-serving  bureaucratic attempt at                                                               
creating another office which will  reduce access to optimal care                                                               
to  Alaskans.   In summary,  he  emphasized that  this bill  will                                                               
increase the cost of health care.                                                                                               
                                                                                                                                
TAPE 04-38, SIDE A                                                                                                            
                                                                                                                                
Number 0033                                                                                                                     
                                                                                                                                
ERIKA  WHITE, Program  Director, University  of Alaska  Anchorage                                                               
(UAA), testified  in support  of HB  186.   She told  the members                                                               
that  the  university  currently  has an  Associates  of  Applied                                                               
Science  Degree  in  Radiologic   Technology.    There  are  also                                                               
students enrolled in  Fairbanks, Juneau, and Ketchikan.   It is a                                                               
21-month  educational   program  that  includes   physiology  and                                                               
anatomy  courses,  safety  training,   and  proper  exposure  and                                                               
positioning training.   The course  curriculum has  been approved                                                               
by the national accrediting body.   This training course prepares                                                               
students to take the national exam.                                                                                             
                                                                                                                                
MS.  WHITE  commented that  the  university  received $84,000  to                                                               
implement a  limited radiology program  which will be  offered in                                                               
the fall  to PAs  and nurses.   She emphasized  that this  is not                                                               
full training, but limited training.   There is a need throughout                                                               
the state  for trained  professionals who  are licensed  and this                                                               
program  should address  those needs.   Ms.  White said  that the                                                               
most successful  facilities are those that  provide students with                                                               
funding,  by contracting  or sponsoring  students  who then  come                                                               
back to  its facility to work.   She commented that  rural health                                                               
facilities  are not  doing that  and  it is  important for  those                                                               
facilities  to   recognize  that   there  are  ways   to  attract                                                               
registered technologists.                                                                                                       
                                                                                                                                
Number 0292                                                                                                                     
                                                                                                                                
JOHN  BRINGHURST, Administrator,  Petersburg Hospital,  testified                                                               
in  opposition  to HB  186.    Petersburg  Hospital is  a  27-bed                                                               
hospital and long-term  care facility that serves  a community of                                                               
3,500  people whose  only access  to urgent  care services  comes                                                               
from this  facility.  Mr.  Bringhurst pointed out that  like most                                                               
Southeast  communities Petersburg  does not  have road  access to                                                               
other medical  facilities, so  transportation is  required either                                                               
by the marine highway system or air transportation.                                                                             
                                                                                                                                
MR.  BRINGHURST told  the members  that  he was  selected by  the                                                               
Alaska State  Hospital and Nursing Homes  Association (ASHNA) and                                                               
Providence  Hospital  to  represent  both  the  small  and  large                                                               
hospitals' interests in working with  proponents of HB 186 and to                                                               
influence revisions  in the  bill so that  ASHNA can  support it.                                                               
While there  have been efforts to  this end, he said  he does not                                                               
believe  that ASHNA  can support  HB 186  because it  has serious                                                               
flaws.   The bill  now has provisions  for limited  licensing for                                                               
personnel  which  might  help small  hospitals  comply  with  the                                                               
requirement.    However,  the  drafters  of  the  bill  used  the                                                               
definition  of  limited license  to  apply  to  the size  of  the                                                               
community the person is employed in  rather than the scope of the                                                               
work being done.  Many  health care professionals make provisions                                                               
for   limited  scope   workers;  such   as  CNA,   LPN,  pharmacy                                                               
technicians,  and  physical therapy  aides,  etc.   However,  the                                                               
limitations  lie in  the  role  he/she is  able  to  play in  the                                                               
delivery of  the service and  not on  the size of  the community.                                                               
He  summarized  by  saying  he   questions  the  timing  of  this                                                               
legislation.  Mr.  Bringhurst said he believes this  is the worst                                                               
time  to implement  this policy  since Alaska  is experiencing  a                                                               
shortage of  radiological technicians.  Recently  ASHNA conducted                                                               
a  poll which  showed  radiology technicians  as  the number  two                                                               
position  in  terms  of  scarcity, which  is  only  surpassed  by                                                               
registered nurses.  In Petersburg  there is a 100 percent vacancy                                                               
rate in radiology and one of  those positions has been vacant for                                                               
over  22 months.   Small  hospitals have  a hard  time attracting                                                               
radiology  technicians and  often find  the only  solution is  to                                                               
train  staff themselves.   He  said this  legislation would  have                                                               
some  short-term negative  impacts  that would  nullify the  good                                                               
that  is being  accomplished.   Mr. Bringhurst  said he  believes                                                               
there are  serious flaws  that need to  be addressed  before this                                                               
would be a good piece of legislation.                                                                                           
                                                                                                                                
Number 0559                                                                                                                     
                                                                                                                                
B.  J.   ANDERSON,  Laboratory   and  X-Ray   Manager,  Anchorage                                                               
Neighborhood Health Center,  testified on HB 186.   She explained                                                               
that  the Anchorage  Neighborhood  Health Center  is a  community                                                               
health  center.     Ms.  Anderson  commended   UAA  for  creating                                                               
excellent course work  for radiologic technicians.   She said she                                                               
believes that  the new on-line  program will be a  great benefit;                                                               
however,  she expressed  concern with  required licensing  at the                                                               
state  level.   Ms.  Anderson  told the  members  that this  will                                                               
create a barrier  for those interested in  radiologic careers and                                                               
job opportunity.   This kind  of career opportunity is  common in                                                               
rural areas,  small clinics,  physicians' offices,  and community                                                               
health centers,  she said.  It  is difficult for these  small and                                                               
rural  offices to  recruit  certified personnel.    She said  she                                                               
can't over state that fact.   For instance, at  Iliuliuk Family &                                                               
Health   Services,  Inc.   in  Dutch   Harbor  there   are  three                                                               
individuals  who have  been trained  in radiological  procedures;                                                               
one  was  trained in  the  Philippines  and  the other  two  were                                                               
trained  on the  job.   She  stated that  these individuals  have                                                               
excellent skills,  but none  of the three  are certified.   These                                                               
individuals are also cross-trained to  perform lab testing.  This                                                               
is an  important dynamic in rural  health.  She told  the members                                                               
that she  has an  employee that  is highly  skilled, trustworthy,                                                               
dependable, and of high integrity.   Things that cannot be gauged                                                               
by  licensing  alone.    While   he  does  not  have  a  national                                                               
certificate, he is the best employee  she has.  Ms. Anderson told                                                               
the members that state licensing  created barriers for her in two                                                               
other states that  she has worked.  Ms.  Anderson summarized that                                                               
she  believes  education  is  the key,  not  licensing.    People                                                               
entering the health care field  will seek further education.  For                                                               
these reasons she opposes HB 186, Ms. Anderson stated.                                                                          
                                                                                                                                
Number 0746                                                                                                                     
                                                                                                                                
VERA  JAMES,   Program  Manager,  Alaska  Native   Health  Board,                                                               
testified in opposition to HB 186.   She told the member that the                                                               
Alaska Native Health Board  is nonprofit organization established                                                               
in 1968  that advocates  for 229  federally recognized  tribes on                                                               
health care issues.   The board believes that the  adoption of HB                                                               
186  as  currently  written  will be  harmful  to  tribal  health                                                               
providers  ability  to  provide  x-ray services  in  the  smaller                                                               
communities  that are  unable to  support radiology  technicians.                                                               
This is  because community health  aides in many  remote villages                                                               
are the  only providers available  to take images as  there would                                                               
be no  licensed practitioner  on-site.  It  is for  these reasons                                                               
the Alaska Native Health Board opposes HB 186.                                                                                  
                                                                                                                                
Number 0852                                                                                                                     
                                                                                                                                
BARBARA  HUFFTUCKNESS,  Director,  Governmental  and  Legislative                                                               
Affairs, Teamsters  Local 959,  testified in  support of  HB 186.                                                               
She  explained  that  Teamsters  Local  959  represents  all  the                                                               
employees  at  South Peninsula  Hospital  in  Homer.   While  the                                                               
community is  connected by the  road system, the  residents there                                                               
consider  themselves somewhat  rural.   She added  that Teamsters                                                               
Local  959   also  represent  the  employees   at  Kodiak  Island                                                               
Hospital.   She  said that  she always  made the  assumption that                                                               
radiologic  technologists  performing  the tests  were  licensed.                                                               
Every  employee who  is hired  at South  Peninsula Hospital  must                                                               
meet high standards.  Ms.  Hufftuckness said that Teamsters Local                                                               
959  support  HB 186  because  it  is  believed  it is  a  career                                                               
opportunity  in  building growth.    Employees  that have  worked                                                               
within  the  system,  for example  certified  nurses  aides,  are                                                               
required  to go  through  the licensure  process.   Many  careers                                                               
require licensing  including nurses.   It does not make  sense to                                                               
say that because there is a  shortage of nurses that licensing on                                                               
nurses  should be  eliminated.   Ms. Hufftuckness  said that  she                                                               
sympathizes  with  rural  areas that  have  difficulties  finding                                                               
employees, but sees it as a  career opportunity both in rural and                                                               
urban areas of  the state.  She reiterated  Teamsters Local 959's                                                               
support for passage of HB 186.                                                                                                  
                                                                                                                                
Number 1050                                                                                                                     
                                                                                                                                
CHAIR WILSON asked Mr. Shine if there is a senate-matching bill.                                                                
                                                                                                                                
Number 1079                                                                                                                     
                                                                                                                                
MR. SHINE  replied there  is not.   He commented  that he  is not                                                               
sure that some of the testifiers  have the current version of the                                                               
bill.  The last  version of the bill on Basis  is one that passed                                                               
out  of  the  House  Labor and  Commerce  Standing  Committee  in                                                               
January.   He noted, however,  the bill before the  House Health,                                                               
Education and Social Services  Standing Committee is dramatically                                                               
different.  One of the  testifiers mentioned that this bill would                                                               
create  a new  level of  bureaucracy; however,  one of  the major                                                               
changes  is that  the bill's  language went  from having  a board                                                               
with  the Alaska  Society of  Radiologic Technologists  and other                                                               
members from the  industry taking care of the  licensing issue to                                                               
the Division of Occupational Licensing  handling it, he said.  He                                                               
emphasized that no new level of bureaucracy is being created.                                                                   
                                                                                                                                
MR. SHINE commented  that if anyone has questions  about the bill                                                               
Donna Rufsholm  of the Alaska Society  of Radiology Technologists                                                               
is very  knowledgeable.   He emphasized  that there  are dramatic                                                               
changes  in version  E which  is  before the  committee.   Anyone                                                               
wishing to receive  a copy of the latest version  can contact him                                                               
at 1-800-465-4939.                                                                                                              
                                                                                                                                
Number 1185                                                                                                                     
                                                                                                                                
[HB 186 was held in committee.]                                                                                                 
                                                                                                                                
HB 434-NATUROPATHIC MEDICINE                                                                                                  
                                                                                                                                
Number 1283                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE  BILL  NO.  434,  "An  Act  relating  to  the  practice  of                                                               
naturopathic medicine; and providing for an effective date."                                                                    
                                                                                                                                
ALEX MALTER,  M.D., President, Alaska State  Medical Association,                                                               
testified on  HB 434,  and answered  questions from  the members.                                                               
He  urged the  members  not to  support this  bill.   Dr.  Malter                                                               
provided the following statement:                                                                                               
                                                                                                                                
     The expansion  of naturopaths' scope of  practice would                                                                    
     not enhance  patient care, nor would  it improve access                                                                    
     to  care.   Training for  naturopaths is  less rigorous                                                                    
     for that  of medical doctors  in both length  and depth                                                                    
     of study.   The  emphasis on  natural healing  does not                                                                    
     allow sufficient time for its students to fully learn                                                                      
      the accepted pathology, physiology, and pharmacology                                                                      
     necessary to treat most medical conditions.                                                                                
                                                                                                                                
DR. MALTER  pointed to  Attachment 1  [The Professional  Scope of                                                               
Practice  for   Naturopaths]  in  the  packet   provided  to  the                                                               
committee  which  was  compiled  by the  [Alaska  Association  of                                                               
Naturopathic   Physicians,  Inc.]   and  which   shows  different                                                               
treatment techniques studied  by naturopaths.  He said  this is a                                                               
broad  list  and it  is  important  to note  that  pharmaceutical                                                               
treatment  is at  the bottom  of the  list.   He said  it is  the                                                               
Alaska State  Medical Association's  position that four  years of                                                               
training and  two years of  clinical training is not  enough time                                                               
to master that  entire list and still become  proficient at using                                                               
prescription drugs.   He said that  he is not convinced  that the                                                               
first two years  of naturopath school and medical  school are the                                                               
same.                                                                                                                           
                                                                                                                                
DR. MALTER said  he believes that for any courses  that cover the                                                               
material in  similar depth medical  students are  better prepared                                                               
to  learn  that  material  because admission  to  medical  school                                                               
requires  extensive  undergraduate  science background  and  then                                                               
passing rigorous competitive exams.   He referred to Attachment 2                                                               
[Table 17.  Nonexclusive list of schools  providing education and                                                               
training   for  naturopaths,   2000.]  and   explained  that   by                                                               
comparison there  are no similar  admission tests  for naturopath                                                               
schools and some do not even  require a college degree to get in,                                                               
he said.   More importantly,  medical students spend at  least an                                                               
additional four  years in school and  residency before licensure.                                                               
These  clinical  years  emphasize  the appropriate  safe  use  of                                                               
medicines and are  the backbone of physician  training, he added.                                                               
Naturopath programs do not require  such residencies and the last                                                               
two years  of their schools  focus on alternative  treatments, he                                                               
said.   Physicians can't be  licensed after medical  school; they                                                               
are  licensed two  years later.   The  bill before  the committee                                                               
would  allow   naturopaths  to   be  licensed   after  completing                                                               
naturopath   school  and   not  doing   any  clinical   focus  on                                                               
pharmacological agents.   This could  be unsafe for  Alaskans, he                                                               
emphasized.                                                                                                                     
                                                                                                                                
DR. MALTER told the members  that some individuals would say that                                                               
naturopaths are  better educated than  PAs.  He said  he believes                                                               
that  it  is  not  the  amount of  schooling  that  qualifies  an                                                               
individual,  it  is the  focus  of  that training.    Physician's                                                               
assistants  are immersed  in the  safe use  of medicines  and are                                                               
therefore  more  qualified  even  though their  training  may  be                                                               
slightly less than a naturopath.                                                                                                
                                                                                                                                
Number 1398                                                                                                                     
                                                                                                                                
DR. MALTER  told the  members that  a comprehensive  analysis for                                                               
Massachusetts  Special   Commission  on   Complimentary  Medicine                                                               
concluded that naturopathic medicine  is a dangerous activity and                                                               
no amount  of regulation  is likely  to mitigate  this fact.   He                                                               
said that  Medicare has also  expressed similar  reservations and                                                               
asked  the  members  to  look  at  Attachment  3  [Conclusion  of                                                               
Medicare's  Report on  Naturopaths,  U.S.  Department of  Health,                                                               
Education,   and   Welfare,   Independent   Practitioners   under                                                               
Medicare, December, 1968] which reads as follows:                                                                               
                                                                                                                                
     Conclusions:  Naturopathic theory  and practice are not                                                                    
     based  on  the  body  of  basic  knowledge  related  to                                                                    
     health, disease, and health care  which has been widely                                                                    
     accepted  by  the   scientific  community.    Moreover,                                                                    
     irrespective of  its theory, the  scope and  quality of                                                                    
     naturopathic education do  not prepare the practitioner                                                                    
     to make  an adequate diagnosis and  provide appropriate                                                                    
     treatment.                                                                                                                 
                                                                                                                                
DR. MALTER  told the members that  he personally has cared  for a                                                               
patient  who  died  prematurely  because she  had  been  under  a                                                               
naturopath's care  for six months  for chronic  fatigue syndrome.                                                               
He explained  that when  she came  to him  she had  very advanced                                                               
lymphoma  and died  quite quickly  of a  disease that  would have                                                               
been either curable or certainly  easily treatable to prolong her                                                               
life.                                                                                                                           
                                                                                                                                
DR. MALTER  emphasized that  he believes  expanding the  scope of                                                               
the  30  naturopaths in  Alaska  is  really unlikely  to  improve                                                               
access  to care.   He  said he  is not  aware of  any naturopaths                                                               
practicing in parts  of the state where access  is most critical.                                                               
The association  believes it would  be unwise and unsafe  for the                                                               
state to  endorse the practice  of naturopathy by  granting these                                                               
folks  prescriptive  authority  and  urged  the  members  not  to                                                               
support the bill, Dr. Malter concluded.                                                                                         
                                                                                                                                
Number 1539                                                                                                                     
                                                                                                                                
REPRESENTATIVE   SEATON   commented    that   naturopath   is   a                                                               
nonregulated  term and  he noted  that Dr.  Malter used  the term                                                               
frequently in  his testimony.   This bill deals  exclusively with                                                               
naturopathic physicians.   He  pointed out  that this  bill would                                                               
restrict  the use  of the  term naturopath  to only  naturopathic                                                               
physicians  in the  future.   Right  now anyone  can  hang out  a                                                               
shingle  that  says  naturopath,  so the  requirement  that  only                                                               
naturopathic  physicians can  use  the term  will guarantee  some                                                               
medical expertise to  that term, he said.   Representative Seaton                                                               
asked if Dr. Malter has distinguished between the two terms.                                                                    
                                                                                                                                
Number 1585                                                                                                                     
                                                                                                                                
DR. MALTER responded  that the only requirement  to be considered                                                               
a naturopathic physician  is that an individual would  have to go                                                               
through a  naturopathic school or  program.  He said  his concern                                                               
is that in some  cases a person does not even  have to go through                                                               
high  school to  get  into  the program.    In  many cases  these                                                               
programs  do  not even  require  much  of a  science  background;                                                               
however,  he acknowledged  that  these individuals  must pass  an                                                               
exam.   Dr. Malter  posed the question  of whether  the committee                                                               
want to  endorse someone as a  physician who had four  years of a                                                               
graduate program,  but who has  had minimal training in  the safe                                                               
and appropriate clinical use of pharmaceuticals.                                                                                
                                                                                                                                
REPRESENTATIVE  SEATON  emphasized that  naturopathic  physicians                                                               
have  been licensed  in  Alaska for  17  years, not  naturopaths.                                                               
Many  of the  people that  are being  mentioned are  not actually                                                               
naturopathic physicians, he  clarified.  It is  important to keep                                                               
the terms straight, Representative Seaton emphasized.                                                                           
                                                                                                                                
DR.  MALTER said  he appreciates  what  Representative Seaton  is                                                               
saying, but  pointed out that  if the  committee were to  look at                                                               
the requirements to  attend these schools it would  be found that                                                               
there are no required undergraduate  science classes.  He said it                                                               
is  the  Alaska  State  Medical Association's  feeling  that  the                                                               
legislature should  be cautious  about endorsing the  practice in                                                               
any way that might suggest to  residents of Alaska that the state                                                               
is really endorsing the practice.                                                                                               
                                                                                                                                
[HB 434 was taken up again later in this hearing.]                                                                              
                                                                                                                                
The committee took an at-ease from 5:20 p.m. to 5:29 p.m.                                                                       
                                                                                                                                
HB 239-ID SYSTEM FOR PRESCRIPTIONS                                                                                            
                                                                                                                                
Number 1764                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL  NO. 239, "An  Act directing the Department  of Public                                                               
Safety   to  establish   an  Internet-based   identification  and                                                               
tracking  system  relating  to  controlled  substances  that  are                                                               
prescribed for  human use;  and relating to  the manner  in which                                                               
prescriptions  for  controlled  substances  may be  filled  by  a                                                               
pharmacist."                                                                                                                    
                                                                                                                                
Number 2131                                                                                                                     
                                                                                                                                
SUE WRIGHT,  Staff to Representative Mike  Chenault, Alaska State                                                               
Legislature,  presented  HB  239   on  behalf  of  Representative                                                               
Chenault, sponsor  of HB 239.   She told the members  that Alaska                                                               
has  a  drug problem  of  epidemic  proportions.   In  the  Kenai                                                               
Peninsula area there  have been 27 near fatal  or fatal overdoses                                                               
of  OxyContin.    This  number   includes  accidental  deaths  or                                                               
suicides.    She  told  the  members that  there  is  a  licensed                                                               
physician in  Anchorage who prescribed  16,000 milligrams  in one                                                               
30-day  period in  July  of 2001.    Ms. Wright  said  it is  not                                                               
possible  to  ingest  that  much.     The  person  who  that  was                                                               
prescribed to is dead, she added.                                                                                               
                                                                                                                                
CHAIR WILSON asked if that prescription was for one person.                                                                     
                                                                                                                                
MS. WRIGHT  replied yes, it was  prescribed to one person  who is                                                               
now dead.   She explained that the patient died  in July of 2001,                                                               
but the prescriptions were not  filled until September or October                                                               
of that year.  It is assumed  that these drugs were being sold on                                                               
the  street.   Ms. Wright  added that  Medicaid dollars  paid for                                                               
these prescriptions.  One person  on the Kenai Peninsula has been                                                               
present at seven  different deaths and is a  known [drug] dealer.                                                               
She told the  members that Representative   Chenault's office has                                                               
worked with a  police chief whose wife had been  on OxyContin and                                                               
who  had obtained  it illegally.    Ms. Wright  pointed out  that                                                               
Representative Wolf  has sponsored two bills  that either outlaws                                                               
or restricts  OxyContin use.   She  told the  member that  HB 239                                                               
allows  for the  Board  of  Pharmacy to  design  and implement  a                                                               
system  to  track controlled  substances  in  schedule IA  in  AS                                                               
11.71.140.   The  board was  chosen because  the pharmacy  is the                                                               
origination of  a filled prescription.   It is the best  place to                                                               
control the use of a drug, she added.                                                                                           
                                                                                                                                
Number 2262                                                                                                                     
                                                                                                                                
MS.  WRIGHT  said this  bill  gives  the  Board of  Pharmacy  the                                                               
authority  to manage  the tracking  system once  it is  designed.                                                               
This shall be done through regulation,  she added.  The bill also                                                               
requires the revamping  of the delivery of schedule  IA drugs via                                                               
the U.S.  Postal Service  or other delivery  services.   She said                                                               
there have  been concerns raised  by out-of-state  providers such                                                               
as Medco  Health Solutions, Inc.  [letter dated April  6,2004] of                                                               
increased  costs to  providers of  $16.76.   Ms. Wright  told the                                                               
members that  she researched  this question  by visiting  the UPS                                                               
web  site and  found that  it would  increase cost  by $1.75  per                                                               
prescription.   Ms. Wright  pointed out  that there  are in-state                                                               
pharmacies   that   already    implement   controlled   substance                                                               
deliveries  out into  the bush  communities  by registered  mail.                                                               
There is an  additional $5.00 charge per  prescription, she said.                                                               
Ms. Wright told the members that  while this bill is not perfect,                                                               
it is a start.                                                                                                                  
                                                                                                                                
Number 2314                                                                                                                     
                                                                                                                                
MS. WRIGHT  shared that  there are  concerns that  the additional                                                               
requirements  would  "red flag"  drug  packages.   She  said  she                                                               
learned  that outside  pharmaceutical  companies  often have  its                                                               
name  printed  on  the  outside   of  delivery  packages.    When                                                               
companies use its company's logo  on the outside of packages, she                                                               
said she believes  it is a moot  point to say the  package is red                                                               
flagged by  requiring a signature  for delivery  at a home.   She                                                               
noted that Medco uses its logo on the outside of packages.                                                                      
                                                                                                                                
MS.  WRIGHT  said in  conclusion,  Medicaid  alone paid  over  $2                                                               
million  in  2001 for  OxyContin.    Between  10 percent  and  27                                                               
percent of Medicaid costs for  OxyContin were for drugs that were                                                               
sold on  the streets.  If  these statistics are shown  to be true                                                               
for one drug  and if tracking can be shown  to keep OxyContin off                                                               
the streets, it  may be possible to save  several million dollars                                                               
by  implementing this  tracking  system, she  said.   Ms.  Wright                                                               
emphasized that this  is not meant to be an  invasion of privacy,                                                               
but a reaction to the drug problems that face Alaska.                                                                           
                                                                                                                                
TAPE 04-38, SIDE B                                                                                                            
                                                                                                                                
Number 2361                                                                                                                     
                                                                                                                                
REPRESENTATIVE  SEATON referred  to the  Department of  Community                                                               
and Economic Development's November 17, 2003 letter which says:                                                                 
                                                                                                                                
      We feel, however, that for any monitoring program to                                                                      
       work, the prescribers must be included along with                                                                        
     pharmacists and law enforcement agencies.                                                                                  
                                                                                                                                
                                                                                                                                
REPRESENTATIVE  SEATON asked  Ms.  Wright if  this provision  was                                                               
incorporated into the legislation.                                                                                              
                                                                                                                                
MS.  WRIGHT   replied  that  the  letter   Representative  Seaton                                                               
referred to is  addressing a different version of the  bill.  She                                                               
explained that the new version of  HB 239 provides for a state of                                                               
the  art tracking  system that  would  run over  the same  secure                                                               
Internet lines that  are currently being used  by pharmacies when                                                               
billing  or prequalifying  insurance  payments on  prescriptions.                                                               
Ms.  Wright told  the members  that there  is a  software company                                                               
that   designs  this   type  of   system  and   has  successfully                                                               
implemented it nationwide.                                                                                                      
                                                                                                                                
Number 2241                                                                                                                     
                                                                                                                                
CHAIR  WILSON  moved  to  adopt CSHB  239,  23-LS0897\S,  as  the                                                               
working  document.   There  being  no  objection, Version  S  was                                                               
before committee.                                                                                                               
                                                                                                                                
Number 2221                                                                                                                     
                                                                                                                                
MARGARET  SODEN, Chair,  Alaska  Board of  Pharmacy, Division  of                                                               
Occupational  Licensing,  Department  of Community  and  Economic                                                               
Development, testified on HB 239.   She told the members that her                                                               
testimony is only on behalf of  herself, as the board has not had                                                               
an opportunity  to look at the  latest version of the  bill.  Ms.                                                               
Soden  said that  the board  and  pharmacists in  general are  in                                                               
favor  of  this  concept  of  an  Internet  tracking  system  for                                                               
controlled  substances.     She  explained  that   the  board  of                                                               
pharmacy's budget  is quite  slim so  in order  to do  this right                                                               
there would have to be adequate  funding to implement it and keep                                                               
it running.                                                                                                                     
                                                                                                                                
Number 2157                                                                                                                     
                                                                                                                                
CHAIR WILSON  commented that she  has had calls  from pharmacists                                                               
who believe they  will be in the position of  being the policemen                                                               
in this system.                                                                                                                 
                                                                                                                                
MS. SODEN replied  that is true.  She pointed  to Section 1, page                                                               
1, lines 7 through 11, which says:                                                                                              
                                                                                                                                
     ...  secure   networked  server-based  data   base  and                                                                    
     procedures  under which  each pharmacist  in the  state                                                                    
     will  be  required  to  determine,  by  consulting  the                                                                    
     secure  data   base,  whether  a  prescription   for  a                                                                    
     controlled  substance that  is being  dispensed by  the                                                                    
     pharmacist to cover  a certain time period  for a human                                                                    
     patient  duplicates  a prescription  already  dispensed                                                                    
       for the same patient that was intended to cover a                                                                        
     substantial portion of the same time period.                                                                               
                                                                                                                                
MS.  SODEN  commented  that  it  will be  very  difficult  for  a                                                               
pharmacists to make  that kind of determination and  it will make                                                               
it difficult  for a patient  to get  a prescription filled.   She                                                               
said she has  a problem with this portion of  the bill because of                                                               
the burden it places on the pharmacists.                                                                                        
                                                                                                                                
CHAIR WILSON asked if pharmacists  across the state would have to                                                               
purchase new software to accomplish this requirement.                                                                           
                                                                                                                                
MS. SODEN  replied that there  are some pharmacists in  the state                                                               
that only bill  Medicaid over the Internet.  In  those cases, the                                                               
pharmacist does not do any  insurance billing electronically, she                                                               
said.   She  acknowledged that  it would  be necessary  for those                                                               
pharmacists to  purchase software.   Ms. Soden said she  has seen                                                               
studies that  say it costs  anywhere from $150,000  to $1,000,000                                                               
to setup  these programs.  She  commented that she does  not know                                                               
who would  pay for it.   There are probably some  grants from the                                                               
U.S. Department of Justice, she commented.                                                                                      
                                                                                                                                
CHAIR WILSON said that Commissioner  Gilbertson has expressed the                                                               
desire  to track  prescription  drugs.   She  suggested that  Ms.                                                               
Wright and  the Board of  Pharmacy meet with the  commissioner to                                                               
work on a compromise to bring to the legislature next session.                                                                  
                                                                                                                                
MS. WRIGHT  replied that avenue  has been explored and  there was                                                               
an outburst of  concern that the Department Public  Safety or the                                                               
Department  of  Health  and Social  Services  would  control  the                                                               
tracking system.   The concern  was that the departments  are too                                                               
big and  too many  people would have  access to  the information.                                                               
It was  for that reason  Representative Chenault chose  the Board                                                               
of Pharmacy.                                                                                                                    
                                                                                                                                
Number 1950                                                                                                                     
                                                                                                                                
[CSHB 239, Version S, was held in committee.]                                                                                   
                                                                                                                                
                                                                                                                                
HB 502-DISPENSING OPTICIANS: BOARD & REGULATION                                                                               
Number 1940                                                                                                                     
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL NO. 502, "An  Act relating to dispensing opticians and                                                               
dispensing optician apprentices."                                                                                               
                                                                                                                                
Number 1936                                                                                                                     
                                                                                                                                
MATT  RUDIG,  Staff  to Representative  Jim  Holm,  Alaska  State                                                               
Legislature, presented  HB 502 on behalf  of Representative Holm,                                                               
sponsor of HB  502.  He told the members  that the bill clarifies                                                               
the education  and training requirements  to become  an optician,                                                               
allows  qualified  opticians from  other  states  to practice  in                                                               
Alaska, and sets out requirement  to fit and sell contact lenses.                                                               
This bill will  increase the amount of hours  necessary to become                                                               
a  dispensing optician  or an  apprentice.   Mr. Rudig  explained                                                               
that a  few years ago the  levels of training hours  were lowered                                                               
below any other state that  requires training hours and this bill                                                               
would restore that requirement.                                                                                                 
                                                                                                                                
MR.  RUDIG  warned that  the  members  may hear  objections  from                                                               
national interests  such as Wal-Mart  and Target who want  to put                                                               
18 year olds  out there and call them opticians.   This bill will                                                               
ensure that the necessary training  hours in Alaska is comparable                                                               
to other states.   The Alaska Opticians Board  brought this issue                                                               
forward,  and  Representative  Holms believes  Alaskan  opticians                                                               
should regulate their own industry, he said.                                                                                    
                                                                                                                                
Number 1844                                                                                                                     
                                                                                                                                
CHAIR WILSON asked how many  training hours were necessary before                                                               
there was a reduction in education and training.                                                                                
                                                                                                                                
MR. RUDIG  replied there were 6,000  hours.  He added  that there                                                               
was no  distinction between training  for eyeglasses  and contact                                                               
lenses.   There was a request  that there be a  distinction drawn                                                               
between  the  number  of  hours  for  each  of  these.    HB  502                                                               
accomplishes this, he commented.                                                                                                
                                                                                                                                
CHAIR  WILSON  asked  how  the  requirements  for  education  and                                                               
training  were  reduced.   What  was  the reasoning  behind  this                                                               
reduction, she questioned.                                                                                                      
                                                                                                                                
MR. RUDIG responded  that it was done "under the  24-hour rule by                                                               
the National Opticians and Optometrists."                                                                                       
                                                                                                                                
CHAIR WILSON asked  for clarification that this  was a nationwide                                                               
move done in Washington, D.C.                                                                                                   
                                                                                                                                
MR.  RUDIG replied  that he  believes it  was done  at the  state                                                               
level in various  states that had optician boards.   He suggested                                                               
that someone on the optician  board could provide more definitive                                                               
information  on that  question.   In response  to Chair  Wilson's                                                               
inquiry, Mr. Rudig  said that Alaska has an  opticians' board and                                                               
the Opticians Association of Alaska.   The Legislative Budget and                                                               
Audit  Committee  has recommended  that  the  opticians board  be                                                               
sunsetted.  This bill does  not extend that sunset, but transfers                                                               
the burden of  licensing and apprentice program  authority to the                                                               
U.S. Department of Labor.                                                                                                       
                                                                                                                                
Number 1772                                                                                                                     
                                                                                                                                
CHAIR  WILSON asked  if she  understands  correctly that  several                                                               
years ago the  Alaska Board of Opticians asked for  the number of                                                               
hours of training  and education be reduced,  and the legislature                                                               
approved that reduction.                                                                                                        
                                                                                                                                
MR.  RUDIG agreed  and said  that  he believes  the reduction  in                                                               
training and education occurred two years ago.                                                                                  
                                                                                                                                
CHAIR  WILSON asked  for clarification  on his  comment regarding                                                               
the Legislative Budget and Audit Committee's recommendation.                                                                    
                                                                                                                                
Number 1737                                                                                                                     
                                                                                                                                
MR. RUDIG  pointed to  the audit in  the members'  packet [Alaska                                                               
Division of  Legislative Audit, Audit  Digest #08-20022-03].   In                                                               
that  audit  there was  no  recommendation  with respect  to  the                                                               
number of hours of training needed  for opticians.  He offered to                                                               
get  back to  the committee  with additional  information on  the                                                               
recommendations  in  the  audit.    However,  he  suggested  that                                                               
perhaps  one of  the  opticians who  will  testify could  provide                                                               
further clarification.                                                                                                          
                                                                                                                                
Number 1558                                                                                                                     
                                                                                                                                
RANDALL  DAHL,  Opticians  Association of  Alaska,  testified  in                                                               
support of  HB 502 and answered  questions from the members.   He                                                               
told  the members  that he  could  not comment  on the  questions                                                               
Chair  Wilson posed.    Mr.  Dahl said  that  his  main point  in                                                               
testifying  is  to  express  his  strong  support  for  increased                                                               
training and  the apprenticeship  program.  He  said that  he has                                                               
been a  licensed optician in Alaska  for 22 years and  one of his                                                               
main  duties  has been  to  train  opticians.   Under  the  prior                                                               
statute  that preceded  2002 the  apprenticeship program  was not                                                               
structured.    Even  though there  was  a  6,000-hour  apprentice                                                               
requirement, there  was no program.   The new program  which will                                                               
be administered  through the  U.S. Department  of Labor  is quite                                                               
structured,  he  explained.     There  are  learning  objectives,                                                               
training schedules,  and sign  offs.  Mr.  Dahl said  he supports                                                               
the required 6,000 hours of  training as an apprentice, including                                                               
4,000 hours of  training for eyeglasses and at  least 2,000 hours                                                               
for  contact  lenses.     This  bill  would   bring  the  state's                                                               
requirements into  alignment with the U.S.  Department of Labor's                                                               
requirement for its apprenticeship  program.  Mr. Dahl summarized                                                               
that he believes  this is a very good bill  and urged the members                                                               
to pass the bill out of committee.                                                                                              
                                                                                                                                
CHAIR WILSON  asked how many  hours the U.S. Department  of Labor                                                               
requires for licensure as an optician.                                                                                          
                                                                                                                                
MR.  DAHL responded  that  the  U.S. Department  of  Labor has  a                                                               
4,000-hour requirement, but he noted that  he is not sure if that                                                               
is inclusive of the spectacles and contact lenses training.                                                                     
                                                                                                                                
CHAIR WILSON commented  that normally Alaskans like  to do things                                                               
independently, separate from federal  involvement.  She asked why                                                               
he believes this is a good idea.                                                                                                
                                                                                                                                
Number 1522                                                                                                                     
                                                                                                                                
MR. DAHL replied  that the state program was  not structured even                                                               
though there was  a lot of time spent  administering the program.                                                               
The  U.S.  Department  of  Labor   has  an  existing  nationwide,                                                               
cohesive program already in place, he added.                                                                                    
                                                                                                                                
Number 1475                                                                                                                     
                                                                                                                                
CHRISTI  BRAND,   President,  Optician  Association   of  Alaska,                                                               
testified in  support of HB  502 and answered questions  from the                                                               
members.   She told the  members that opticians  found themselves                                                               
in  the position  of  having  to sign  up  every  employee as  an                                                               
apprentice, even  if the individual  had no interest in  being an                                                               
apprentice.   It was required  by state law.   Two years  ago, SB                                                               
270   provided  for   separate   classification  for   optician's                                                               
assistants.  In this way an  employee can work in the office, but                                                               
not be classified  as an apprentice unless that  is their desire,                                                               
she explained.   This bill  would formalize the  training through                                                               
the  U.S.  Department  of  Labor's  program  which  would  enable                                                               
employers to  apply for grants  and provide an incentive  to hire                                                               
unemployed  people.   This  program would  clean  things up,  Ms.                                                               
Brand said.   In summary, if  the state does sunset  the board of                                                               
opticians  it is  important to  have this  program in  place, she                                                               
added.                                                                                                                          
                                                                                                                                
Number 1381                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON  asked if  he is  correct in  assuming that                                                               
there are no education requirements for an optician's assistant.                                                                
                                                                                                                                
MS. BRAND  replied that is  correct.  An optician's  assistant is                                                               
more of  a sales clerk who  helps a customer pick  out glasses or                                                               
sells  glasses.   An  assistant  would  not  be  able to  help  a                                                               
customer with a prescription or provide advice regarding vision.                                                                
                                                                                                                                
REPRESENTATIVE   SEATON  surmised   that   there  are   currently                                                               
distinctions between an optician's assistant and an apprentice.                                                                 
                                                                                                                                
MS. BRAND  responded that is  correct.  This bill  would maintain                                                               
that distinction, she added.                                                                                                    
                                                                                                                                
Number 1314                                                                                                                     
                                                                                                                                
JAMES ROTHMEYER,  Chair, Board of Dispensing  Opticians, Division                                                               
of Occupational  Licensing, Department of Community  and Economic                                                               
Development,  testified  in  support   of  HB  502  and  answered                                                               
questions  from  the members.    He  told  the members  that  the                                                               
education and training  of apprentices use to be  left to chance.                                                               
If  an  apprentice  got  a  good sponsor  or  employer  then  the                                                               
individual  received the  training, but  many did  not, he  said.                                                               
This bill will provide that only  those who are career bound need                                                               
to register  as apprentices.   All the apprentices will  have the                                                               
same structured  training through  the U.S. Department  of Labor.                                                               
This bill will also fix the  problem of the expenses connected to                                                               
the board in administering the apprenticeship program, he added.                                                                
                                                                                                                                
Number 1258                                                                                                                     
                                                                                                                                
REPRESENTATIVE COGHILL asked for  clarification that if the Board                                                               
of Dispensing Opticians sunsets,  then the apprenticeship program                                                               
will be administered by a federal regulatory program.                                                                           
                                                                                                                                
MR. ROTHMEYER responded  that if the board sunsets  there will be                                                               
no  licensing or  oversight of  dispensing of  contact lenses  or                                                               
spectacles  in the  state, other  than a  doctor of  optometry or                                                               
ophthalmologists.                                                                                                               
                                                                                                                                
CHAIR WILSON  asked Mr. Rothmeyer  whether the  legislative audit                                                               
recommended a sunset of the board.                                                                                              
                                                                                                                                
MR. ROTHMEYER  replied that the  legislative audit had  two major                                                               
concerns.  The first is that  the training for apprentices is too                                                               
subjective and  prone to  challenge by  license applicants.   The                                                               
bill  provides  that  there would  be  a  structured  educational                                                               
opportunity through the U.S. Department of Labor.                                                                               
                                                                                                                                
CHAIR  WILSON   surmised  that  Mr.   Rothmeyer  is   saying  the                                                               
Legislative  Budget and  Audit  Committee recommended  sunsetting                                                               
the Board of Dispensing Opticians.                                                                                              
                                                                                                                                
MR.   ROTHMEYER  replied   that   the   audit  provided   several                                                               
recommendations,  one  of which  was  sunsetting  the board,  and                                                               
another was to move to  a voluntary certification program.  Under                                                               
the  voluntary plan  there would  not  be anyone  to oversee  the                                                               
continuing educational components, he added.                                                                                    
                                                                                                                                
Number 1158                                                                                                                     
                                                                                                                                
REPRESENTATIVE  SEATON commented  that several  boards are  being                                                               
eliminated and the duties and  authority are being assumed by the                                                               
Division of Occupational Licensing.                                                                                             
                                                                                                                                
MR.  ROTHMEYER  responded  that   the  Division  of  Occupational                                                               
Licensing is ill prepared to  assume the mantel of distinguishing                                                               
a  licensed   opticians  duties  and  the   continuing  education                                                               
required.   It would be licensing  in name only and  no oversight                                                               
would actually be provided, he said.                                                                                            
                                                                                                                                
Number 1088                                                                                                                     
                                                                                                                                
FRANKLIN  ROZAK,  Secretary-Treasurer,  National  Association  of                                                               
Optometrists  and Opticians,  testified  on HB  502 and  answered                                                               
questions  from  the  members.   Mr.  Rozak  told  the  committee                                                               
several  companies that  are members  of the  association provide                                                               
services to Alaska.  He  told the members that Legislative Budget                                                               
and Audit Committee  has recommended that the  board be sunsetted                                                               
for  a variety  of reasons.   Mr.  Rozak commented  that he  will                                                               
focus in  on one main reason  which is manpower.   At the present                                                               
time, according to  the Legislative Audit for FY03  there are 107                                                               
licensed  opticians  in  Alaska.    That is  far  below  what  is                                                               
necessary to effectively have  a pro-competitive and pro-consumer                                                               
market  for Alaskan  consumers, he  said.   He  pointed out  that                                                               
FY00,  FY01, and  FY02 there  were between  34 and  40 apprentice                                                               
opticians  registered.     In  FY03   there  are   11  registered                                                               
apprentice  opticians.   There  is  a  significant drop  off,  he                                                               
stated.  Mr. Rozak commented that some  of that may be due to the                                                               
discussions of  doubling the education  requirements which  is in                                                               
HB  502.    In  2002, the  legislature  decreased  the  education                                                               
requirements for eligibility to take  the exam for licensure, Mr.                                                               
Rozak commented.   Two things happen when there is  a shortage of                                                               
manpower,  prices  go up,  and  accessibility  is diminished,  he                                                               
explained.   If  the board  is to  continue then  the association                                                               
would  support  doing  whatever  is  necessary  to  increase  the                                                               
availability of qualified manpower in Alaska.                                                                                   
                                                                                                                                
Number 0997                                                                                                                     
                                                                                                                                
MR. ROZAK  pointed to page 19  of the report [Alaska  Division of                                                               
Legislative Audit,  Audit Digest  #08-20022-03] which  shows that                                                               
there was  a total of eight  complaints, only one of  which was a                                                               
consumer  in  the  previous  48  months.    The  balance  of  the                                                               
complaints came from competitors, he said.                                                                                      
                                                                                                                                
MR.  ROZAK  shared that  the  departments  of health  in  Kansas,                                                               
Colorado, and Minnesota have written  formal reports where it was                                                               
advised  against the  need to  license opticians.   It  was found                                                               
that there  was no public health  or protection benefit.   It was                                                               
also found  that adequate existing training  was provided through                                                               
apprenticeships    by    various   corporations,    optometrists,                                                               
ophthalmologists,  and other  dispensing  opticians.   Mr.  Rozak                                                               
told  the  members that  these  reports  showed that  there  were                                                               
numerous means of regress for  customer problems.  In summary, he                                                               
said, it  was found  that licensing would  result in  an economic                                                               
disadvantage for optical consumers.                                                                                             
                                                                                                                                
MR.  ROZAK  said   that  increasing  the  number   of  hours  for                                                               
apprenticeship is  not the  way to  increase manpower,  given the                                                               
fact  that the  number  of  apprenticeships is  going  down.   He                                                               
supports  the  U.S.  Department  of Labor's  efforts  to  run  an                                                               
apprenticeship  program,  but  believes the  department  will  be                                                               
hamstrung if  it necessary to  meet the number of  hours required                                                               
in HB 502.                                                                                                                      
                                                                                                                                
Number 0872                                                                                                                     
                                                                                                                                
MR. RUDIG asked Mr. Rozak where he is calling from.                                                                             
                                                                                                                                
MR. ROZAK responded that he is calling from Marblehead, Ohio.                                                                   
                                                                                                                                
Number 0854                                                                                                                     
                                                                                                                                
CHAIR   WILSON  commented   that   she  agrees   that  when   the                                                               
requirements are increased  on an area where there  is a shortage                                                               
prices usually  do go  up.   It is  a concern  for rural  area of                                                               
Alaska, she stated.                                                                                                             
                                                                                                                                
MR. RUDIG  agreed that is  a good point.   He questioned  why the                                                               
prices did not  go down when the requirements were  lowered a few                                                               
years  ago.   He  told  the  committee  he respects  Mr.  Rozak's                                                               
opinion,  but  believes  that Alaskan  opticians  have  a  better                                                               
handle on what is happening here in Alaska.                                                                                     
                                                                                                                                
Number 0768                                                                                                                     
                                                                                                                                
REPRESENTATIVE  SEATON  told  the members  that  the  legislative                                                               
audit is  recommending not to  extend the board which  would mean                                                               
it would terminate on June 30,  2005.  He commented that there is                                                               
at  least one  more legislative  session before  this would  take                                                               
effect.   Representative  Seaton asked  Mr. Rudig  if there  have                                                               
been  discussions about  the audit  because he  cannot understand                                                               
the  recommendation  not  to  extend  the board.    He  asked  if                                                               
Representative Holm rejects the recommendations of the audit.                                                                   
                                                                                                                                
MR.   RUDIG  responded   that  the   sponsor  has   accepted  the                                                               
recommendations  of the  audit.   This bill  allows the  board to                                                               
sunset because  it was losing  money and the opticians  wished to                                                               
move  to the  program  [offered through  the  U.S. Department  of                                                               
Labor].                                                                                                                         
                                                                                                                                
REPRESENTATIVE SEATON  surmised that  this bill  is in  line with                                                               
the Legislative Audit, #08-20022-03.                                                                                            
                                                                                                                                
MR. RUDIG replied that is correct.                                                                                              
                                                                                                                                
CHAIR WILSON  suggested that a checklist  of recommendations made                                                               
by the Legislative Budget and  Audit Committee be provided at the                                                               
next hearing  of the  bill.   She announced that  HB 502  will be                                                               
held in committee.                                                                                                              
                                                                                                                                
                                                                                                                                
HB 434-NATUROPATHIC MEDICINE                                                                                                  
Number 0611                                                                                                                     
                                                                                                                                
CHAIR WILSON  returned attention to  HOUSE BILL NO. 434,  "An Act                                                               
relating to the practice of  naturopathic medicine; and providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
CHAIR WILSON  told the members  that the working  document before                                                               
the committee is CSHB 434, Version Q, Mischel, 4/24/04.                                                                         
                                                                                                                                
Number 0581                                                                                                                     
                                                                                                                                
BARBARA COTTING,  Staff to Representative Jim  Holm, Alaska State                                                               
Legislature, testified on behalf  of Representative Holm, sponsor                                                               
of HB 434.  She said that much  of what is in this version of the                                                               
bill  was a  result  of collaboration  between  Chair Wilson  and                                                               
Linda Anderson.                                                                                                                 
                                                                                                                                
Number 0520                                                                                                                     
                                                                                                                                
LINDA  ANDERSON,  Lobbyist,  Naturopaths Association  of  Alaska,                                                               
testified on  HB 434.   For the  record she corrected  an earlier                                                               
statement  by  Ms.  Cotting  that she  and  Chair  Wilson  worked                                                               
collaboratively on the bill; they did  not, but she did bring the                                                               
bill  to  the   Chair  earlier  today,  she  said.     There  are                                                               
compromises included  in the bill  and on-going  discussions with                                                               
individual medical doctors are continuing.   This same version is                                                               
currently  in the  other body  of  the legislature  as well,  she                                                               
added.                                                                                                                          
                                                                                                                                
MS. ANDERSON  told the members that  the key changes in  the bill                                                               
is that  the legislation  will remove all  schedule 2  drugs from                                                               
the naturopathic  physicians' ability  to prescribe.   The thrust                                                               
of  the compromise  of this  legislation is  that this  bill will                                                               
allow naturopaths  to prescribe,  but in doing  so they  would be                                                               
required to enter  into a collaborative agreement  with a medical                                                               
doctor  and that  medical doctor  will  agree to  a formulary  of                                                               
prescriptions.    So in  this  bill  naturopaths could  prescribe                                                               
legendary drugs and schedules 3, 4,  and 5 drugs.  That agreement                                                               
will be  on a case-by-case  basis depending on  those naturopaths                                                               
and their specialties.                                                                                                          
                                                                                                                                
Number 0377                                                                                                                     
                                                                                                                                
MS.  ANDERSON  summarized  that  if   a  naturopath  can  find  a                                                               
physician  to  enter  into a  collaborative  agreement  then  the                                                               
naturopath will have  a tailored prescriptive ability.   The bill                                                               
also includes  peer review.   It  simply says  since there  is no                                                               
board, the  Division of Occupational  Licensing will  oversee the                                                               
regulations and the  complaints will be filed,  the division will                                                               
pick  up the  file and  call a  group of  identified naturopathic                                                               
physicians who  would review the  complaints.  Ms.  Anderson said                                                               
the bill  suggests that  the group  meet quarterly;  however, the                                                               
division  has said  that quarterly  meetings  are not  necessary.                                                               
She added that there has been fewer that one complaint a year.                                                                  
                                                                                                                                
MS. ANDERSON  pointed out that  another key  part of the  bill is                                                               
that  collaborative agreements  are  repealed  after four  years.                                                               
The idea is  that after the medical communities  have worked with                                                               
naturopathic physicians  and medical physicians the  track record                                                               
will speak for  itself.  She said she believes  there will not be                                                               
any further need for collaboration.                                                                                             
                                                                                                                                
MS. ANDERSON  pointed out  that in  14 other  states naturopathic                                                               
physicians  are given  prescriptive authority.   Naturopaths  are                                                               
willing to  meet that  test of collaborative  work to  assure the                                                               
public safety for Alaskans.                                                                                                     
                                                                                                                                
Number 0179                                                                                                                     
                                                                                                                                
MS.  ANDERSON  commented  that  many of  the  members  heard  Dr.                                                               
Malter's  testimony   and  were  provided  with   information  on                                                               
naturopath programs.   She told the  members that not one  of the                                                               
programs  that  he listed  are  from  federally approved  medical                                                               
schools for naturopaths.   Ms. Anderson stated that  this bill is                                                               
only addressing  those individuals who  have attended one  of the                                                               
five federally recognized medical  schools for naturopaths in the                                                               
nation.   It  is  a very  different list,  she  emphasized.   Dr.                                                               
Malter provided  the committee  with a list  of schools  that are                                                               
not currently regulated at all, she stated.                                                                                     
                                                                                                                                
[HB 434 was held in committee.]                                                                                                 
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health, Education and Social  Services Standing Committee meeting                                                               
was adjourned at 6:22 p.m.                                                                                                      

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