03/25/2010 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB309 | |
| HB361 | |
| HB392 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 309 | TELECONFERENCED | |
| + | HB 361 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 392 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 25, 2010
3:13 p.m.
MEMBERS PRESENT
Representative Bob Herron, Co-Chair
Representative Wes Keller, Co-Chair
Representative Tammie Wilson, Vice Chair
Representative Bob Lynn
Representative Paul Seaton
Representative Lindsey Holmes
MEMBERS ABSENT
Representative Sharon Cissna
COMMITTEE CALENDAR
HOUSE BILL NO. 309
"An Act prohibiting health care insurers that provide dental
care coverage from setting a minimum age for receiving dental
care coverage, allowing those insurers to set a maximum age for
receiving dental care coverage as a dependent, and prohibiting
those insurers from setting fees that a dentist may charge for
dental services not covered under the insurer's policy."
- MOVED CSHB 309(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 361
"An Act requiring 911 dispatchers to be trained in
cardiopulmonary resuscitation; and providing for an effective
date."
- HEARD & HELD
HOUSE BILL NO. 392
"An Act establishing a loan repayment program and employment
incentive program for certain health care professionals employed
in the state; and providing for an effective date."
- MOVED CSHB 392(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 309
SHORT TITLE: DENTAL CARE INSURANCE
SPONSOR(s): REPRESENTATIVE(s) THOMAS
01/19/10 (H) READ THE FIRST TIME - REFERRALS
01/19/10 (H) HSS, FIN
02/11/10 (H) HSS AT 3:00 PM CAPITOL 106
02/11/10 (H) Scheduled But Not Heard
02/23/10 (H) HSS AT 3:00 PM CAPITOL 106
02/23/10 (H) Heard & Held
02/23/10 (H) MINUTE(HSS)
03/09/10 (H) HSS AT 3:00 PM CAPITOL 106
03/09/10 (H) <Bill Hearing Canceled>
03/25/10 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 361
SHORT TITLE: CPR TRAINING FOR 911 DISPATCHERS
SPONSOR(s): REPRESENTATIVE(s) FAIRCLOUGH
02/23/10 (H) READ THE FIRST TIME - REFERRALS
02/23/10 (H) CRA, HSS
03/09/10 (H) CRA AT 8:00 AM BARNES 124
03/09/10 (H) Moved Out of Committee
03/09/10 (H) MINUTE(CRA)
03/10/10 (H) CRA RPT 5NR
03/10/10 (H) NR: GARDNER, KELLER, HARRIS, MUNOZ,
HERRON
03/10/10 (H) FIN REFERRAL ADDED AFTER HSS
03/25/10 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 392
SHORT TITLE: INCENTIVES FOR CERTAIN MEDICAL PROVIDERS
SPONSOR(s): REPRESENTATIVE(s) HERRON
02/23/10 (H) READ THE FIRST TIME - REFERRALS
02/23/10 (H) HSS, FIN
03/18/10 (H) HSS AT 3:00 PM CAPITOL 106
03/18/10 (H) Heard & Held
03/18/10 (H) MINUTE(HSS)
03/23/10 (H) HSS AT 3:00 PM CAPITOL 106
03/23/10 (H) Heard & Held
03/23/10 (H) MINUTE(HSS)
03/25/10 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
CECILE ELLIOTT, Staff
to Representative Bill Thomas
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced the proposed Committee
Substitute (CS) for HB 309, Version C, for the prime sponsor of
the bill, Representative Thomas.
DAVID LOGAN, Dentist
Alaska Dental Society
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions about HB
309.
REED STOOPS, Lobbyist
Aetna
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion on HB
309.
DENNIS BAILEY, Attorney
Legislative Legal Counsel
Legislative Legal and Research Services
Legislative Affairs Agency
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
309.
CHRIS HENRY, Treasurer
Alaska Dental Society
Fairbanks, Alaska
POSITION STATEMENT: Offered to answer questions during
discussion of HB 309.
JIM TOWLE, Executive Director
Alaska Dental Society
Anchorage, Alaska
POSITION STATEMENT: Offered to answer questions during
discussion of HB 309.
CRYSTAL KOENEMAN, Staff
to Representative Anna Fairclough
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 361 for the prime sponsor,
Representative Anna Fairclough.
MICHAEL O'HARE, Deputy Director
Division of Homeland Security/Emergency Management
Department of Military & Veterans' Affairs (DMVA)
Ft. Richardson, Alaska
POSITION STATEMENT: Testified during discussion of HB 361.
SUE STANCLIFF, Special Assistant
Office of the Commissioner
Department of Public Safety (DPS)
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HB 361.
RODNEY DIAL, Lieutenant
Alaska State Troopers
Ketchikan, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
361.
NIKOOSH CARLO, Staff
to Representative Bob Herron
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced the CS for HB 392 for the prime
sponsor, Representative Bob Herron.
DIANE BARRANS, Executive Director
Alaska Commission on Postsecondary Education (ACPE)
Juneau, Alaska
POSITION STATEMENT: Testified during discussion on HB 392.
ACTION NARRATIVE
3:13:35 PM
CO-CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:13 p.m.
Representatives Keller, Herron, Seaton, Lynn, and T. Wilson were
present at the call to order. Representative Holmes arrived as
the meeting was in progress. Representative Cissna was excused.
HB 309-DENTAL CARE INSURANCE
3:13:52 PM
CO-CHAIR KELLER announced that the first order of business would
be HOUSE BILL NO. 309, "An Act prohibiting health care insurers
that provide dental care coverage from setting a minimum age for
receiving dental care coverage, allowing those insurers to set a
maximum age for receiving dental care coverage as a dependent,
and prohibiting those insurers from setting fees that a dentist
may charge for dental services not covered under the insurer's
policy." [In front of the committee was the proposed Committee
Substitute (CS) for HB 309, 26-LS1315\C, Bailey, 3/24/10.]
3:14:38 PM
CECILE ELLIOTT, Staff to Representative Bill Thomas, Alaska
State Legislature, explained that Version C resulted as a
compromise between the dental community, the insurance industry,
and the small business community. She pointed out that the
section regarding age limit had been removed, as it was covered
elsewhere in statute; and the second section, prohibiting fee
capping, was amended to reflect the compromise. She explained
that dentists would now be offered the opportunity to sign
contracts for covered and, if desired, non-covered services.
3:16:25 PM
CO-CHAIR HERRON moved to adopt the proposed Committee Substitute
(CS) for HB 309, 26-LS1315\C, Bailey, 3/24/10, as the working
draft. There being no objection, Version C was before the
committee.
3:16:54 PM
REPRESENTATIVE T. WILSON asked if this affected self insured
policies.
3:17:11 PM
MS. ELLIOTT said that it did not.
REPRESENTATIVE T. WILSON asked if this would only affect small
businesses with policies similar to Blue Cross/ Blue Shield.
MS. ELLIOTT explained that HB 309 referenced preferred provider
contracts. In response to Representative T. Wilson, she
explained that these were contracts negotiated between the
insurance company and the dentist on a fee schedule.
REPRESENTATIVE T. WILSON asked if there was a mechanism for the
self insured to abide by the same rules.
3:18:33 PM
DAVID LOGAN, Dentist, Alaska Dental Society, explained that the
two broad categories of insurance were the traditional indemnity
plans, where the provider billed the insurance company and the
managed plans, which included Preferred Provider Organization
(PPO) plans. He explained that with PPOs, the insurance company
had contracted with dentists to provide services at a set fee
schedule. In response to Representative T. Wilson, he pointed
out that federal legislation regulated the Employee Retirement
Income Security Act of 1974 (ERISA) plans.
3:20:15 PM
REPRESENTATIVE SEATON asked how HB 309 would ensure that the
insurance company notified the insured about the costs charged
by each provider.
MS. ELLIOTT offered her belief that the insurance company would
provide that information to the consumer, but she did not know
how it was provided. She pointed out that the insurance
companies had provided the language for the CS.
3:22:23 PM
REPRESENTATIVE SEATON pointed to the permissive language on page
2, line 15, and noted that this was a change from prior policy
which had required notification to the insured.
CO-CHAIR KELLER re opened public testimony.
REPRESENTATIVE SEATON asked if the new uncapped plan had any
requirement for the dentist to notify the PPO patient that some
fees were no longer capped.
MS. ELLIOTT deferred the question to Dr. David Logan.
3:25:32 PM
DR. LOGAN said that the committee substitute did not stipulate
this, and there was not any statutory requirement for
notification to the insured. He opined that most medical
offices attempted to inform patients about the fee structure for
services.
CO-CHAIR KELLER directed attention to page 2, lines 6 and 10,
and asked for clarification of the phrase "take an action
against the dentist."
DR. LOGAN explained the intent to be that if a dentist signed a
contract for either covered services, or covered and non-covered
services, there would not be a differential in the fee schedule
that would apply to the insured based on the contract. He
reported that there was also language in Version C that the
insurers may differentiate between the types of provider
contract, but not fail to notify the insured that the dentist
has signed a contract.
3:27:41 PM
REED STOOPS, Lobbyist, Aetna, in response to Representative T.
Wilson, said that Linda Hall could best respond to questions
about ERISA. He said that a self insured plan would be exempt
from mandated coverage, and he offered the minimum age
requirement as an example of mandated coverage.
3:29:21 PM
MR. STOOPS, in response to Co-Chair Keller, said that the
employee handbook explains the benefits. Currently, there was
no obligation from the insurer for prior notice. He said that
Version C dictated a change of the current notification
procedure.
3:31:27 PM
REPRESENTATIVE T. WILSON asked about the rate change for small
business.
3:31:49 PM
MR. STOOPS said that the cost of insurance would not change, but
that the cost to the consumer for non-covered service could
change. He suggested asking the dentists if charges would
increase.
3:32:24 PM
REPRESENTATIVE SEATON asked if non-covered services might be
offered at a lower cost than through the insurance fee schedule.
MR. STOOPS replied that a dentist could charge less, but he
opined those costs to be greater, or HB 309 would not be
necessary.
3:33:33 PM
REPRESENTATIVE SEATON directed attention to Version C, page 2,
line 15, and asked if the insurance providers would object to a
change from "may authorize the insurer to provide information to
the insured" to "shall notify the insured." He pointed out that
this notification would include both the list of all covered
fees, and that there was no fee cap for the uncovered services
from the provider.
3:34:18 PM
MR. STOOPS replied that he would research this.
REPRESENTATIVE SEATON opined that these were forward contracts,
and the providers would be listed in the policy handbook. He
asked when the provider list would be updated.
MR. STOOPS said that existing contracts would be affected by HB
309, and that dentists would have the option to opt out of the
non-covered service portions of the contracts, without a new
contract being reissued. He said that it could be an extended
period of time for contracts to be modified, and for new
publications to be distributed.
DR. LOGAN, in response to Mr. Stoops, stated that this did
present a challenge for notification to the consumer, as the
contracts were constantly changing.
3:39:49 PM
CO-CHAIR KELLER asked why this was not occurring with primary
care, as well.
MR. STOOPS offered his belief that it was the dental providers
who had introduced this legislation.
DR. LOGAN, in response to Co-Chair Keller, said that dentists
joined PPOs, which offered care at a discount rate, to fill
otherwise unscheduled office time and to allow an opportunity
for customary service rates to procedures not included under the
insurance plans.
3:42:40 PM
CO-CHAIR KELLER asked if HB 309 would affect current and future
contracts with regard to information distribution to the
consumer.
DENNIS BAILEY, Attorney, Legislative Legal Counsel, Legislative
Legal and Research Services, Legislative Affairs Agency, said
that HB 309 would only apply to new contracts and that this
would be an ongoing process.
3:44:44 PM
REPRESENTATIVE SEATON asked for clarification that providers
could opt out, without renewing the contract.
MR. BAILEY replied that this was not specified in the bill, but
would apply if it was in an existing contract.
3:45:44 PM
REPRESENTATIVE SEATON expressed concern for notification to the
insured that there would now be two types of PPO contracts. He
directed attention to Version C, page 2, line 15, and asked if
the language could change to ensure that the insured would
understand the fees prior to the services.
MR. BAILEY replied that Version C was currently permissive. He
agreed that it was possible to describe the requested
information and state that it was mandatory to provide the
information. He opined that it may already exist in insurance
statute.
3:47:49 PM
REPRESENTATIVE SEATON asked if this could be changed with a
conceptual amendment.
MR. BAILEY agreed that a conceptual amendment for "may" to be
changed to "shall" and to include both the insurer and the
provider was acceptable.
3:49:11 PM
CHRIS HENRY, Treasurer, Alaska Dental Society, said that he had
been following the bill and that he was available to answer any
questions.
3:49:45 PM
JIM TOWLE, Executive Director, Alaska Dental Society, stated
that he was also available to answer any questions.
3:50:27 PM
CO-CHAIR KELLER closed public testimony.
3:50:46 PM
REPRESENTATIVE T. WILSON offered her belief that although both
the insurance industry and the dental providers had come to
agreement, HB 309 was not fair to the self insurers.
3:51:16 PM
CO-CHAIR HERRON moved to adopt Amendment 1, which read:
Page 1, Line 14
After (2)
Insert "not"
REPRESENTATIVE T. WILSON objected for discussion.
MS. ELLIOTT explained that during the changes to the bill, this
was an oversight and the amendment would correct this.
REPRESENTATIVE T. WILSON removed her objection.
There being no objection, Amendment 1 was adopted.
3:52:30 PM
REPRESENTATIVE SEATON moved to adopt Conceptual Amendment 2, as
follows:
Page 2, line 15, following (ii)
Delete "may authorize"
Insert "shall require both";
Following "insurer"
Insert "and the dentist"
REPRESENTATIVE T. WILSON objected for discussion.
REPRESENTATIVE SEATON read the proposed line 15:
(ii) shall require both the insurer and the dentist to
provide information to the insured describing the
dentist's choice of contract and fee schedules;
3:53:29 PM
MS. ELLIOTT, in response to Representative T. Wilson, said that
the sponsor was neutral on Conceptual Amendment 2 and would
defer to the will of the committee.
3:53:51 PM
REPRESENTATIVE HOLMES asked to clarify if the costs would be
increased.
MS. ELLIOTT said that she did not know.
3:54:46 PM
CO-CHAIR KELLER opened public testimony.
MS. ELLIOTT asked to clarify proposed Conceptual Amendment 2.
REPRESENTATIVE SEATON restated proposed Conceptual Amendment 2,
as follows:
(ii) shall require both the insurer and the dentist to
provide information to the insured describing the
dentist's choice of contract and fee schedules;
3:55:45 PM
DR. LOGAN, in response to Representative Holmes, said that
Conceptual Amendment 2 would not increase dental rates.
3:56:28 PM
DR. LOGAN, in response to Representative T. Wilson, offered his
belief that Conceptual Amendment 2 would inform the insured
whether the contract was for covered services only, or for
covered and non-covered services. He noted that the fee
schedule for non covered services would also be provided.
REPRESENTATIVE T. WILSON asked if the entire fee schedule would
need to be revealed.
DR. LOGAN replied that the contract for the covered fee schedule
was with the insurance company. He opined that the provider
would show the fees not included in the negotiated fee schedule.
3:58:13 PM
REPRESENTATIVE SEATON clarified that he had only modified the
language from the dentists and the insured community. He stated
his intention to be for the insured person to know the cost for
service.
3:59:08 PM
CO-CHAIR KELLER closed public testimony.
3:59:26 PM
REPRESENTATIVE T. WILSON removed her objection to Conceptual
Amendment 2.
There being no further objection, Conceptual Amendment 2 was
adopted.
4:00:04 PM
REPRESENTATIVE SEATON relayed that he was uncomfortable with
this as a procedure as it could raise costs for individuals. He
stated that he did not want to have this procedure expanded to
include other medical fields.
4:00:50 PM
CO-CHAIR KELLER pointed out that new federal legislation may
make some changes to this bill.
4:01:38 PM
REPRESENTATIVE LYNN asked if dental service was covered under
the federal health care bill.
CHAIR KELLER said that he did not know.
The committee took a brief at-ease.
4:02:44 PM
REPRESENTATIVE T. WILSON moved to report CSHB 309, 26-LS1315\C,
Bailey, 3/24/10, as amended, out of committee with individual
recommendations and the accompanying fiscal notes.
There being no objection, CSHB 309 (HSS) was forwarded from the
House Health and Social Services Standing Committee.
4:03:21 PM
HB 361-CPR TRAINING FOR 911 DISPATCHERS
4:03:30 PM
CO-CHAIR KELLER announced that the next order of business would
be HOUSE BILL NO. 361, "An Act requiring 911 dispatchers to be
trained in cardiopulmonary resuscitation; and providing for an
effective date." [In front of the committee was the proposed
committee substitute (CS) for HB 361, 26-LS1478\R,
Luckhaupt/Mischel, 3/11/10.]
CRYSTAL KOENEMAN, Staff to Representative Anna Fairclough,
Alaska State Legislature, explained that HB 361 was an act
requiring that 911 dispatchers be trained in cardiopulmonary
resuscitation (CPR). She offered her belief that this was an
important step as Alaska was one of only 18 states which did not
mandate this.
4:04:49 PM
CO-CHAIR HERRON moved to adopt the proposed committee substitute
(CS) for HB 361, 26-LS1478\R, Luckhaupt/Mischel, 3/11/10, as the
working document. There being no objection, Version R was
before the committee.
MS. KOENEMAN explained that the 911 coordinator was currently a
position within the Department of Military & Veterans' Affairs
(DMVA), and it was suggested the coordinator position should be
moved to the Department of Public Safety (DPS).
4:06:01 PM
REPRESENTATIVE T. WILSON asked if it would be necessary to have
a person certified in CPR in each bush Alaska community.
4:06:21 PM
MS. KOENEMAN replied that most municipalities had dispatchers
trained as emergency medical dispatchers, which included CPR.
She acknowledged that bush dispatchers would be required to
receive CPR training and that CPR certification was available
online.
4:07:43 PM
REPRESENTATIVE T. WILSON questioned the value of an online CPR
training and certification.
MS. KOENEMAN said that the 911 coordinator would facilitate and
monitor the CPR training.
REPRESENTATIVE T. WILSON asked how many communities needed the
CPR certification for its dispatchers.
MS. KOENEMAN said that it was difficult to get the exact
information.
4:09:15 PM
REPRESENTATIVE SEATON reported that CPR no longer included
airway breathing, and was now only "100 beats per minute." He
asked if this CPR adaptation would affect the wording in the
proposed bill and that the bill might be mandating something
that was no longer recommended.
4:10:15 PM
MS. KOENEMAN noted that she was aware of the new chest pump
protocol and she suggested that DMVA or DPS might have more
information.
4:10:52 PM
REPRESENTATIVE T. WILSON asked if there was a fiscal note.
MS. KOENEMAN replied that a new fiscal note was forthcoming from
DPS. She pointed out that the bill did have a referral to the
House Finance Committee.
4:11:33 PM
CO-CHAIR KELLER suggested forwarding the bill to the House
Finance Committee.
4:12:06 PM
REPRESENTATIVE LYNN asked about the pros and cons for moving the
911 coordinator position within departments.
4:12:26 PM
MS. KOENEMAN replied that neither department had objected. She
opined that DMVA had initially received federal funding for the
position. In response to Representative Lynn, she said the
decision came through discussions with both the departments.
4:13:40 PM
MICHAEL O'HARE, Deputy Director, Division of Homeland
Security/Emergency Management, Department of Military &
Veterans' Affairs (DMVA), explained that the position had been
created at the end of 2004 for emergency communications as DMVA
had responsibility for emergency communications during a
catastrophic disaster. He explained that the day to day 911
system should belong in the Department of Public Safety (DPS),
and as defined in statute, it was not appropriate within DMVA.
4:15:37 PM
REPRESENTATIVE HOLMES asked if the position description in HB
361 was the same as currently in DMVA.
MR. O'HARE agreed. In response to Representative Seaton, he
said that CPR was still the current requirement, but that upon
recertification, the protocol would be for chest pumps.
REPRESENTATIVE SEATON expressed his concern for the use of the
term CPR in statute, as it was no longer recommended.
MR. O'HARE offered his belief that the term, CPR, reflected a
current technique. He agreed that should the term be changed,
then the statute would also have to change.
4:17:42 PM
REPRESENTATIVE SEATON reflected on a need to use the correct
term in statute.
CO-CHAIR KELLER agreed, and shared an anecdote about an
acquaintance who had recently trained with the chest pump
technique although the certification was still for CPR.
4:18:23 PM
SUE STANCLIFF, Special Assistant, Office of the Commissioner,
Department of Public Safety, noted that there were two parts to
the bill: CPR and the departmental transfer of the 911
coordinator. She said that a poll to the statewide agencies had
revealed that the majority required CPR, while many offered even
more extensive training. She reported that DPS left the
determination for CPR with the dispatch commanders, but that HB
361 would now require CPR. She offered her support for CPR and
additional training. Addressing the transfer of the 911
coordinator to DPS, she stated that as DPS did not currently
have this position, it would require hiring a position within
the Alaska State Troopers. She explained the additional duties
for this position. She reflected that a fiscal note would be
forthcoming.
4:23:12 PM
REPRESENTATIVE T. WILSON asked how many communities did not
require CPR.
MS. STANCLIFF replied that no communities were required to have
CPR certification. In response to Representative T. Wilson, she
said that some communities, such as Anchorage and Fairbanks, had
a municipal ordinance for CPR certification.
REPRESENTATIVE T. WILSON asked if this was a problem in some
communities and she asked if the coordinator would need to
travel to the bush communities. She questioned whether this
would be a burden to the rural communities.
MS. STANCLIFF said that six police chiefs had responded to a DPS
poll that they were already requiring CPR certification.
REPRESENTATIVE T. WILSON asked if Alaska State Troopers and
Village Public Safety Officers (VPSO) were required to have CPR
certification.
MS. STANCLIFF replied that this was part of the training.
4:25:57 PM
CO-CHAIR HERRON asked why the 911 coordinator duties could not
be assigned to an existing position.
MS. STANCLIFF replied that DPS would not accept a statutory
position without doing it correctly. She said that the search
and rescue coordination, the emergency response, and the
emergency calls in conjunction with DMVA all required training.
She opined that the 911 coordinator would not be limited to CPR
training. She pointed out that the job description would be
based on the requirements listed in the statute.
4:27:30 PM
CO-CHAIR HERRON expressed concern for an additional position to
be created for the 911 coordinator.
MS. STANCLIFF, in response, said that the DPS would not take the
job responsibility lightly.
CO-CHAIR HERRON asked if there was lateral funding from DMVA.
4:29:27 PM
MR. O'HARE explained that, in 2004, this position was an
unfunded mandate which DMVA had since been attempting to move to
another department. He explained that the 911 coordinator
position was in conjunction with the Alaska Land Mobile Radio
system, which had since been moved to Department of
Administration (DOA). He explained that, although the statute
was with DMVA, the coordination was with DOA and the Network
Security Officer. He said that HB 361 would add more
responsibility, which would require the position to be full
time.
4:31:44 PM
REPRESENTATIVE T. WILSON asked for the current coordinator
duties.
MR. O'HARE explained that the 911 coordinator identified the
statewide 911 dispatchers, and researched the technologies to
enhance 911 statewide for approval by the legislature. The new
job description would include coordination of the statewide 911
dispatchers for other required responsibilities.
4:32:40 PM
REPRESENTATIVE T. WILSON asked which communities this would
impact and if this was a positive impact.
4:34:35 PM
RODNEY DIAL, Lieutenant, Alaska State Troopers, in response to
Representative T. Wilson, said that there were very few small
dispatch centers, and that this would not affect any of them.
He reported that it would have more impact on hub facilities in
bush communities, the majority of which were state trooper
facilities. He said that the Alaska State Troopers did require
CPR and it was also taught on a departmental level as time
permitted.
4:35:31 PM
REPRESENTATIVE T. WILSON asked what community this would impact.
LT. DIAL replied that he could not think of a community that
would be negatively impacted. He opined that most communities
were offering emergency medical dispatch training to the
dispatchers. He mentioned that providing CPR instructions over
the phone was different than performing CPR, and he did not know
if there would be a phone certification. He opined that it may
be necessary for a CPR instructor certification, instead.
4:37:04 PM
REPRESENTATIVE SEATON directed attention to page 2, line 5 which
stated that "a municipality shall require that emergency
dispatchers on the 911 system be trained and currently
certified..." He asked if this applied to DPS.
LT. DIAL said that he had not yet received a response from the
Department of Law (DOL).
REPRESENTATIVE SEATON pointed out that the bill language did not
mention instruction, and he asked Lt. Dial if the language
should be amended to include instruction.
LT. DIAL replied that if dispatchers were only trained in basic
CPR, they may not be qualified to give CPR instruction over the
telephone. He referred to an earlier response by the American
Heart Association.
4:39:35 PM
MS. KOENEMAN, in response to Representative T. Wilson, clarified
that municipalities were not required, but had chosen to train
emergency medical dispatchers. She recognized the concern for
CPR instruction over the phone versus the individual
certification for CPR. She noted that this would be worked out
with the DPS, the dispatchers, and the new 911 coordinator for
the best direction.
4:41:39 PM
CO-CHAIR KELLER closed public testimony.
[HB 361 was held over.]
HB 392-INCENTIVES FOR CERTAIN MEDICAL PROVIDERS
4:42:10 PM
CO-CHAIR KELLER announced that the final order of business be
HOUSE BILL NO. 392, "An Act establishing a loan repayment
program and employment incentive program for certain health care
professionals employed in the state; and providing for an
effective date."
4:42:28 PM
CO-CHAIR HERRON moved to adopt proposed committee substitute
(CS) for HB 392, 26-LS1528\S, Mischel, 3/17/10 as the working
draft.
4:42:46 PM
REPRESENTATIVE SEATON objected for discussion.
4:42:57 PM
NIKOOSH CARLO, Staff to Representative Bob Herron, Alaska State
Legislature, explained that the change to Version S was on page
5, line 15, and it inserted "to not fewer than three
participants employed in very hard-to-fill positions."
DR. CARLO explained that HB 392 created an incentive program and
loan repayment program within Department of Health and Social
Services.
4:46:19 PM
DR. CARLO, in response to a questions about the earlier Version
E, explained that on page 5, line 12, "continuing participant"
had been inadvertently deleted.
The committee took an at-ease from 4:46 p.m. to 4:47 p.m.
4:47:50 PM
REPRESENTATIVE T. WILSON asked for a definition of "hard-to-
fill."
DR. CARLO replied that this definition would be worked out in
regulations.
4:48:30 PM
CO-CHAIR KELLER asked for the determination of "hard-to-fill."
DIANE BARRANS, Executive Director, Alaska Commission on
Postsecondary Education (ACPE), replied that this would be
determined by Department of Health and Social Services.
4:49:02 PM
REPRESENTATIVE SEATON asked about the duration for loan
repayments to the Washington, Wyoming, Alaska, Montana, and
Idaho (WWAMI) graduate medical education program. He commented
that HB 392 had a six year loan repayment program, and he asked
if there were any other programs of that duration.
4:49:38 PM
MS. BARRANS replied that the two WWAMI repayment terms were
three years for underserved areas and five years for urban
areas. She said that it was important to distinguish the
fundamental structure of WWAMI. She explained that the
agreement was entered into when students entered the first year
of the graduate medical program, and the funds were paid
directly to the University of Washington School of Medicine.
She pointed out that if a graduate did not return to Alaska to
practice, the service agreement would convert into a loan with
active repayment. She said that there was not a similar, active
program. She explained that there was a small teacher education
loan with a similar structure to WWAMI. She pointed out that
this proposed program could be paid off after three years of
service, depending on the amount of debt.
4:52:01 PM
REPRESENTATIVE SEATON questioned that if the proposed program
was for any student loans, was it necessary to make direct
payment to the loan holder, other than an Alaskan state loan, or
just make the payment to the student.
4:53:05 PM
MS. BARRANS said that this program had evolved over the years,
and that it was only recently that the direct incentive of cash
payment was included. She opined that the loan repayment
language could be vestigial and that some groups believed the
student loan payment to be duplicative.
4:54:04 PM
REPRESENTATIVE SEATON asked if the reference could just be to
the Alaska student loan program.
MS. BARRANS offered her belief that this would be a different
objective from the original program. She explained that the
broad education loan eligibility was to allow recruitment from
out of state. She said that a change might limit the
participation.
4:55:22 PM
REPRESENTATIVE SEATON offered his belief that this change would
make it easier administratively, and he did not see "any
downsides."
4:56:05 PM
CO-CHAIR KELLER allowed that this would be the sponsor's
decision.
REPRESENTATIVE T. WILSON offered her support and stated that the
doctor shortage was only going to worsen.
4:56:53 PM
CO-CHAIR HERRON, as the prime sponsor of HB 392, expressed
agreement with Representative Seaton.
4:58:04 PM
REPRESENTATIVE SEATON suggested that a conceptual amendment
would streamline the bill.
CO-CHAIR HERRON asked if the conceptual agreement was for
another means to administer the loan program.
4:59:30 PM
REPRESENTATIVE SEATON moved to adopt Conceptual Amendment 1,
which he explained would only limit the loan repayment be used
for Alaska state issue loans, with the remainder of the same
amount to now be paid by direct incentive.
5:00:02 PM
REPRESENTATIVE T. WILSON objected for discussion. She expressed
concern that this would limit the participation.
REPRESENTATIVE HOLMES also objected for discussion. She stated
her agreement with the intent to simplify the paperwork and
lower the administrative cost. She expressed concern with any
unforeseen consequences by somehow "skewing who is eligible to
receive the money."
5:01:33 PM
REPRESENTATIVE SEATON replied that the intent was for repayment
to Alaska state loans, with the cap to remain the same.
5:02:09 PM
REPRESENTATIVE T. WILSON removed her objection.
REPRESENTATIVE HOLMES removed her objection.
5:02:24 PM
DR. CARLO emphasized that an applicant was eligible for the
program whether or not they had any loans.
5:02:40 PM
There being no objection, Conceptual Amendment 1 was adopted.
REPRESENTATIVE HOLMES expressed her support for HB 392.
5:03:29 PM
CO-CHAIR KELLER stated his discomfort with the necessity to
subsidize the salaries of these professionals, and he opined
that government rate regulation had removed any incentives for
practice. He reiterated that the current federal health care
legislation could make it necessary to re-visit this bill.
[Version S was adopted as the working draft.]
5:05:06 PM
REPRESENTATIVE T. WILSON moved to report proposed committee
substitute (CS) for HB 392, 26-LS1528\S, Mischel, 3/17/10, as
amended, out of committee with individual recommendations and
the accompanying fiscal notes. There being no objection, CSHB
392 (HSS) was forwarded from the House Health and Social
Services Standing Committee.
5:05:49 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:05 p.m.
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