03/20/2007 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB135 | |
| HB178 | |
| HB113 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 135 | TELECONFERENCED | |
| *+ | HB 178 | TELECONFERENCED | |
| *+ | HB 113 | TELECONFERENCED | |
| *+ | HB 173 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 20, 2007
3:02 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Bob Roses, Vice Chair
Representative Anna Fairclough
Representative Mark Neuman
Representative Paul Seaton
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
All members present
OTHER LEGISLATORS PRESENT
Senator Johnny Ellis
COMMITTEE CALENDAR
HOUSE BILL NO. 135
"An Act establishing a higher education savings program for
eligible children who were placed in out-of-home care by the
state; and providing for confidentiality of identifying
information of a beneficiary under the program."
- MOVED CSHB 135(HES) OUT OF COMMITTEE
HOUSE BILL NO. 178
"An Act relating to the Governor's Committee on Employment of
People with Disabilities; and providing for an effective date."
- MOVED CSHB 178(HES) OUT OF COMMITTEE
HOUSE BILL NO. 113
"An Act relating to the prescription and use of pharmaceutical
agents, including controlled substances, by optometrists."
- HEARD AND HELD
HOUSE BILL NO. 173
"An Act relating to court approval of involuntary administration
of psychotropic medication; and providing for an effective
date."
- BILL HEARING CANCELED
PREVIOUS COMMITTEE ACTION
BILL: HB 135
SHORT TITLE: TUITION FOR CERTAIN CHILDREN
SPONSOR(s): REPRESENTATIVE(s) STOLTZE
02/14/07 (H) READ THE FIRST TIME - REFERRALS
02/14/07 (H) HES, FIN
03/20/07 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 178
SHORT TITLE: EMPLOYM'T OF PEOPLE W/ DISABILITIES COM.
SPONSOR(s): HEALTH, EDUCATION & SOCIAL SERVICES
03/05/07 (H) READ THE FIRST TIME - REFERRALS
03/05/07 (H) HES, FIN
03/20/07 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 113
SHORT TITLE: OPTOMETRISTS' USE OF PHARMACEUTICALS
SPONSOR(s): REPRESENTATIVE(s) SAMUELS
01/30/07 (H) READ THE FIRST TIME - REFERRALS
01/30/07 (H) HES, L&C
03/20/07 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
ROBERT FOOTE-JONES, Staff
to Representative Bill Stoltze
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 135 on behalf of
Representative Bill Stoltze, sponsor.
JIM LYNCH, Associate Vice President
Statewide Administration
University of Alaska
Fairbanks, Alaska
POSITION STATEMENT: Testified during the hearing on HB 135.
MICHAEL CURRAN, Program Coordinator
Office of Faith-Based and Community Initiatives (FBCI)
Office of the Commissioner
Department of Health & Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 135.
CHIP WAGONER, Executive Director
Alaska Conference of Catholic Bishops
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 135.
MIKE LESMANN, Community Relations Manager
Office of Children's Services (OCS)
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified during the hearing of HB 135.
ROBERT MYERS, Intern
to Representative Peggy Wilson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 178, on behalf of
Representative Peggy Wilson, sponsor.
GALE SINNOTT, Director
Statewide Programs
Division of Vocational Rehabilitation
Department of Labor & Workforce Development (DLWD)
Juneau, Alaska
POSITION STATEMENT: Testified during the hearing on HB 178.
PAULA SCAVERA, Special Assistant
Office of the Commissioner
Department of Labor & Workforce Development
Juneau, Alaska
POSITION STATEMENT: Testified during the hearing on HB 178
SYDNEY MORGAN, Staff
to Representative Ralph Samuels
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the Committee Substitute for HB
113 on behalf of Representative Ralph Samuels, prime sponsor.
CINDY BRADFORD, Doctor of Ophthalmology
American Academy of Ophthalmology;
Assistant Professor,
Dean A. McGee Eye Institute
Department of Ophthalmology
University of Oklahoma Health Center
University of Oklahoma
Oklahoma City, Oklahoma
POSITION STATEMENT: Testified in opposition to HB 113.
LESLEY L. WALLS, Doctor of Optometry;
Doctor of Medicine;
President
Southern California College of Optometry
Fullerton, California
POSITION STATEMENT: Testified in support of HB 113.
MICHAEL BENNETT, Doctor of Optometry;
President
Alaska Optometric Association
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 113.
BOB LOESCHER
Juneau, Alaska
POSITION STATEMENT: Testified in opposition to HB 113.
JILL GEERING MATHESON, Doctor of Optometry;
Chair
Alaska Board of Examiners in Optometry
Juneau, Alaska
POSITION STATEMENT: Speaking as an individual, testified in
support of HB 113.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:02:56 PM.
Representatives Wilson, Seaton, Roses, and Fairclough were
present at the call to order. Representatives Neuman, Cissna,
and Gardner arrived as the meeting was in progress.
HB 135-TUITION FOR CERTAIN CHILDREN
3:03:08 PM
CHAIR WILSON announced that the first order of business would be
HOUSE BILL NO. 135 "An Act establishing a higher education
savings program for eligible children who were placed in out-of-
home care by the state; and providing for confidentiality of
identifying information of a beneficiary under the program."
3:05:00 PM
ROBERT FOOTE-JONES, Staff to Representative Bill Stoltze, Alaska
State Legislature, introduced HB 135 on behalf of the sponsor.
Mr. Foote-Jones informed the committee that HB 135 is a
companion bill to SB 76, sponsored by Senator Johnny Ellis. The
bill will assist children in foster care to attain higher
education through the ASPIRE program, which is an acronym for
Alaska's youth Succeed when People Invest Resources in
Education. This legislation will allow churches, community
organizations, nonprofits, businesses, and individuals to
establish education savings accounts for children in foster
care. The bill authorizes the Office of Children's Services
(OCS), Department of Health & Social Services (DHSS), to release
necessary information to the Alaska Office of Faith-Based and
Community Initiatives (FBCI) in order to open a state sponsored
University of Alaska (UA) Section 529, Internal Revenue Service
college saving plan in the name of the foster child.
MR. FOOTE-JONES explained that the funds can be used for
educational or vocational training, in addition to tuition. The
beneficiaries of this program will be chosen by OCS for their
age and the length of time, over a minimum of two years, that
they have been in foster care. Mr. Foote-Jones explained that a
foster child is "aged out" of the state's custody at the age of
18, without further support from the state. He pointed out that
children in foster care most likely have no chance to further
their education.
3:07:42 PM
REPRESENTATIVE CISSNA asked whether the sponsor has been in
contact with the Annie E. Casey Foundation or the Alaska Court
System, which is working on a related program.
MR. FOOTE-JONES replied no.
3:08:42 PM
REPRESENTATIVE GARDNER stated that this could be a very
important program. Reaching the age of 18 does not mean that a
child is ready for independence. She asked whether the FBCI or
the OCS has issued an opinion on this bill.
MR. FOOTE-JONES replied that the FBCI is represented at the
hearing.
3:09:41 PM
REPRESENTATIVE CISSNA asked whether the savings account could be
used at an institution of higher learning other than the
University of Alaska.
MR. FOOTE-JONES answered that this fund is available for any
educational purpose until the beneficiary reaches the age of 30.
3:10:37 PM
JIM LYNCH, Associate Vice President, Statewide Administration,
University of Alaska (UA), stated his support for HB 135. He
noted that the acronym for the program is ASPIRE, and it holds a
similar goal as the general UA college savings program for
Alaska youth and their families. Mr. Lynch expressed his hope
that all Alaska students expect to continue to post secondary
education after graduation from high school. He relayed that 50
percent of the children in foster care are from middle income
families and many of these children come from families with
lower incomes, and where the parents may not have been to
college. It allows the student, from an early age, to plan to
go to college. Mr. Lynch concluded by pointing out that if the
funds are not utilized by one student, the account will be re-
directed to another foster child.
3:13:36 PM
MICHAEL CURRAN, Program Coordinator, Office of Faith-Based and
Community Initiatives (FBCI), Office of the Commissioner,
Department of Health & Social Services (DHSS), stated his
support for HB 135, paraphrasing from a prepared statement,
which read as follows [original punctuation provided]:
As a worker for social justice and community building,
an ordained priest, and former teacher for over twenty
years in the rural, remote, and small communities of
Alaska, I am very aware of the challenges that face
our youth in out-of-home care.
Prior to my position with the Alaska Office of Faith-
Based and Community Initiatives I was an Associate
Coordinator to the Program Director for the State of
Alaska, Head Start program with the Department of
Education and Early Development. A great deal of my
time was spent doing research concerning the
transition of young foster children's care in foster
homes and out-of-home care to their lives of self-
sufficiency. As a teacher, there were many students
in my classrooms that were living in foster care and
were about to, or had transitioned to, independent
living outside their small communities. In my life as
a parish priest I had opportunities in private,
congregational and community ministries to pastor
families who cared for foster children and also to the
foster children who "aged-out" of foster care.
My experiences and my research revealed that those
youth who did age out of foster care versus their
counterparts who were not a part of the foster care
system, all faced higher risks and the actual
experiences of homelessness, unemployment, financial
hardships, diminished physical health, criminal
behaviors, psycho-social disorders, suicide and lower
achievements in education.
Most of these precious children (young adults) want to
pursue (ASPIRE to) education beyond high school but
the financial roadblocks are too great for them to
even begin, let alone complete a higher educational
degree. Many studies have shown that nearly 75
percent of these young adults must abandon the idea of
pursuing a degree or complete it.
This proposed House Bill, HB 135, and its program
would effectively address this challenge that these
young people face. It is a program that would bring
the guiding principal of real community together. It
would give the ability and opportunity for
individuals, faith-based organizations, businesses,
civic groups and other organizations to invest in our
most precious commodity, the youth of our State. They
are our future. This proposal will enable them to
fulfill their dreams and live productive lives. These
youth are our future investment who will in turn,
fulfill the visions of our great State.
3:18:06 PM
REPRESENTATIVE SEATON asked how much of the total budget of
$41,000 will be targeted for television advertising.
MR. CURRAN responded that the administration of the program will
take 25 percent of the time of the existing program coordinator.
He stated that $20 per year is estimated for contractual funds
to print brochures and support a promotional effort.
REPRESENTATIVE SEATON observed that the amount should be
$20,000.
MR. CURRAN agreed that there must be a misprint.
REPRESENTATIVE SEATON again asked whether the television
advertising is included.
MR. CURRAN said that he did not know.
3:19:48 PM
CHAIR WILSON pointed out that the fiscal note indicates $20,000
per year for contractual funds.
3:20:13 PM
CHIP WAGONER, Executive Director, Alaska Conference of Catholic
Bishops, stated his organization's support for HB 135. He
informed the committee that, as an advocate for many children's
services, he has testified in support of many state funded
programs for the poor. Mr. Wagoner acknowledged that the
government can not provide all of the services to the poor that
are needed and that this bill will provide an opportunity for
individuals, under the obligation of their faith, to support the
poor. It is very important, Mr. Wagoner added, to market this
program so individuals are aware of the opportunity to
participate in supporting educational goals for foster children.
3:22:25 PM
MIKE LESMANN, Community Relations Manager, Office of Children's
Services (OCS), Department of Health & Social Services (DHSS),
stated support for HB 135 on behalf of the department,
paraphrasing from a prepared statement, which read as follows
[original punctuation provided]:
The department supports HB 135 and would like to thank
the sponsor for introducing this idea to members of
the House. We have worked closely with Senator Ellis
and his staff on the language of the Senate's version
of this bill. Children that become wards of the State
are sometimes not financially prepared to enroll in
post-secondary educational opportunities. The ASPIRE
program would create the potential for their community
to assist them in that endeavor. If you believe that
the young are our future, this is important
legislation to all Alaskans.
3:23:32 PM
CHAIR WILSON asked whether a foster child's Permanent Fund
Dividend (PFD) will be deposited to the savings account.
MR. LESMANN replied that children in state custody have their
PFD directed to a trust fund each year. When the child is
emancipated or released to their family, guardian, or adoptive
family, the PFD is released to them. He opined that the PFD
will not be deposited to the college savings account.
3:24:45 PM
REPRESENTATIVE NEUMAN referred to the fiscal note and asked
whether the estimated cost is just to keep a central office
open.
MR. LESMANN opined that one FBCI staff person will be
administering the program and the $20,000 will be dedicated to
marketing.
REPRESENTATIVE NEUMAN asked how many young adults will be
affected by this bill.
MR. LESMANN answered that approximately 2,100 children are
placed in state custody outside of their homes. Of those
children, he said, 96 will attain the age of 18 as of 08/01/07.
3:27:05 PM
CHAIR WILSON noted that this would be approximately 100 per
year.
MR. LESMANN affirmed that the number of children in state
custody changes daily, but it could be around 100 per year who
age-out of the system.
3:27:30 PM
REPRESENTATIVE GARDNER asked whether a provision will be made to
allow the beneficiary of the program to meet his/her sponsor.
MR. LESMANN answered that the bill directs FBCI, OCS, and the
Division of Juvenile Justice (DJJ), to administer the program.
He opined that this idea has been discussed and will require the
agreement of the donor.
3:29:16 PM
REPRESENTATIVE SEATON asked whether these savings accounts will
be held for children who are adopted, and whether the adoptive
parents will have access to the savings.
MR. LYNCH responded that a determination on this issue would be
made by the director of the department at the time. He advised
that the state is the owner of the account.
CHAIR WILSON asked whether the details are still fluid because
the regulations have not been written.
MR. LYNCH replied that the state will be the owner of the
account and UA will follow the directions, provided by DHSS,
regarding the distribution of the funds.
3:31:41 PM
MR. LESMANN added that two possibilities have been envisioned.
One is the possibility that the donor will know the recipient.
The donor could be a neighbor of the foster parent. Thus, the
donor may specify a certain child as the recipient. Another
possibility is of a child who is aging out of the state system,
who has been achieving academically, and who does not have a
sponsor. This child could be identified by the state and become
a recipient. He opined that there is not an age or time
specified for the release of the savings account.
3:33:49 PM
REPRESENTATIVE SEATON called the committee's attention to page
2, lines 19 and 20, of the bill and said that there is no
indication that the account is only to be used for educational
purposes. He suggested that, as this bill goes forward, it
should be made clear that these funds can only be used for
education, and the donor should be confident of that purpose.
3:35:38 PM
CHAIR WILSON asked whether a group of people could donate to a
child, even if the program was not already established.
MR. LESMANN told the committee that community members can
specify a child as a recipient and donations can be directed to
that child. However, information about the child, or donors,
can not be disclosed unless HB 135 passes and amends the
existing statute.
3:37:03 PM
REPRESENTATIVE CISSNA commented that it is important that
educational opportunities are made available to children in
foster care. She then asked what safeguards have been put in
place to ensure that foster children aging out of the system
have the educational "pieces" in place to benefit from this type
of program. She advised that children in state custody need
extra oversight due to unintended consequences that can be
brought to bear by foster parents with ill will. Representative
Cissna said that, in her experience, foster children are known
targets and are vulnerable to abuse by adults. She asked
whether the department will be able protect them, and direct the
savings accounts to them, simultaneously.
3:40:39 PM
MR. LESMANN said that he could not answer that question.
REPRESENTATIVE CISSNA stated that her confidence in this bill
would be raised if the sponsors consult with the Annie E. Casey
Foundation and the judicial system.
3:41:40 PM
CHAIR WILSON observed that the money does not go into the hand
of a recipient or a foster parent, but directly to the
educational institution.
3:42:05 PM
REPRESENTATIVE ROSES added that there is also the question of
what happens to the money if the recipient does not attend the
school. He then called the committee's attention to page 3,
line 1 and 2, that defines "out-of-home care" as care at the
residence or facility at which a child is placed by the state.
Representative Roses clarified that this definition does not
include every child attending the residential program at Mt.
Edgecumbe High School.
MR. LESMANN said, "That is correct."
3:43:20 PM
REPRESENTATIVE GARDNER added that a child is not placed at Mt.
Edgecumbe, but is accepted or enrolled. She went on to say that
marketing the needs of a child may result in many donations for
that child. In addition, the needs of a child in a small
community may be well known to community members. In those
cases, a child may be over sponsored, and others may be eligible
but not have sponsors. The distribution of donations should be
fair under any circumstances.
MR. LESMANN acknowledged that the details of administering the
program are not fully established. However, if an individual
has an account which is already well endowed, the department
will need to inform the donor.
3:45:45 PM
REPRESENTATIVE FAIRCLOUGH asked whether there are contribution
incentives for the donors.
MR. LYNCH replied that if a contribution is properly made it
would qualify for a federal tax deduction.
3:46:40 PM
REPRESENTATIVE CISSNA observed that many foster children are
placed in the Lower 48 with relatives. She asked whether a
foster child housed outside of Alaska is considered a resident.
MR. LESMANN expressed his understanding that a ward of the state
of Alaska remains a resident, even when placed outside of the
state.
3:47:53 PM
CHAIR WILSON closed public testimony.
3:48:06 PM
REPRESENTATIVE SEATON asked that the sponsor ensure that the
donations can only be used for educational purposes.
[The sponsor indicated his agreement from the gallery.]
REPRESENTATIVE CISSNA asked for confirmation that the sponsor
will contact the Annie E. Casey Foundation.
[The sponsor indicated his agreement from the gallery.]
3:50:17 PM
REPRESENTATIVE FAIRCLOUGH moved to adopt CSHB 135, 25-LS0592\C,
as the working document.
[Although not formally stated, Version C was before the
committee.]
3:50:35 PM
REPRESENTATIVE GARDNER moved to report CSHB 135, Version C, out
of committee with individual recommendations and the
accompanying fiscal notes. There being no objection, CSHB
135(HES) was reported out of the House Health, Education and
Social Services Standing Committee.
HB 178-EMPLOYM'T OF PEOPLE W/ DISABILITIES COM.
3:51:29 PM
CHAIR WILSON announced that the next order of business would be
HOUSE BILL NO. 178, "An Act relating to the Governor's Committee
on Employment of People with Disabilities; and providing for an
effective date."
3:51:32 PM
ROBERT MYERS, Intern to Representative Peggy Wilson, presented
HB 178, on behalf of the sponsor, paraphrasing from a prepared
statement, which read as follows [original punctuation
provided]:
We have brought HB 178 before you as a request from
the Governor's Council on Employment of People with
Disabilities. Congress has changed the requirements
for these committees, and we need to change our
statute to comply in order to continue to receive
federal money for the program. Their budget is 70
percent federal, so this is important to them.
Sections 1 and 5 are for a name change. They add "and
Rehabilitation" to the title of the committee.
Sections 2 through 4 gives the changes required to
bring us into compliance with federal law. These
provisions include allowing for more people on the
council, the selection of committee members as per
federal statute, an elected rather than appointed
chair, and new requirements for meetings.
Section 6 gives the bill an immediate effective date.
3:53:15 PM
REPRESENTATIVE SEATON called the committee's attention to page
2, line 19 and 20, and asked for clarification of the number of
meetings to be attended in person.
CHAIR WILSON responded that one meeting per year will include
all members in person, and the other three meetings will be
teleconferenced.
MR. MYERS affirmed Representative Wilson's interpretation.
3:54:27 PM
REPRESENTATIVE SEATON asked whether there is an enforceable
penalty for non-compliance of attendance requirements by
members.
3:54:56 PM
REPRESENTATIVE GARDNER acknowledged that attendance for any
committee is difficult.
3:55:45 PM
GALE SINNOTT, Director, Statewide Programs, Division of
Vocational Rehabilitation, Department of Labor & Workforce
Development, stated that members are allowed to meet
telephonically three times per year, and meet once face-to-face.
3:56:27 PM
REPRESENTATIVE SEATON offered [Conceptual Amendment 1] for page
2, line 20, and strike the words "all members attend the" and
substitute, after shall, "be a meeting in person."
CHAIR WILSON suggested inserting "shall be a group meeting."
REPRESENTATIVE SEATON noted that the drafters can correct a
conceptual amendment.
3:57:46 PM
REPRESENTATIVE FAIRCLOUGH expressed her opinion that there is a
contradiction. The language could be interpreted to mean that
each member must attend at least one meeting in person.
MS. SINNOTT confirmed that the members meet four times a year,
in fact, it does not specify in federal regulations that members
meet telephonically or face-to-face. She suggested that the
entire sentence be deleted.
CHAIR WILSON stated that if the federal guidelines require one
face-to-face meeting per year this language should stay for
funding purposes.
3:59:07 PM
PAULA SCAVERA, Special Assistant, Office of the Commissioner,
Department of Labor & Workforce Development, stated that
Conceptual Amendment 1 was the original language provided to the
drafters and it was removed. Ms. Scavera said that she informed
the drafters that three meetings could be telephonic, but one
meeting per year should be face-to-face and with a quorum.
4:00:04 PM
CHAIR WILSON objected to Conceptual Amendment 1.
4:00:19 PM
REPRESENTATIVE FAIRCLOUGH remarked:
... there are exceptions where people will not be able
to be at the meeting and so they may designate a
meeting that is, this is the in person meeting, and be
able to offer travel arrangements but the agreement
between the parties that are serving on the committee
is that if they don't make it by chance, they would
show up to a different meeting and be flown in to a
different meeting, if necessary, to meet the one per
... year requirement of face-to-face.
MS. SCAVERA agreed. She then said that this language is in the
meeting section of the bill and not in the composition, or
selection of members, section.
REPRESENTATIVE FAIRCLOUGH remarked:
In, Representative Seaton, that was his specific
point, on trying to drive it differently and so we
interpreted that everyone had to be there. And then
his follow-up question was, "What's the consequence
for not attending?" And that's why I actually pulled
the statute and I don't really see a consequence
inside of [AS] 23.15.
4:01:51 PM
MS. SINNOTT said that there is no consequence in the bill. She
informed the members that each governor's committee has a set of
bylaws for that purpose.
4:02:16 PM
REPRESENTATIVE ROSES offered an amendment to Conceptual
Amendment 1, which read:
Members may participate in quarterly meetings
telephonically, except that one meeting each year
shall be in person.
CHAIR WILSON objected for discussion purposes. She then said:
My interpretation is that there has to be four
meetings a year and the only qualification that one of
them has to be a meeting where everyone is invited to
the same spot. And that's all.
MS. SCAVERA said that Representative Wilson is correct. She
suggested to include "there shall be one public meeting", but
said that the bottom line is that you have to have four meetings
a year and one must be a public meeting with members in
attendance, and the others can be telephonic.
CHAIR WILSON said that "all members" should be removed.
4:04:00 PM
REPRESENTATIVE ROSES explained his amendment to Conceptual
Amendment 1. He said that Representative Seaton's
interpretation is that there are [four] meetings and for one of
the meetings the attempt is made to have all of the members in
the same room. However, Representative Fairclough's
interpretation is that if a member did not participate in the
face-to-face meeting, the member could personally attend a
different meeting. Representative Roses stated that both
interpretations were confirmed by Ms. Scavera.
4:05:00 PM
MS. SCAVERA remarked:
... if we had a public meeting and not all members
were able to attend that public meeting, we would not
have a telephonic meeting and fly one person in and
the rest not. We ... try very hard, give different
dates, to have a public meeting, once a year for this
committee, where all members can attend. And we, it's
a scheduling nightmare, but we try to make that
happen.
4:05:54 PM
REPRESENTATIVE SEATON opined that crossing out the last
"meeting" in line 20 would not be a problem, but taking out "for
at least one" is problematic because the committee may wish to
meet in person more than once.
4:06:38 PM
REPRESENTATIVE ROSES withdrew his amendment to Conceptual
Amendment 1.
4:06:49 PM
MS. SCAVERA suggested taking out the word "all" on line 20.
4:07:07 PM
REPRESENTATIVE GARDNER expressed her understanding that this
committee is being changed from 12 members to the new federal
mandate. Referring to the fiscal note, she asked whether the
committee now has only three members.
CHAIR WILSON clarified that there will be three additional
members.
4:07:44 PM
REPRESENTATIVE CISSNA offered, for discussion, that "a quorum of
members may participate in quarterly meetings telephonically,
except for at least one meeting each year shall be in person."
She added that it is a good idea to always have a quorum.
MS. SINNOTT affirmed that a quorum is needed at all meetings to
conduct business.
4:09:01 PM
MS. SCAVERA stated that Representative Cissna's suggestion would
be an acceptable conceptual amendment.
4:09:20 PM
REPRESENTATIVE SEATON restated Conceptual Amendment 1 that would
read as follows:
Members may participate in quarterly meetings
telephonically except for at least one meeting each
year shall be a meeting in person.
4:09:52 PM
REPRESENTATIVE FAIRCLOUGH said that she would be voting against
Conceptual Amendment 1 due to the fact that the attorneys at
Legislative Legal and Research have already removed that
language.
4:10:17 PM
CHAIR WILSON observed that the drafters could be instructed to
follow the committee's direction.
4:10:38 PM
REPRESENTATIVE NEUMAN pointed out that the governor will be
notified if a member is not attending appropriately, and that
would make the language in the bill applicable.
4:11:39 PM
MS. SINNOTT stated that the federal guidelines require the
employment committee to meet four times per year, but not all
members have to meet four times per year. She agreed that "all"
should be removed.
4:12:17 PM
REPRESENTATIVE GARDNER expressed her belief that the language
needs to be clarified by the drafters.
4:12:56 PM
MS. SCAVERA offered to work with the chair's staff and the
drafters to correct the language.
4:13:23 PM
REPRESENTATIVE CISSNA asked for the next committee of referral.
4:13:34 PM
CHAIR WILSON responded that the next committee of referral is
the House Finance Committee.
4:14:06 PM
REPRESENTATIVE ROSES recommended that the bill be moved out of
committee.
CHAIR WILSON recalled that there is an amendment to consider.
4:14:19 PM
REPRESENTATIVE CISSNA asked whether the committee bylaws will
address the question of the number of required meetings.
MS. SINNOTT replied no. She further advised that the retention
of members is not a part of state statute or federal regulation,
but is addressed in the committee bylaws.
4:15:03 PM
REPRESENTATIVE SEATON reminded the committee that the amendment
is conceptual and that the chair's staff is aware of its intent.
CHAIR WILSON removed her objection. There being no further
objection, Conceptual Amendment 1 was adopted.
4:15:21 PM
REPRESENTATIVE ROSES moved to report HB 178, as amended, out of
committee with individual recommendations and the accompanying
fiscal notes.
4:15:45 PM
REPRESENTATIVE FAIRCLOUGH objected to Conceptual Amendment 1.
REPRESENTATIVE ROSES withdrew the motion to report HB 178, as
amended, from committee.
4:16:09 PM
CHAIR WILSON called for a roll call vote.
REPRESENTATIVE GARDNER asked for a reading of the amendment.
REPRESENTATIVE SEATON re-read Conceptual Amendment 1 as follows:
Members may participate in quarterly meetings
telephonically except that at least one meeting each
year shall be a meeting in person.
4:16:42 PM
REPRESENTATIVE CISSNA asked for discussion of the objection.
4:16:51 PM
REPRESENTATIVE FAIRCLOUGH restated that the original language is
correct.
4:17:31 PM
A roll call vote was taken. Representatives Seaton, Cissna,
Gardner, Roses, and Wilson voted in favor of Conceptual
Amendment 1. Representatives Fairclough and Neuman voted
against it. Therefore, Conceptual Amendment 1 passed by a vote
of 5-2.
4:18:08 PM
REPRESENTATIVE ROSES moved to report HB 178, as amended, out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSHB 178(HES), was
reported out of the House Health, Education and Social Services
Standing Committee.
HB 113-OPTOMETRISTS' USE OF PHARMACEUTICALS
4:18:46 PM
CHAIR WILSON announced that the final order of business would be
HOUSE BILL NO. 113, "An Act relating to the prescription and use
of pharmaceutical agents, including controlled substances, by
optometrists."
4:19:16 PM
REPRESENTATIVE NEUMAN moved to adopt CSHB 113, Version 25-
LS0411\K, Bullard, 3/5/07. There being no objection, Version K
was before the committee.
4:19:35 PM
REPRESENTATIVE RALPH SAMUELS, Alaska State Legislature, speaking
as the prime sponsor, paraphrased from the sponsor statement,
which read as follows [original punctuation provided]:
House Bill 113 would allow optometrists to prescribe
systemic (oral) medication to treat a patient's eyes
or for an allergic shock reaction. Currently Alaskan
optometrists are limited to prescribing only topical
medications, while optometrists in 45 states, the
District of Columbia and Guam are able to prescribe
systemic (oral) medications.
The course of study that optometrists undergo is
comparable or exceeds that required of their peers in
the health care professionals who are already granted
the ability to prescribe medications. Optometry
programs include several semesters of pharmacology, in
addition to studies in human anatomy, physiology, and
biochemistry. Optometrists, like dentists and
podiatrists, attend four years of graduate school
after receiving their undergraduate degree, while
nurse practitioners and physicians assistants only
complete two years of graduate school. Yet of these
professions, only optometrists are limited to
prescribing topical agents.
Regulations are already in place to ensure that only
qualified optometrists may prescribe systemic
medications. Optometrists must pass an exam, such as
the "Treatment and Management of Ocular Disease" from
the National Board of Examiners in Optometry, and must
show that they have completed the necessary continuing
education in pharmacology each year in order to
prescribe any medications authorized under statute.
Increasing optometrists' prescribing authority will be
of benefit to Alaskan patients, preventing those who
require oral or inject-able prescriptions from having
to visit a general practitioner in addition to their
regular optometrist. This will save patients time and
money, and allow optometrists greater participation in
their patients' care.
REPRESENTATIVE SAMUELS cautioned the committee that it will hear
much testimony that may not support the bill; however, it is
important and necessary.
4:21:36 PM
CHAIR WILSON clarified that this bill will enable optometrists
to treat anaphylactic reaction and other conditions.
REPRESENTATIVE SAMUELS said that HB 113 is especially for the
benefit of rural Alaskans, and these services are commonly
performed across the country in less rural areas.
4:22:44 PM
REPRESENTATIVE GARDNER asked how many communities in Alaska have
an optometrist, but do not have an ophthalmologist or a
physician.
REPRESENTATIVE SAMUELS answered that there are twenty
ophthalmologists in six locations, and one hundred and nine
optometrists in eighty-five locations.
4:24:02 PM
REPRESENTATIVE CISSNA asked how many optometrists are located on
the road system.
REPRESENTATIVE SAMUELS deferred answering her question to his
staff.
4:24:48 PM
CHAIR WILSON requested a description of Version K.
4:24:58 PM
SYDNEY MORGAN, Staff to Representative Ralph Samuels, Alaska
State Legislature, prime sponsor, explained that Version K
specifies the scope of the prescriptive authority and
educational requirements. She said that additions in Sec. 1
clarify that the endorsement allows the prescription of
pharmaceutical agents if the applicant passes the exam on ocular
pharmacology, completes 23 hours in an approved non-topical
therapeutic pharmaceutical agent course, and completes seven
hours in an injections course. She continued to say that a new
subsection is included in Sec. 2, that adds endorsement renewal
requirements of eight hours of continuing education concerning
the use and prescription of pharmaceutical agents, seven hours
of continuing education concerning injections, and other board
requirements. In addition, new language in Sec. 3 defines what
controlled substance the endorsement allows the licensee to
prescribe. An allowable controlled substance is prescribed and
used for the treatment of ocular disease or conditions, ocular
adnexal disease or conditions, or emergency anaphylaxis; is not
a schedule 1, 2, or 6 drug; is not prescribed for more that four
days of use; is not injected into the eyeball. In addition, the
licensee must have a physician-patient relationship and a Drug
Enforcement Administration (DEA) registration number.
4:28:17 PM
REPRESENTATIVE FAIRCLOUGH asked for a definition of a physician-
patient relationship.
MS. MORGAN expressed her understanding that it would have to do
with the payment for the service and she offered to supply a
clear definition at a later date.
REPRESENTATIVE FAIRCLOUGH referred to page 3, line 5, and asked
for clarification of the term "physician-patient relationship."
She asked whether an optometrist will be considered a physician
in the interpretation of the term.
4:29:59 PM
CHAIR WILSON noted that the bill states, "as defined by the
board in regulation."
4:30:13 PM
MS. MORGAN added that further testimony will be provided on this
subject.
4:30:27 PM
REPRESENTATIVE SEATON asked whether the four-day limit on the
prescription will prevent a patient from completing a course of
antibiotics.
4:31:12 PM
MS. MORGAN offered that optometrists can address the majority of
issues brought before them within the time limit.
4:31:42 PM
CHAIR WILSON pointed out that the four-day limit only pertains
to a controlled substance, such as pain medication, not an
antibiotic. She opined that a patient who needs pain medication
for more than four days will need to be referred to a doctor.
4:32:31 PM
CINDY BRADFORD, Doctor of Ophthalmology, American Academy of
Ophthalmology; Assistant Professor, Dean A. McGee Eye Institute,
Department of Ophthalmology, University of Oklahoma Health
Center, University of Oklahoma, stated her opposition to HB 113.
She informed the committee that she teaches ophthalmology and
eye surgery to internal medicine and family practice resident
medical students. Dr. Bradford stated that HB 113 is an
expansion of what is legal in most of the other states.
Oklahoma allows for the broadest of authority of optometry, and
the Alaska bill will be broader than all but Oklahoma. It is
important, she said, that optometry and ophthalmology work
together to serve the large number of patients. However, this
bill removes the limits of the pharmaceutical rights of
optometry and expands the rights to medications that affect the
entire body. She opined that narcotics are rarely needed for
eye conditions unless a patient has had retinal surgery. These
systemic medications interact with other medications being taken
by a patient and, in fact, factors can be involved on a level
that an optometrist would not be trained to diagnose and
prescribe for the type of treatment that is covered in HB 113.
Dr. Bradford described the training involved for optometry
versus ophthalmology. She concluded by saying that quality care
for patients means that they are treated by professionals who
have been trained to diagnose and prescribe appropriately.
4:40:11 PM
REPRESENTATIVE ROSES asked about drug and drug interaction
training for ophthalmologists.
DR. BRADFORD replied that there is a one year internship
treating patients with many diseases, and supervised by an
attending physician. She reviewed the teaching process
regarding pharmacology.
REPRESENTATIVE ROSES further asked about the percentage of
training time that is dedicated to drug interaction and
pharmaceuticals.
DR. BRADFORD responded that every day of medical school,
students are learning about medications and drugs.
4:42:06 PM
REPRESENTATIVE ROSES asked Dr. Bradford to estimate the time
optometrists spend learning about drug interaction and the use
of the pharmaceuticals that are endorsed by HB 113.
DR. BRADFORD opined that this bill endorses a large group of
systemic pharmaceuticals that affect the entire body, and that
optometrists would never have encountered.
REPRESENTATIVE ROSES restated his question.
DR. BRADFORD emphasized that the medications that this bill
allows are beyond an optometrist's clinical experience.
4:44:21 PM
CHAIR WILSON asked about an ophthalmologist's internship.
DR. BRADFORD answered that, during the one-year internship,
students are not working in the eye clinic but are studying
internal medicine and are managing a variety of patients.
4:46:55 PM
LESLEY L. WALLS, Physician of Optometry, Medicine, and president
of the Southern California College of Optometry, stated his
support for HB 113.
CHAIR WILSON asked for a description of Dr. Walls' medical
training.
DR. WALLS responded that he is a board certified family doctor,
an optometrist, and is a former associate dean of the University
of Oklahoma. He opined that Alaska's optometrists are able to
safely and effectively use the drugs and treatments allowed in
the bill. Dr. Walls said that the four year continuing
education requirement is more than adequate, together with the
four year degree that optometrists hold. He described the
training that optometrists receive and disagreed with the
previous testifier. Dr. Walls assured the committee that, upon
graduation, optometrists have the clinical experience and the
pathological and pharmacological qualifications to manage
patients.
4:51:28 PM
REPRESENTATIVE ROSES asked what percentage of training an
optometrist receives for the dispensing of, and interaction
with, the drugs authorized by HB 113.
DR. WALLS replied that it is difficult to say; however, it is a
major part of every examination. In addition, an optometrist's
clinical experience is with patients who have potential drug
interactions.
4:52:31 PM
REPRESENTATIVE ROSES asked whether Dr. Walls is familiar with
Alaska's licensing exam for optometrists, and whether the test
is adequate to determine the ability of the state optometrists
to administer these drugs.
DR. WALLS, calling on his experience as a Dean of Optometry at
the Southern California College of Optometry, and as a former
member of the National Board of Examiners in Optometry, assured
the committee that it is a rigorous examination. In fact, he
said that he has been involved in the development of training
and testing for the courses of injectable and systemic
medications in other states.
REPRESENTATIVE ROSES asked whether Dr. Walls could compare the
optometrist's and ophthalmologist's state certifications
regarding the use of pharmaceuticals.
DR. WALLS responded that ophthalmologists automatically hold
full prescriptive authority by their state medical license. In
answer to a question, he added that optometrist's licensing
falls under state statute.
4:55:15 PM
REPRESENTATIVE NEUMAN asked what role a pharmacist would play in
dispensing the correct prescription drugs.
DR. WALLS replied that his college recommends to its students
the use of pharmacists as a resource in many areas.
4:56:03 PM
REPRESENTATIVE ROSES asked Dr. Walls to compare Alaska with the
licensing tests in other states that currently allow
optometrists to prescribe pharmaceutical agents.
DR. WALLS responded that Alaska's test will be more rigorous
because it requires more hours of training on injectables;
however, testing on prescribing systemic drugs is similar to
that of other states.
4:56:57 PM
REPRESENTATIVE ROSES asked whether Dr. Wall knew what kind of
insurance and malpractice insurance coverage an optometrist or
ophthalmologist would be required hold.
DR. WALLS informed the committee that malpractice insurance has
not increased in the states that allow optometrists the expanded
responsibilities authorized by HB 113.
4:57:51 PM
REPRESENTATIVE GARDNER asked whether there is a large range of
limitations in the 45 states that allow expanded authority by
optometrists.
DR. WALLS noted that, except for medical and osteopathic
doctorates, individual legislatures set the licensing
requirements. Therefore, there are no identical laws between
states.
4:59:20 PM
REPRESENTATIVE FAIRCLOUGH asked what the major, new
responsibilities are that optometrists are allowed to perform in
various states.
5:00:12 PM
DR. WALLS answered that some states don't allow injections, or
may have restrictions on certain medications.
REPRESENTATIVE FAIRCLOUGH further asked Dr. Walls to compare
Alaska's law with the other 45 states and requested the specific
disparity between the state's regulations.
5:02:10 PM
DR. WALLS referred to information that can be provided by the
American Optometric Association and that describes state by
state prescriptive authority.
5:02:38 PM
MICHAEL BENNETT, Doctor of Optometry; President, Alaska
Optometry Association, informed the committee that he is in
private practice in Juneau. Dr. Bennett said that he received
his education in Michigan and also has research experience.
5:04:59 PM
REPRESENTATIVE GARDNER asked whether his degree is a Doctorate
in Optometry.
DR. BENNETT answered yes. He explained that optometrists have
been recognized as physicians by Medicare and insurance carriers
since the 1970s.
REPRESENTATIVE GARDNER asked whether all optometrists are
doctors.
DR. BENNETT responded yes. He added that there is an
accreditation board for optometry schools. Optometrists attend
four years of medical school, including 200 hours of
pharmacology, plus anatomy and clinical work. Dr. Bennett
continued to say that optometrists, who see many patients, are
the gate keepers to eye care. All day long his patients come in
with multiple health issues. Dr. Bennett said that he makes
frequent contact with his patient's primary care physician. In
response to a question, he explained that his is a standard
practice and his training is similar to others in his field.
CHAIR WILSON observed that all optometric schools require 200
hours of pharmacology. She then asked about undergraduate
requirements.
DR. BENNETT replied that the criterion is an undergraduate
degree, just as though a student was applying to any other
medical school.
CHAIR WILSON confirmed that all optometric schools require four
years of study.
5:09:51 PM
REPRESENTATIVE ROSES asked Dr. Bennett about the percentage of
his patients that have been referred to ophthalmologists for
care.
DR. BENNETT responded that, over the length of his practice,
between 15 to 20 percent have been referred.
5:11:04 PM
REPRESENTATIVE ROSES asked whether the passage of HB 113 will
affect the percentage of referrals.
DR. BENNETT estimated that the change would not decrease the
referrals by one percent. What is primarily addressed in this
bill is the treatment of eyelid infections, and the majority of
these are very minor.
5:12:13 PM
REPRESENTATIVE ROSES questioned whether the passage of this bill
is a way for optometrists to begin to perform laser and
corrective surgery.
DR. BENNETT disagreed.
REPRESENTATIVE ROSES asked whether the passage of this bill will
significantly increase Dr. Bennett's income stream.
DR. BENNETT answered, "I don't think it's going to change my
income stream at all." He explained that a patient is charged
when they are seen, whether they are referred or not. He opined
that HB 113 will result in a small percentage of increased
cases.
5:13:57 PM
REPRESENTATIVE ROSES asked whether Dr. Bennett has any concerns
about patient care if HB 113 passes.
DR. BENNETT empathized with the committee's responsibility to
deal with an unknown entity. However, he opined that the track
record is impeccable for optometrists and the committee should
not have too much concern. The states with similar regulations
that were polled by the Alaska State Medical Board in 2001, do
not have problems to report or an increase in malpractice
insurance cases.
5:16:15 PM
REPRESENTATIVE GARDNER requested a copy of the 2001 survey.
5:17:00 PM
BOB LOESCHER informed the committee that he is a life long
Juneau resident and has traveled extensively in rural Alaska.
Mr. Loescher explained that he is opposed to HB 113. As a
kidney transplant patient and a diabetic, he is under the care
of an ophthalmologist. His sight is lost in one eye, and there
is no regaining what is lost. As a citizen with many eye care
conditions, he urged the committee to consider the importance of
the eyes to patients. His optometrist did tests but, within a
week, his diabetes took his eyesight. The optometrist did not
know about his other medical conditions. Also, he is on
steroids, and a doctor's care is important to manage these types
of drugs. He suggested that the prescription of drugs is of
critical importance and asked the committee to err on the side
of medical doctors and support ophthalmology.
5:23:07 PM
REPRESENTATIVE ROSES commented that this bill has brought
testimony from doctors, but that Mr. Loescher is the first
individual citizen to come forward.
5:23:43 PM
CHAIR WILSON related a personal story of misdiagnosis, and
observed that, regardless of the title, a doctor may or may not
be competent.
5:25:10 PM
JILL GEERING MATHESON, Doctor of Optometry, and chair of the
Alaska State Board of Examiners in Optometry, stated her
personal support for HB 113. She said that the board has not
issued an official position; however, she assured the committee
that if HB 113 passes, the board will cooperate with the
department to pass regulations.
5:26:21 PM
REPRESENTATIVE ROSES repeated his question about optometrists
trying to get approval to perform laser surgery.
DR. GEERING MATHESON answered that laser surgery is not included
in HB 113.
REPRESENTATIVE ROSES asked whether Dr. Geering Matheson's
revenue stream will be increased by the passage of the bill.
DR. GEERING MATHESON said no.
5:27:26 PM
CHAIR WILSON announced that HB 113 would be held over for
further testimony.
5:27:32 PM
REPRESENTATIVE GARDNER asked the sponsor to have the Alaska
State Medical Board provide an opinion on the bill.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 5:27:53 PM.
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