04/27/2004 03:11 PM House HES
| Audio | Topic |
|---|
+ 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.
| Document Name | Date/Time | Subjects |
|---|