04/07/2005 03:30 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB193 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 193 | TELECONFERENCED | |
| += | HB 13 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
April 7, 2005
3:36 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Paul Seaton, Vice Chair
Representative Vic Kohring
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
Representative Tom Anderson
Representative Lesil McGuire
COMMITTEE CALENDAR
HOUSE BILL NO. 193
"An Act relating to the licensing, regulation, enforcement, and
appeal rights of ambulatory surgical centers, assisted living
homes, child care facilities, child placement agencies, foster
homes, free-standing birth centers, home health agencies,
hospices or agencies providing hospice services, hospitals,
intermediate care facilities for the mentally retarded,
maternity homes, nursing facilities, residential child care
facilities, residential psychiatric treatment centers, and rural
health clinics; relating to criminal history requirements, and a
registry, regarding certain licenses, certifications, approvals,
and authorizations by the Department of Health and Social
Services; making conforming amendments; and providing for an
effective date."
- HEARD AND HELD
HOUSE BILL NO. 13
"An Act relating to reimbursement of municipal bonds for school
construction; and providing for an effective date."
- SCHEDULED BUT NOT HEARD
CONFIRMATION HEARING(S)
Teaching Practices Commission
Bonnie C. Gaborik - North Pole
- SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 193
SHORT TITLE: LICENSING MEDICAL OR CARE FACILITIES
SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR
03/02/05 (H) READ THE FIRST TIME - REFERRALS
03/02/05 (H) HES, JUD, FIN
03/15/05 (H) HES AT 3:00 PM CAPITOL 106
03/15/05 (H) Scheduled But Not Heard
03/17/05 (H) HES AT 3:00 PM CAPITOL 106
03/17/05 (H) Heard & Held
03/17/05 (H) MINUTE(HES)
04/07/05 (H) HES AT 3:30 PM CAPITOL 106
BILL: HB 13
SHORT TITLE: SCHOOL CONSTRUCTION BOND REIMBURSEMENT
SPONSOR(S): REPRESENTATIVE(S) GATTO, GRUENBERG
01/10/05 (H) PREFILE RELEASED 12/30/04
01/10/05 (H) READ THE FIRST TIME - REFERRALS
01/10/05 (H) EDU, HES, FIN
01/25/05 (H) EDU AT 11:00 AM CAPITOL 106
01/25/05 (H) -- Meeting Canceled --
02/01/05 (H) EDU AT 11:00 AM CAPITOL 106
02/01/05 (H) Heard & Held
02/01/05 (H) MINUTE(EDU)
02/22/05 (H) EDU AT 11:00 AM CAPITOL 106
02/22/05 (H) -- Meeting Canceled --
03/03/05 (H) EDU AT 11:00 AM CAPITOL 106
03/03/05 (H) Moved Out of Committee
03/03/05 (H) MINUTE(EDU)
03/04/05 (H) EDU RPT 5DP
03/04/05 (H) DP: GARA, GATTO, WILSON, THOMAS, NEUMAN
03/15/05 (H) HES AT 3:00 PM CAPITOL 106
03/15/05 (H) Scheduled But Not Heard
03/22/05 (H) HES AT 3:00 PM CAPITOL 106
03/22/05 (H) <subcommittee meeting>
03/29/05 (H) HES AT 3:00 PM CAPITOL 106
03/29/05 (H) Heard & Held
03/29/05 (H) MINUTE(HES)
04/05/05 (H) HES AT 3:00 PM CAPITOL 106
04/05/05 (H) Heard & Held
04/05/05 (H) MINUTE(HES)
04/07/05 (H) HES AT 3:30 PM CAPITOL 106
WITNESS REGISTER
RICHARD MANDSAGER, M.D., Director
Division of Public Health
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 193 and provided
relevant information on behalf of the Division of Public Health
and Department of Health and Social Services.
VIRGINIA STONKUS, Chief
Division of Certification and Licensing
Division of Public Health
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Provided relevant information on behalf of
the Division of Public Health regarding HB 193.
ACTION NARRATIVE
CHAIR PEGGY WILSON reconvened the House Health, Education and
Social Services Standing Committee meeting of April 5, 2005, to
order at 3:36:09 PM. Representatives Seaton, Cissna, and
Gardner were present at the call to order. Representative
Kohring arrived as the meeting was in progress.
HB 193-LICENSING MEDICAL OR CARE FACILITIES
CHAIR WILSON announced that the first order of business would be
HOUSE BILL NO. 193 "An Act relating to the licensing,
regulation, enforcement, and appeal rights of ambulatory
surgical centers, assisted living homes, child care facilities,
child placement agencies, foster homes, free-standing birth
centers, home health agencies, hospices or agencies providing
hospice services, hospitals, intermediate care facilities for
the mentally retarded, maternity homes, nursing facilities,
residential child care facilities, residential psychiatric
treatment centers, and rural health clinics; relating to
criminal history requirements, and a registry, regarding certain
licenses, certifications, approvals, and authorizations by the
Department of Health and Social Services; making conforming
amendments; and providing for an effective date."
3:37:41 PM
RICHARD MANDSAGER, M.D., Director, Division of Public Health,
Department of Health and Social Services, (Department),
explained that HB 193 is a governor's bill and that there will
be an emphasis to make necessary amendments and move it forward
before the end of the legislative session. He said that he has
received comments of support and ideas for possible amendments
for HB 193 from eight or nine [human service] organizations.
DR. MANDSAGER pointed out that there are written amendments for
HB 193 included in the committee packet. He added that the
intent of HB 193 is to consolidate the various licensing and
certification activities of the Department including licensing
hospitals and assisted living homes. HB 193 mandates a
background check process to industries regulated by the
Department and an employee misconduct registry, he related. He
said:
[A centralized registry] exists today with certified
nurse aids, presently administered by the Board of
Nursing and the registry concept that's in this bill
is modeled very heavily on what exists today for
certified nurse aids ... the employee misconduct
registry deals with civil issues of abuse, neglect or
exploitation and the criminal background check deals
with criminal activities a person may have been
involved in ... the complexity that has developed in
statute and regulation ... that these types of
industries have developed ... [have] grown up with
some mixture of statute and regulation all
individually developed. [The] Department of Law gets
to try and interpret this every time we have an appeal
or administrative hearing and has to figure out where
this activity fits and the organizations that do more
than one type of work ... they may have assisted
living homes, they may have psychiatric treatment
centers, they may have other social service functions,
some organizations might have hospitals and nursing
homes; they have to keep track of all of these
different state rules for their different parts of
work. ... the reason for the bill is to try to put
into one statute the various rules ... and then have
regulations that are as much similar as possible ...
then regulations can be adapted to problems as we go
forward over time ... that's why we are here today on
this journey that is going to be somewhat laborious.
DR. MANDSAGER referred to HB 193 [Version 24-GH1016\A] and
addressed page 27, line 26 where [Section 47.05.330] the
centralized registry is defined. He related that the
centralized registry is based on the current certified nurse aid
registry but expands it to all employees. He explained, "The
purpose is to get at people who have committed exploitation,
abuse or neglect and then, as we develop this registry, this
then becomes a barrier to their employment in another industry."
He said that he has received calls from two different executives
from different organizations who have retold stories of
employees that they fired for Medicaid fraud, who were then
rehired by sister organizations that were unaware of their
[criminal] history. He pointed out that the employee misconduct
registry would be public and available to executives or employee
organizations.
CHAIR WILSON inquired as to who has access to [the proposed
employee misconduct registry].
DR. MANDSAGER explained that the state would be providing that
information to the employer. He said that the criminal
information [registry] is available [to the public] through the
court system.
3:47:11 PM
REPRESENTATIVE SEATON inquired as to the registry being
available to the general public.
DR. MANDSAGER said that the employee misconduct registry is
modeled on the current certified nurse aid registry, which is
available to the public. He added that the Department is
looking for advice from the House Health, Education and Social
Services Standing Committee in terms of the availability of the
[employee misconduct] registry.
3:48:00 PM
REPRESENTATIVE SEATON inquired as to what will be included on
the [employee misconduct] registry. He specifically asked if
offenses that are not proven will be included.
3:48:57 PM
DR. MANDSAGER stated that what is envisioned is a registry in
which the employers would make reports but the Department would
have to have findings to which an employee would be able to
contest and have administrative hearings, before their name
would go in some kind of an activity that doesn't have a court
action. He referred to page 28, line 5 of HB 193 and said that
there are orders, judgments and adjudications that the employee
has committed abuse, neglect, or exploitation under certain
statutes and they are listed.
CHAIR WILSON commented that HB 193 will pass in the House
Judiciary Standing Committee next, and said that she would like
this section to be looked at closely by the members of that
committee.
3:50:19 PM
VIRGINIA STONKUS, Acting Chief, Division of Certification and
Licensing, Division of Public Health, Department of Health and
Social Services, clarified that the employee misconduct registry
is based only on action taken that has been through a decision,
an adjudication, or a hearing and proven that someone has
abused, neglected, or exploited someone in that field that is
not necessarily of a criminal nature. She explained:
If you are applying for a job in this field for the
first time, there would be no reason to ever be on
that registry. If you are in that field and there is
a finding ... reported by an assisted living home
provider, or through the course of an inspection ...
and it does go through a hearing or process that we
can, in fact, substantiate, that's when ... [it could]
go on the registry. The other issues right now, in
terms of what would go on the registry, would be
enough information only to identify the person through
name and, perhaps, birthdate, and some indication ...
that there was, in fact, something found and that
would be the only information that would be available
on that registry.
3:51:54 PM
REPRESENTATIVE GARDNER inquired as to the adjudication and
whether issues such as this would be dealt with by the
Department or in court.
MS. STONKUS said, "Whether it has to go through a full, formal
hearing process or ... the hearing would have to be initiated by
the Department, through the process that we would explore if
someone chose ... to challenge that, and want to have a hearing,
then we would do that."
3:52:53 PM
REPRESENTATIVE CISSNA inquired as to how the Department plans to
deal with "problem" employees that possibly have charges against
them or that have had cases cleared out of court, but are likely
to "offend" again.
DR. MANDSAGER pointed out that the provider's responsibility is
to report a concern, a suspicion, or a known activity and the
Department's responsibility is to investigate and conduct some
kind of a process to reach a finding.
3:54:49 PM
REPRESENTATIVE CISSNA stated that the concern of the House
Health, Education and Social Services Standing Committee is
focused on the quality of health services. She remarked that
[HB 193] can offer better enforcement of quality care for
children and adults that are in vulnerable situations in Alaska
and through licensure the private sector can be affected.
DR. MANDSAGER stated that the [Alaska State Legislature] will
have to define the statute related to these issues.
3:56:43 PM
REPRESENTATIVE CISSNA expressed her concern in letting the next
committee of reference deal with HB 193 when there are many
issues of health and social welfare that are not yet resolved.
CHAIR WILSON stated that she is open to adding any necessary
amendments and encouraged Representative Cissna to make changes
to HB 193.
REPRESENTATIVE CISSNA said that she would like to spend more
time discussing HB 193 in the House Health, Education and Social
Services Standing Committee. She offered that [future]
amendments could include defining the "screening" process.
DR. MANDSAGER referred to page 28, line 23 of HB 193 and
explained that the information contained in the registry is
available to the public.
REPRESENTATIVE CISSNA said "[if] you're talking about doing
something else that isn't in here, that ought to be left to
another bill."
DR. MANDSAGER addressed Representative Cissna and said that he
wanted to clarify his statement, in case he didn't effectively
make his point. He said:
What we are talking about is ... in regulation,
defining this, because it's clearly going to have to
be much better defined ... but, if the Legislature
wants more detail and more in statute ... that is
possible. We, currently, are working on language that
could either be in statute, if the Legislature wants
it that way, or could be in regulation to define how
this process will work.
REPRESENTATIVE SEATON inquired as to the intent of the registry
and if it serves as a preliminary background check for employers
to utilize.
4:00:30 PM
DR. MANDSAGER said:
What I envision that an employee misconduct registry
does is if I am an employer, [an applicant] comes in
and wants to apply for work, I can quickly type into
my computer, [to] see if Joe Smith has committed any
of these activities ... if so, I don't need to receive
an employment application from Joe Smith ... most
people won't be on this registry, because they won't
have committed these activities ... [if] Joe Smith
does apply [and isn't listed on the registry] ...
then, we go through the process of doing a criminal
background check ... by the time they are employed,
both parts of their past are known.
4:01:15 PM
REPRESENTATIVE SEATON opined that there is an expense associated
to having the registry when it is only listing adjudicated items
and the full background check is required when a new employee is
hired. He said he is concerned with Section 47.05.330 [of HB
193, Version 24-GH1016\A], Subsection (e). He stated that the
liability of putting in information that hasn't been adjudicated
as a barrier to employment, could be [a huge liability] for the
State of Alaska.
4:03:03 PM
DR. MANDSAGER clarified that the employee misconduct registry
deals with civil issues and the criminal background check deals
with criminal issues. He said that information that is
unverified, unsubstantiated, or unadjudicated should not be
incorporated into an applicant's record.
4:03:57 PM
REPRESENTATIVE SEATON clarified that the [employee misconduct
registry] will include civil cases.
4:04:34 PM
REPRESENTATIVE GARDNER said:
I have a constituent who brought this issue to me ...
[he] has ... [a] large [business], he employs a lot of
people who provide services to frail adults, elderly,
disabled people ... in their homes. He has, over
time, had a lot of situations in which he had to fire
an employee, for mistreatment of any sort, for fraud,
where they've billed for hours that they didn't
actually work ... as an employer, not only does he
fire the person but he is also responsible for
repaying that money, and so, he has a liability ...
then, he would find ... these people that he fired for
whatever reason, were now working for another provider
down the street ... there was no legal way for him to
tell them [to watch out for misconduct] ...
REPRESENTATIVE GARDNER continued:
What's the threshold of proof [for this registry] ...
the state can't afford to have a trial for all of
these things ... one question that is absolutely
legal, ... is, "Would you hire this person again?" ...
and the state doesn't have to have any panel or
adjudication, nobody's open to lawsuits, we simply
say, as an employer, "it is my responsibility if I
want to protect all of the people that I am caring
for, to just call their previous employer and ask
them."
CHAIR WILSON said that there are cases where personalities
conflict. She pointed out that some employers would not rehire
someone based on basic personality differences.
4:07:34 PM
MS. STONKUS said:
As a licensing agency, we are responsible for assuring
that the programs that we fund meet the standards that
are set. The issue of the registry would be, if there
is a report ... they would report to us, a concern for
abuse, neglect, or exploitation, but that would be
part of our investigation ... to substantiate, and
assure, that we found enough information based on that
investigation to support a concern ... the individual
would be notified that we have come up ... with
substantial findings ... they would have an
opportunity to request a full review ... making sure
that it wasn't just a personality issue ... if they
declined ... then the decisions would be made that
they would be eligible for their name going on that
registry. If they chose to do the hearing and we went
through that process and that finding was upheld, then
we have the adjudication, and the support ... to put
that individual's name on the registry.
MS.STONKUS continued:
Throughout the whole process ... [there would be] ...
the chance to go back and challenge that there was a
finding that they thought was done in error ... I
think our concern and consideration, here, is wanting
to be respectful of the folks who would be on that
registry ... there are enough situations where we
could not legally, or through the court process, or
through the criminal process, find that capacity ...
there's legal precedent to have this in place.
REPRESENTATIVE SEATON inquired as to the necessity of making the
registry public and available. He opined that if the registry
is public, the names on it could be published in the newspaper
or made available in a number of ways that could be problematic.
4:11:27 PM
DR. MANDSAGER related that there are several options when it
comes to creating the registry. The first option, he said, is
that the registry is open to the public. The registry could
also be set up so that employers have to sign up and passwords
are assigned to qualified individuals to view [the registry], he
explained. He pointed out another scenario where an employer
could call [the Department], and ask a staff member for registry
information.
4:12:31 PM
REPRESENTATIVE CISSNA remarked that the [employment misconduct
registry] seems more like a criminal background check than
anything else. She inquired as to how the registry would
function, who would make the decisions as to who was included on
it and how appeals would be managed. She asked about other
states [that utilize similar registry's] and how those
registry's function. She added that to utilize a registry costs
money and takes time. She requested information pertaining to
the attached fiscal note.
DR. MANDSAGER addressed Representative Cissna's concerns and
explained that the more rights that are given to individuals for
appeals will create a higher cost and the fiscal note will
increase. The amendment process related to this bill, he said,
will have to help balance these types of issues.
4:15:43 PM
MS. STONKUS explained that this [registry] is part of the
process of assuring that the folks that are regulated meet the
standards that they are supposed to. She added that this allows
them another opportunity to take concerns that they find and
assure that they will not happen again.
4:16:55 PM
REPRESENTATIVE CISSNA expressed that she is very interested in
this legislation and in making necessary amendments. She
inquired as to the process of creating the registry and why the
legislature was not included in it's development.
4:17:47 PM
DR. MANDSAGER said, "The formal answer ... is that, at least
until a bill got submitted, there wasn't really something for
you to work with. The informal answer ... we [could] have
invited some of the legislators to work on this process ...
maybe we should have."
CHAIR WILSON asked Representative Cissna if she would like to
represent the [House Health, Education and Social Services
Standing Committee] with the [Department] as they go through
that process.
REPRESENTATIVE CISSNA said that she would be thrilled.
CHAIR WILSON stated that Representative Cissna is appointed to
work with the Department on the employment misconduct registry.
4:19:02 PM
REPRESENTATIVE SEATON said that he would like to see Dr.
Mandsager return to the House Health, Education and Social
Services Standing Committee with a proposed amendment for the
registry.
DR. MANDSAGER clarified that the proposed amendment that
Representative Seaton was discussing would change [Section
47.05.330, Subsection (f)] of HB 193.
REPRESENTATIVE SEATON stated that is correct. He added that
[Section 47.05.330, Subsection (e) in HB 193] could have clearer
language, as well.
DR. MANDSAGER related that most of this bill [HB 193] has been
created from "the best" of current statute.
REPRESENTATIVE SEATON said that he has heard so much [during the
legislative session] from assisted living homes about the
problems of current regulations and changes. He remarked that
he wanted to make sure that this legislation does not create
more of a problem.
DR. MANDSAGER emphasized that he would like to be notified of
any current problems with statute or regulation.
DR. MANDSAGER brought attention to Amendment 1, labeled 24G-1,
4/4/2005 (9:32 AM), which read:
Page 2, lines 25 - 27:
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Insert "(A)"
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Insert "(ii)"
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Insert "and"
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"(B) includes a facility that performs
invasive diagnostic or therapeutic services;"
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Insert "(5)"
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Page 31, following line 9:
Insert a new bill section to read:
"* Sec. 29. AS 47.32.010 is amended by adding a new
subsection to read:
(c) The provisions of AS 47.05.300 - 47.05.390,
regarding criminal history, criminal history checks,
criminal history use standards, and a centralized registry,
apply to entities listed in (b) of this section as provided
in AS 47.05.300."
Renumber the following bill sections accordingly.
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Following "by":
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of"
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"* Sec. 42. The uncodified law of the State of Alaska is
amended by adding a new section to read:
APPLICABILITY REGARDING SEC. 17 OF THIS ACT; DEPARTMENT
ACTION. (a) The changes made by sec. 17 of this Act apply to
(1) applications or requests submitted within the 30
days before, or submitted on or after, the effective date of
sec. 17 of this Act for initial licensure, certification, or
other approval or selection as any of the following:
(A) an entity or individual service provider
that is subject to AS 47.05.300 - 47.05.390, enacted by
sec. 17 of this Act;
(B) an entity listed in AS 47.32.010(b), enacted
by sec. 1 of this Act, that is not described in (A) of this
paragraph; and
(2) applications or requests submitted within the 30
days before, or submitted on or after, the effective date of
sec. 17 of this Act, for renewal of a license, certification, or
other approval or selection for an entity or individual service
provider that is subject to AS 47.05.300 - 47.05.390, enacted by
sec. 17 of this Act.
(b) The Department of Health and Social Services may not
make a final determination regarding an application or request
described in (a) of this section earlier than the effective date
of sec. 17 of this Act.
(c) In this section,
(1) "entity" includes an entity subject to AS
47.05.300 - 47.05.390, enacted by sec. 17 of this Act, and an
entity listed in AS 47.32.010(b), enacted by sec. 1 of this Act,
that is not subject to AS 47.05.300 - 47.05.390, enacted by sec.
17 of this Act;
(2) "individual service provider" has the meaning
given in AS 47.05.390, enacted by sec. 17 of this Act."
Renumber the following sections accordingly.
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Insert a new bill section to read:
"* Sec. 45. The uncodified law of the State of Alaska is
amended by adding a new section to read:
TRANSITION: PENDING APPLICATIONS AND OTHER REQUESTS
REGARDING SEC. 17 OF THIS ACT. (a) An application or other
request for licensure, certification, or other approval or
selection as an entity or individual service provider that would
be subject to AS 47.05.300 - 47.05.390, enacted by sec. 17 of
this Act, that was submitted more than 30 days before the
effective date of sec. 17 of this Act and is pending department
action on the effective date of sec. 17 of this Act shall
continue to be processed, and either granted or denied, by the
department under the applicable statutes and regulations that
were in effect on the day before the effective date of sec. 17
of this Act. In this subsection,
(1) "entity" means an entity that would be subject to
AS 47.05.300 - 47.05.390, enacted by sec. 17 of this Act;
(2) "individual service provider" has the meaning
given in AS 47.05.390, enacted by sec. 17 of this Act.
(b) In this section,
(1) "department" means the Department of Health and
Social Services;
(2) "license" includes a renewed license."
Renumber the following bill sections accordingly.
Page 35, line 28, following "REGULATIONS.":
Insert "(a)"
Page 35, line 29, following "implement":
Insert "secs. 1 - 16, 18 - 28, and 30 - 40 of"
Page 35, following line 31:
Insert the following new material:
"(b) The Department of Health and Social Services may
proceed to adopt regulations necessary to implement secs. 17 and
29 of this Act. The regulations take effect under AS 44.62.
* Sec. 47. The uncodified law of the State of Alaska is
amended by adding a new section to read:
CERTIFICATION OF EFFECTIVE DATE OF REGULATIONS. The
lieutenant governor shall certify to the revisor of statutes the
effective date of the regulations adopted by the Department of
Health and Social Services under sec. 46(b) of this Act."
Renumber the following bill sections accordingly.
Page 36, line 1:
Delete "40, 42, and 43"
Insert "41, 42, and 44 - 47"
Page 36, line 3:
Delete "32"
Insert "33"
Page 36, following line 3:
Insert a new bill section to read:
"* Sec. 50. Sections 17 and 29 of this Act take effect
(1) on the effective date of the regulations adopted
by the Department of Health and Social Services under sec. 46(b)
of this Act implementing sec. 17 of this Act, or March 1, 2006,
whichever is earlier; but
(2) no earlier than July 2, 2005."
Renumber the remaining bill section accordingly.
Page 36, line 4:
Delete "44 and 45"
Insert "48 - 50"
DR. MANDSAGER explained:
Most of this ... has to do with renumbering ... the
first issue ... is a dating issue. When this was
drafted, it was envisioned that the criminal
background check would start on July 1, 2005 ... by
the time legislation finally gets passed, and
regulation development ... most of Amendment 1 moves
the effective date to the spring of 2006 ... or ...
after the bill gets passed. The other issue ... is
the last two lines of page 1 and you have to open up
part of your bill to go with this, which is, page 15,
line 24 ... on page 2 [of HB 193], it lists all of the
entities that this applies to ... as medical
technology changes, certain very complex stuff moves
out of hospitals into free standing things and in many
states in the country right now, there are three main
kinds of these activities ... radiation treatment
units ... for treating cancer with radiation ...
chemotherapy units for treating cancer and the third
is cardiac catheterization laboratories ... as they
move out [of hospitals] ... [the] last two lines on
page 1 ... [can] put some flexibility into the
definition of an ambulatory surgical center ... the
state could say that this entity, now, is going to
become licensed and going to propose "regs" to propose
licensing or regulating that entity.
In our state, there really is only one of those ...
because of our small population ... there is a free
standing cardiac catheterization lab in Anchorage that
is outside the hospital and outside of any licensure
or regulation at present ... this is about ... trying
to find ... some language that would give some
flexibility but would not be so broad that would be
way too broad. If we can't come up with language then
... in the future, the whole statute should just be
amended for some particular thing.
DR. MANDSAGER referred to Amendment 1, Version 24G-1, 4/4/2005
(9:32 AM), page 1, line 18 and stated that the word "facility"
needs to be defined.
4:29:20 PM
CHAIR WILSON said that the entities listed in [Section
47.32.010] of HB 193 need to be regulated.
REPRESENTATIVE SEATON asked why the entities on page 2 of HB 193
have to be regulated. He said that these entities are medically
technical and specific already, and doesn't see the need to put
more regulations on them.
DR. MANDSAGER said, "there may be enough self-regulating
mechanisms in place for those high end, medical, complex things
between insurance, the cost of operations ... because the cost
of development is going to be so high ... it very may well be
that this idea we should just drop for now.
4:31:29 PM
REPRESENTATIVE CISSNA inquired as to the [American Medical
Association's, AMA] involvement in issues related to the
licensing of the aforementioned health facilities.
DR. MANDSAGER clarified that physician licensing is handled by
the Board of Medicine. He said that Representative Seaton
brought up the issue of the fact that physicians have enough
regulations in place already that deal with "quality."
[The committee treated Amendment 1, Version 24G-1, 4/4/2005
(9:32 AM) as before it.]
[CHAIR WILSON turned the gavel over to Vice-Chair Seaton.]
VICE-CHAIR SEATON moved to adopt Amendment 1, to Amendment 1,
labeled Version 24G-1, 4/4/2005 (9:32 AM), as follows:
Page 1, delete lines 18-21
There being no objection, it was so ordered.
REPRESENTATIVE SEATON moved to adopt Amendment 1, as amended.
There being no objection, Amendment 1, as amended, Version 24G-
1, 4/4/2005 (9:32 AM), was adopted.
The committee took an at-ease from 4:34:58 to 4:45:03.
4:45:43 PM
REPRESENTATIVE GARDNER moved to rescind the committee's action
in adopting the amended Amendment 1, [Version 24G-1, 4/4/2005
(9:32 AM)]. There being no objection, [the amended] Amendment 1
was rescinded.
REPRESENTATIVE GARDNER moved to adopt Amendment 2, to Amendment
1, [Version 24G-1, 4/4/2005 (9:32 AM)], as follows:
[Page 1], delete lines 4-21
REPRESENTATIVE GARDNER moved to adopt Amendment 1, Version 24G-
1, 4/4/2005 (9:32 AM), as amended. There being no objection,
Amendment 1, Version 24G-1, as amended, was adopted.
4:47:44 PM
DR. MANDSAGER offered Amendment 2, labeled Version 24G-1,
4/4/2005 (2:43 PM), which read:
Page 9, line 24:
Delete "(e)"
Insert "(f)"
Page 9, line 28:
Delete "(e)"
Insert "(f)"
Page 10, line 10:
Delete "(e)"
Insert "(f)"
Page 10, line 18:
Delete "(e)"
Insert "(f)"
Page 10, line 27:
Delete "(e)"
Insert "(f)"
Page 11, following line 25:
Insert the following new material:
"(e) The department may not take action under
(d)(9) of this section unless the commissioner has
reasonable cause to believe that continued management
by the entity while the entity is attempting to cure a
violation would be injurious to the health, safety, or
welfare of individuals receiving services from the
entity."
Page 11, line 26:
Delete "(e)"
Insert "(f)"
Page 12, line 1:
Delete "(f)"
Insert "(g)"
Page 12, line 2:
Delete "(e)"
Insert "(f)"
Page 12, line 6:
Delete "(g)"
Insert "(h)"
Delete "(e)"
Insert "(f)"
Page 12, line 9:
Delete "(f)"
Insert "(g)"
Page 12, line 12:
Delete "(f)"
Insert "(g)"
Page 12, line 13:
Delete "(h)"
Insert "(i)"
Delete "(f)"
Insert "(g)"
Page 12, line 15:
Delete "(e)"
Insert "(f)"
Page 12, line 17:
Delete "(i)"
Insert "(j)"
Delete "(e)"
Insert "(f)"
Page 12, line 25:
Delete "(j)"
Insert "(k)"
Page 13, line 1:
Delete "does not apply"
Insert "applies"
Page 13, line 1, following "hearing.", through line 3:
Delete all material.
Page 13, line 8, following "AS 44.62":
Insert "or AS 44.64"
Page 14, line 20:
Delete "47.32.150(h)"
Insert "47.32.150(i)"
Page 24, following line 5:
Insert a new bill section to read:
"* Sec. 15. AS 44.64.030(a)(33) is amended to
read:
(33) AS 47.32 (Department of Health and
Social Services licensing) [AS 47.33 (ASSISTED LIVING
HOMES)];"
Renumber the following bill sections accordingly.
Page 32, following line 11:
Insert a new bill section to read:
"* Sec. 38. AS 44.64.030(a)(15), 44.64.030(a)(16),
and 44.64.030(a)(34) are repealed."
Renumber the following bill sections accordingly.
Page 32, line 26:
Delete "17"
Insert "18"
Page 32, line 29:
Delete "17"
Insert "18"
Page 33, line 2:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 33, line 3:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 33, line 7:
Delete "17"
Insert "18"
Page 33, line 9:
Delete "17"
Insert "18"
Page 33, line 13:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 33, line 16:
Delete "17"
Insert "18"
Page 33, line 17:
Delete "17"
Insert "18"
Page 33, line 19:
Delete "17"
Insert "18"
Page 33, line 25:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 34, line 1:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 34, line 21:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 34, lines 22 - 23:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 34, line 25:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 34, line 30:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 35, line 2:
Delete "1 - 31 and 33 - 39"
Insert "1 - 32 and 34 - 41"
Page 35, line 13:
Delete "17"
Insert "18"
Page 35, line 14:
Delete "17"
Insert "18"
Page 35, line 15:
Delete "17"
Insert "18"
Page 35, line 17:
Delete "17"
Insert "18"
Page 35, line 19:
Delete "17"
Insert "18"
Page 35, line 22:
Delete "17"
Insert "18"
Page 36, line 1:
Delete "40, 42, and 43"
Insert "42, 44, and 45"
Page 36, line 3:
Delete "32"
Insert "33"
Page 36, line 4:
Delete "44 and 45"
Insert "46 and 47"
DR. MANDSAGER related that the [Alaska State Hospital and
Nursing Home Association, ASHNHA] raised concerns about this
amendment, specifically, on page 2, lines 2-5. He said that
ASHNHA was concerned about the Department's proposal to take
over management of institutions in cases of immediate risk to
life and safety and that they consider this a high risk
endeavor. ASHNHA suggested that the Commissioner [of the
Department of Health and Social Services] be involved when these
decisions are considered.
DR. MANDSAGER said:
And then the second issue is, down at the bottom of
page three of the amendment, starting at line 25, and
this is to fix a drafting error on page 13 of [HB
193], and it has to do with administrative hearings
... line 1 of page 13 said that AS 44.64.060 does not
apply and then there's a sentence about the parts of
the administrator procedure act that do apply ...
that's wrong ... this amendment changes, "does not
apply" to "applies" and deletes the second sentence
...
4:49:25 PM
REPRESENTATIVE GARDNER moved Amendment 2, Version 24G-1,
4/4/2005 (2:43 PM) [text previously provided]. There being no
objections, Amendment 2, Version 24G-1, 4/4/2005 (2:43 PM), was
adopted.
4:50:29 PM
REPRESENTATIVE SEATON returned the gavel to Chair Wilson.
[HB 193 was held over.]
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:53:54 PM.
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