Legislature(2005 - 2006)CAPITOL 120

04/11/2005 01:00 PM JUDICIARY

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
<Bill Hearing Postponed to 4/12>
Heard & Held
<Bill Hearing Rescheduled to 4/13>
Moved Out of Committee
Heard & Held
<Bill Hearing Rescheduled to 4/12>
Bills Previously Heard/Scheduled
Moved CSHB 12(JUD) Out of Committee
Moved CSSB 105(L&C) Out of Committee
Scheduled But Not Heard
                    ALASKA STATE LEGISLATURE                                                                                  
               HOUSE JUDICIARY STANDING COMMITTEE                                                                             
                         April 11, 2005                                                                                         
                           1:14 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Representative Lesil McGuire, Chair                                                                                             
Representative Tom Anderson                                                                                                     
Representative John Coghill                                                                                                     
Representative Nancy Dahlstrom                                                                                                  
Representative Pete Kott                                                                                                        
Representative Les Gara                                                                                                         
Representative Max Gruenberg                                                                                                    
MEMBERS ABSENT                                                                                                                
All members present                                                                                                             
OTHER LEGISLATORS PRESENT                                                                                                     
Senator Ralph Seekins                                                                                                           
COMMITTEE CALENDAR                                                                                                            
HOUSE BILL NO. 14                                                                                                               
"An Act relating to disclosure of information about a child or a                                                                
child's family to a legislator or a member of a legislator's                                                                    
staff; and making conforming changes."                                                                                          
     - HEARD AND HELD                                                                                                           
HOUSE BILL NO. 12                                                                                                               
"An Act relating to televisions and monitors in motor vehicles."                                                                
     - MOVED CSHB 12(JUD) OUT OF COMMITTEE                                                                                      
CS FOR SENATE BILL NO. 105(L&C)                                                                                                 
"An Act relating to the retrospective application and                                                                           
applicability of the overtime compensation exemption for flight                                                                 
crew members; and providing for an effective date."                                                                             
     - MOVED CSSB 105(L&C) OUT OF COMMITTEE                                                                                     
HOUSE JOINT RESOLUTION NO. 9                                                                                                    
Urging the United States Congress to honor the process and                                                                      
judgment of the federal courts in the case of the Exxon Valdez                                                                  
disaster  and to  refrain from  enacting  legislation that  would                                                               
affect the outcome of the courts' resolution of the case.                                                                       
     - MOVED HJR 9 OUT OF COMMITTEE                                                                                             
HOUSE BILL NO. 150                                                                                                              
"An   Act  requiring   licensure  of   occupations  relating   to                                                               
radiologic  technology, radiation  therapy, and  nuclear medicine                                                               
technology; and providing for an effective date."                                                                               
     - HEARD AND HELD                                                                                                           
HOUSE BILL NO. 96                                                                                                               
"An   Act  making   findings  relating   to  marijuana   use  and                                                               
possession;  relating to  marijuana  and  misconduct involving  a                                                               
controlled substance; and providing for an effective date."                                                                     
     - SCHEDULED BUT NOT HEARD                                                                                                  
HOUSE BILL NO. 246                                                                                                              
"An  Act requiring  a  member to  opt into  a  class action;  and                                                               
amending Rule 23(c), Alaska Rules of Civil Procedure."                                                                          
     - BILL HEARING POSTPONED TO 4/12/05                                                                                        
HOUSE BILL NO. 257                                                                                                              
"An Act relating  to a procurement and  electronic commerce tools                                                               
program  for  state  departments  and  instrumentalities  of  the                                                               
state; and providing for an effective date."                                                                                    
     - BILL HEARING POSTPONED TO 4/13/05                                                                                        
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 53                                                                                        
"An  Act relating  to child-in-need-of-aid  proceedings; amending                                                               
the construction  of statutes pertaining  to children in  need of                                                               
aid; relating  to a  duty and  standard of  care for  services to                                                               
children and families, to  the confidentiality of investigations,                                                               
court  hearings, and  public agency  records  and information  in                                                               
child-in-need-of-aid   matters  and   certain  child   protection                                                               
matters,  to  immunity  regarding disclosure  of  information  in                                                               
child-in-  need-of-aid  matters   and  certain  child  protection                                                               
matters, to the retention of certain  privileges of a parent in a                                                               
relinquishment   and   termination   of  a   parent   and   child                                                               
relationship  proceeding,  to   eligibility  for  permanent  fund                                                               
dividends for certain  children in the custody of  the state, and                                                               
to juvenile delinquency  proceedings and placements; establishing                                                               
a right  to a  trial by  jury in  termination of  parental rights                                                               
proceedings;  reestablishing  and  relating  to  state  citizens'                                                               
review panels  for certain child protection  and custody matters;                                                               
amending the duty  to disclose information pertaining  to a child                                                               
in need of aid; authorizing  additional family members to consent                                                               
to  disclosure of  confidential or  privileged information  about                                                               
children and  families involved  with children's  services within                                                               
the Department  of Health  and Social  Services to  officials for                                                               
review  or use  in official  capacities; relating  to reports  of                                                               
harm and  to adoptions  and foster  care; mandating  reporting of                                                               
the  medication of  children in  state  custody; prescribing  the                                                               
rights of grandparents related  to child-in-need-of-aid cases and                                                               
establishing  a  grandparent  priority for  adoption  in  certain                                                               
child-in-need-of-aid  cases;  modifying  adoption  and  placement                                                               
procedures  in   certain  child-in-need-of-aid   cases;  amending                                                               
treatment service requirements for  parents involved in child-in-                                                               
need-of-aid  proceedings;   amending  Rules  9  and   13,  Alaska                                                               
Adoption Rules;  amending Rules  3, 18, and  22, Alaska  Child in                                                               
Need of  Aid Rules of  Procedure; and providing for  an effective                                                               
     - BILL HEARING POSTPONED TO 4/12/05                                                                                        
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: HB  14                                                                                                                  
SHORT TITLE: DISCLOSURES BY FOSTER PARENTS                                                                                      
SPONSOR(S): REPRESENTATIVE(S) ROKEBERG                                                                                          
01/10/05       (H)       PREFILE RELEASED 12/30/04                                                                              
01/10/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/10/05       (H)       HES, JUD                                                                                               
03/31/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
03/31/05       (H)       Scheduled But Not Heard                                                                                
04/05/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
04/05/05       (H)       Moved CSHB 14(HES) Out of Committee                                                                    
04/05/05       (H)       MINUTE(HES)                                                                                            
04/06/05       (H)       HES RPT CS(HES) NT 6DP                                                                                 
04/06/05       (H)       DP: CISSNA, GARDNER, KOHRING, MCGUIRE,                                                                 
                         SEATON, WILSON                                                                                         
04/11/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
BILL: HB  12                                                                                                                  
SHORT TITLE: TVS AND MONITORS IN MOTOR VEHICLES                                                                                 
SPONSOR(S): REPRESENTATIVE(S) GRUENBERG, LYNN, GARDNER, MCGUIRE                                                                 
01/10/05       (H)       PREFILE RELEASED 12/30/04                                                                              
01/10/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/10/05       (H)       STA, JUD, FIN                                                                                          
03/01/05       (H)       STA AT 8:00 AM CAPITOL 106                                                                             
03/01/05       (H)       Scheduled But Not Heard                                                                                
03/05/05       (H)       STA AT 9:30 AM CAPITOL 106                                                                             
03/05/05       (H)       Heard & Held                                                                                           
03/05/05       (H)       MINUTE(STA)                                                                                            
03/17/05       (H)       STA AT 8:00 AM CAPITOL 106                                                                             
03/17/05       (H)       Moved CSHB 12(STA) Out of Committee                                                                    
03/17/05       (H)       MINUTE(STA)                                                                                            
03/18/05       (H)       STA RPT CS(STA) NT 6DP                                                                                 
03/18/05       (H)       DP: GARDNER, LYNN, GATTO, GRUENBERG,                                                                   
                         ELKINS, SEATON                                                                                         
04/01/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
04/01/05       (H)       Heard & Held                                                                                           
04/01/05       (H)       MINUTE(JUD)                                                                                            
04/04/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
04/04/05       (H)       -- Meeting Canceled --                                                                                 
04/06/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
04/06/05       (H)       Heard & Held                                                                                           
04/06/05       (H)       MINUTE(JUD)                                                                                            
04/08/05       (H)       JUD AT 8:00 AM CAPITOL 120                                                                             
04/08/05       (H)       Bill Postponed To 4/11                                                                                 
04/11/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
BILL: SB 105                                                                                                                  
SHORT TITLE: OVERTIME WAGES FOR FLIGHT CREW                                                                                     
SPONSOR(S): SENATOR(S) SEEKINS                                                                                                  
02/14/05       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/14/05       (S)       L&C, JUD                                                                                               
02/22/05       (S)       L&C AT 1:30 PM BELTZ 211                                                                               
02/22/05       (S)       Heard & Held                                                                                           
02/22/05       (S)       MINUTE(L&C)                                                                                            
03/01/05       (S)       L&C AT 1:30 PM BELTZ 211                                                                               
03/01/05       (S)       Moved CSSB 105(L&C) Out of Committee                                                                   
03/01/05       (S)       MINUTE(L&C)                                                                                            
03/02/05       (S)       L&C RPT CS  3DP 1AM  SAME TITLE                                                                        
03/02/05       (S)       DP: BUNDE, SEEKINS, STEVENS B                                                                          
03/02/05       (S)       AM: ELLIS                                                                                              
03/09/05       (S)       JUD AT 8:30 AM BUTROVICH 205                                                                           
03/09/05       (S)       Moved CSSB 105(L&C) Out of Committee                                                                   
03/09/05       (S)       MINUTE(JUD)                                                                                            
03/09/05       (S)       JUD RPT CS(L&C)  2DP 2NR                                                                               
03/09/05       (S)       DP: SEEKINS, HUGGINS                                                                                   
03/09/05       (S)       NR: FRENCH, GUESS                                                                                      
03/18/05       (S)       TRANSMITTED TO (H)                                                                                     
03/18/05       (S)       VERSION: CSSB 105(L&C)                                                                                 
03/21/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/21/05       (H)       JUD                                                                                                    
04/06/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
04/06/05       (H)       Heard & Held                                                                                           
04/06/05       (H)       MINUTE(JUD)                                                                                            
04/11/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
BILL: HJR  9                                                                                                                  
SHORT TITLE: URGE CONGRESS HONOR EXXON VALDEZ JUDGMENT                                                                          
SPONSOR(S): REPRESENTATIVE(S) LEDOUX                                                                                            
02/14/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/14/05       (H)       RES, JUD                                                                                               
03/30/05       (H)       RES AT 1:00 PM SENATE FINANCE 532                                                                      
03/30/05       (H)       Moved Out of Committee                                                                                 
03/30/05       (H)       MINUTE(RES)                                                                                            
04/01/05       (H)       RES RPT 6DP                                                                                            
04/01/05       (H)       DP: OLSON, ELKINS, LEDOUX, CRAWFORD,                                                                   
                        RAMRAS, SAMUELS                                                                                         
04/11/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
BILL: HB 150                                                                                                                  
SHORT TITLE: LICENSING RADIOLOGIC TECHNICIANS                                                                                   
SPONSOR(S): REPRESENTATIVE(S) ANDERSON                                                                                          
02/14/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/14/05       (H)       L&C, JUD, FIN                                                                                          
02/23/05       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
02/23/05       (H)       Scheduled But Not Heard                                                                                
03/02/05       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
03/02/05       (H)       Heard & Held                                                                                           
03/02/05       (H)       MINUTE(L&C)                                                                                            
03/18/05       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
03/18/05       (H)       Moved CSHB 150(L&C) Out of Committee                                                                   
03/18/05       (H)       MINUTE(L&C)                                                                                            
03/22/05       (H)       L&C RPT CS(L&C) 2DP 1NR 2AM                                                                            
03/22/05       (H)       DP: LYNN, ANDERSON;                                                                                    
03/22/05       (H)       NR: CRAWFORD;                                                                                          
03/22/05       (H)       AM: ROKEBERG, KOTT                                                                                     
03/30/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
03/30/05       (H)       Heard & Held                                                                                           
03/30/05       (H)       MINUTE(JUD)                                                                                            
04/06/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
04/06/05       (H)       <Bill Hearing Postponed>                                                                               
04/11/05       (H)       JUD AT 1:00 PM CAPITOL 120                                                                             
WITNESS REGISTER                                                                                                              
HEATHER NOBREGA, Staff                                                                                                          
to Representative Norman Rokeberg                                                                                               
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 14 on behalf of the sponsor,                                                                  
Representative Rokeberg.                                                                                                        
TAMMY SANDOVAL, Acting Deputy Commissioner                                                                                      
Office of Children's Services (OCS)                                                                                             
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in opposition to HB 14.                                                                          
STACIE KRALY, Senior Assistant Attorney General                                                                                 
Human Services Section                                                                                                          
Civil Division (Juneau)                                                                                                         
Department of Law (DOL)                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Responded to questions during discussion of                                                                
HB 14.                                                                                                                          
BRIAN HOVE, Staff                                                                                                               
to Senator Ralph Seekins                                                                                                        
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented SB 105 on behalf of Senator                                                                      
Seekins, sponsor.                                                                                                               
GREY MITCHELL, Director                                                                                                         
Central Office                                                                                                                  
Division of Labor Standards & Safety                                                                                            
Department of Labor & Workforce Development (DLWD)                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions regarding SB 105.                                                                       
SUZANNE HANCOCK, Staff                                                                                                          
to Representative Gabrielle LeDoux                                                                                              
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HJR 9 on behalf of the sponsor,                                                                  
Representative LeDoux.                                                                                                          
JERRY McCUNE, Lobbyist                                                                                                          
for United Fishermen of Alaska;                                                                                                 
Cordova District Fishermen United                                                                                               
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HJR 9.                                                                             
MATTHEW D. JAMIN, Attorney at Law                                                                                               
Jamin, Ebell, Schmitt & Mason                                                                                                   
Kodiak, Alaska                                                                                                                  
POSITION STATEMENT:   Testified in support of HJR 9  on behalf of                                                               
the plaintiffs in the Exxon Valdez oil spill litigation.                                                                        
JON BITTNER, Staff                                                                                                              
to Representative Tom Anderson                                                                                                  
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   On behalf  of the  sponsor, Representative                                                               
Anderson, explained  the changes incorporated in  the proposed CS                                                               
for HB 150, Version S, and responded to a question.                                                                             
DONNA J. RUFSHOLM, R.T., Chair                                                                                                  
Licensure Committee                                                                                                             
Alaska Society of Radiologic Technologists (AKSRT)                                                                              
Homer, Alaska                                                                                                                   
POSITION STATEMENT:   Provided comments  during discussion  of HB                                                               
150 and responded to questions.                                                                                                 
REPRESENTATIVE PEGGY WILSON                                                                                                     
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:   Expressed concerns during  discussion of HB                                                               
PAMELA LaBOLLE                                                                                                                  
The Mulder Company                                                                                                              
Lobbyist  for  the  Alaska Society  of  Radiologic  Technologists                                                               
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:   Provided comments  during discussion  of HB                                                               
150 and responded to a remark.                                                                                                  
CLYDE E. PEARCE, Radiologic Health Specialist II                                                                                
Radiologic Health                                                                                                               
Division of Public Health                                                                                                       
Department of Health and Social Services (DHSS)                                                                                 
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:    Testified  in   support  of  HB  150  and                                                               
responded to questions and concerns.                                                                                            
ED HALL, P.A., Legislative Liaison                                                                                              
Alaska Academy of Physician Assistants (AKAPA)                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Provided comments  during discussion  of HB                                                               
RONALD L. DEIS                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Provided comments  during discussion  of HB                                                               
BARBARA HUFF TUCKNESS, Director                                                                                                 
Governmental And Legislative Affairs                                                                                            
Teamsters Local 959                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 150.                                                                            
B.J. ANDERSON                                                                                                                   
Anchorage Neighborhood Health Center (ANHC)                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Provided comments  during discussion  of HB                                                               
150  and asked  that the  bill be  changed before  it moves  from                                                               
SUSAN MASON-BOUTERSE, Executive Director                                                                                        
Sunshine Community Health Center                                                                                                
Talkeetna, Alaska                                                                                                               
POSITION STATEMENT:   Her written  testimony in opposition  to HB                                                               
150 was paraphrased by Beth Little-Terry.                                                                                       
LORREN J. WEAVER, M.D., Medical Director                                                                                        
Camai Community Health Center                                                                                                   
Naknek, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in  opposition to HB 150 on behalf                                                               
of  the  Bristol Bay  Borough,  which  owns the  Camai  Community                                                               
Health Center.                                                                                                                  
KAREN FAGERSTROM, Director                                                                                                      
Village Health Services                                                                                                         
Community Health Services Division                                                                                              
Norton Sound Health Corporation (NSHC)                                                                                          
Nome, Alaska                                                                                                                    
POSITION  STATEMENT:     Testified  in  opposition   to  HB  150,                                                               
suggested that  changes be made to  the bill, and responded  to a                                                               
LOUISE REED, Diagnostic Imaging Director                                                                                        
Yukon-Kuskokwim Health Corporation (YKHC)                                                                                       
Bethel, Alaska                                                                                                                  
POSITION STATEMENT:   Provided comments  during discussion  of HB                                                               
CHRIS DEVLIN, Executive Director                                                                                                
Eastern Aleutian Tribes, Inc.                                                                                                   
Sand Point, Alaska                                                                                                              
POSITION STATEMENT:  Testified in opposition to HB 150.                                                                         
CHERYL KILGORE, Executive Director                                                                                              
Interior Community Health Center (ICHC)                                                                                         
Fairbanks, Alaska                                                                                                               
POSITION  STATEMENT:    During discussion  of  HB  150,  provided                                                               
comments for  herself and Tammy  Wilkerson, Clinic  Nurse Manager                                                               
for the ICHC.                                                                                                                   
TIMO SAARINEN                                                                                                                   
Homer, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 150.                                                                            
ACTION NARRATIVE                                                                                                              
CHAIR  LESIL   McGUIRE  called   the  House   Judiciary  Standing                                                             
Committee  meeting  to  order at  1:14:28  PM.    Representatives                                                             
McGuire, Coghill,  Dahlstrom, and  Gruenberg were present  at the                                                               
call to order.  Representatives  Anderson, Kott, and Gara arrived                                                               
as  the  meeting was  in  progress.    Senator Seekins  was  also                                                               
HB 14 - DISCLOSURES BY FOSTER PARENTS                                                                                         
CHAIR McGUIRE  announced that the  first order of  business would                                                               
be  HOUSE  BILL  NO.  14,  "An  Act  relating  to  disclosure  of                                                               
information about a child or a  child's family to a legislator or                                                               
a  member   of  a  legislator's  staff;   and  making  conforming                                                               
changes."  [Before the committee was CSHB 14(HES).]                                                                             
1:14:45 PM                                                                                                                    
HEATHER NOBREGA, Staff to  Representative Norman Rokeberg, Alaska                                                               
State  Legislature, sponsor,  said  on  behalf of  Representative                                                               
Rokeberg that HB 14 came  about after constituents relayed to him                                                               
that foster parents  are not currently permitted  to discuss with                                                               
legislators  confidential  information   regarding  their  foster                                                               
children.     This   precludes   foster   parents  from   seeking                                                               
legislative help in matters pertaining  to those children.  House                                                               
Bill 14  will allow  foster parents  to contact  their legislator                                                               
and  speak  with him/her  or  his/her  staff about  their  foster                                                               
children.    She  mentioned  that  it has  been  brought  to  the                                                               
sponsor's attention  that language in  HB 14 might  conflict with                                                               
federal law, and so she asked that  the bill be held over so that                                                               
that issue can be addressed.                                                                                                    
1:16:50 PM                                                                                                                    
TAMMY SANDOVAL, Acting Deputy  Commissioner, Office of Children's                                                               
Services (OCS), Department of Health  and Social Services (DHSS),                                                               
concurred  that  HB  14  proposes  to  allow  foster  parents  of                                                               
children  who are  in State  custody to  disclose privileged  and                                                               
confidential information to  a legislator or a  member of his/her                                                               
staff  for  review or  use  in  the legislator's  or  legislative                                                               
staff's  official  capacity.   However,  subsequent  to the  bill                                                               
being  reported  from  the House  Health,  Education  and  Social                                                               
Services Standing  Committee, the OCS learned  that adding foster                                                               
parents  to  the list  of  those  able to  disclose  confidential                                                               
information  to a  legislator or  legislative staff  member would                                                               
cause the  OCS to  be in violation  of federal  law, specifically                                                               
"title IV-E," and thus jeopardize  approximately $29.7 million in                                                               
federal  reimbursements  for  fiscal  year 2006  (FY  06).    She                                                               
mentioned that  members' packets  include a  copy of  the federal                                                               
MS. SANDOVAL went on to say:                                                                                                    
     Absolutely,  for the  record, I  just want  to say  ...                                                                    
     [that] we want to be  responsive to the needs of foster                                                                    
     parents,  [and]  that  we  believe  that  existing  [AS                                                                    
     47.10.080(q)] clearly defines  and limits what specific                                                                    
     information foster  parents are entitled to.   They are                                                                    
     entitled to the child's  case plan; ... medical, mental                                                                    
     health,  and  educational   information  regarding  the                                                                    
     child to assist  them in providing the  proper care for                                                                    
     that child;  [and] ... information  to help  assure the                                                                    
     safety of the child and their own family's safety.                                                                         
     The  same statute  clearly requires  foster parents  to                                                                    
     maintain confidentiality  of records regarding  a child                                                                    
     placed in their home except  when the disclosure of the                                                                    
     records is  necessary to  obtain medical  and education                                                                    
     services  for  the  child   -  for  example,  providing                                                                    
     information to  physicians.  We believe  that there are                                                                    
     several  avenues by  which foster  parents can  ... get                                                                    
     their  needs met  through our  system.   Foster parents                                                                    
     are a  part of  the regular  case review  system, which                                                                    
     allows  them to  express concerns  they have  about the                                                                    
     plan  and/or services  being provided  for children  in                                                                    
     their care.                                                                                                                
     They're   allowed  and   encouraged  to   attend  court                                                                    
     hearings,  provide  testimony  to  the  judge;  they're                                                                    
     welcome  to  contact  their licensing  specialist,  the                                                                    
     assigned worker  ..., [and]  their ...  social worker's                                                                    
     supervisor.  And  then there are other  levels as well:                                                                    
     the  staff manager,  the  regional children's  services                                                                    
     manager,  and  just  this  morning  I  responded  to  a                                                                    
     concern.   So there are several  lines of communication                                                                    
     by  which we  hope that  foster parents  can get  their                                                                    
     needs  met through  us.   Additionally, foster  parents                                                                    
     have  access  to a  formal  grievance  process and  the                                                                    
     ombudsman's office  if they feel  the issues  they have                                                                    
     with the department  are not being resolved.   For that                                                                    
     reason, the department opposes HB 14.                                                                                      
1:20:35 PM                                                                                                                    
REPRESENTATIVE COGHILL asked what can a foster parent currently                                                                 
discuss with his/her legislator.                                                                                                
MS. SANDOVAL said:                                                                                                              
     I  think  that there's  a  number  of things  that  ...                                                                    
     foster parents can say.   What we're concerned about is                                                                    
     confidential   information.    ...   It    seems   like                                                                    
     specifically what we  want to be able to do  is talk to                                                                    
     you about our process  rather than specific information                                                                    
     about a  child; [we'd]  rather talk about  our policies                                                                    
     and  procedures and  the normal  process.  ... And  you                                                                    
     alerting us  is one thing,  what's being said  and what                                                                    
     we can say back is another.                                                                                                
REPRESENTATIVE GARA asked what is the law currently with regard                                                                 
to what information a foster parent can discuss with a                                                                          
1:22:10 PM                                                                                                                    
STACIE KRALY,  Senior Assistant Attorney General,  Human Services                                                               
Section, Civil  Division (Juneau), Department of  Law (DOL), said                                                               
that theoretically,  all information  in a child  in need  of aid                                                               
(CINA) proceeding  is confidential,  adding that  AS 47.10.092(c)                                                               
provides  criminal penalties  for  violating the  confidentiality                                                               
provisions pertaining to CINA cases.  She elaborated:                                                                           
     A  foster   parent  who  has  access   to  confidential                                                                    
     information should  ... not  call their  legislator and                                                                    
     divulge  that confidential  information,  and doing  so                                                                    
     would potentially  subject them to  criminal penalties.                                                                    
     The question  ... [becomes one of]  reciprocity, if you                                                                    
     will.  If a foster  parent calls a legislator and says,                                                                    
     "I've  got  a problem  with  the  Office of  Children's                                                                    
     Services  and 'X'"  - whatever  the issue  may be  - as                                                                    
     long  as it's  not a  confidential communication,  then                                                                    
     the  legislature  can  call the  Office  of  Children's                                                                    
     Services and  say, "We've got  this issue," and  we can                                                                    
     talk about  the process.   It's  just getting  into the                                                                    
     underlying  confidential information  - the  case plan,                                                                    
     information  about the  parents, information  about the                                                                    
     children,  what sort  of services  they're receiving  -                                                                    
     that  information is  confidential and,  theoretically,                                                                    
     if  divulged   by  anybody,  even  by   the  Office  of                                                                    
     Children's  Services, [they  would be]  subject to  ...                                                                    
     potential criminal penalties. ...                                                                                          
REPRESENTATIVE GARA opined  that if a foster parent  sees a child                                                               
being abused  by the natural parent,  he/she ought to be  able to                                                               
discuss this  with the OCS  even if  "that evidence" was  also an                                                               
aspect of  the CINA  proceeding.   "It seems to  me that  the law                                                               
couldn't be interpreted to mean  you can't talk to somebody about                                                               
what  you   saw  once  it   becomes  part  of   the  confidential                                                               
proceeding; you  just can't talk  about the things that  you only                                                               
know  because  they've  gone on  in  a  confidential  proceeding,                                                               
right?" he asked.                                                                                                               
MS. KRALY  concurred, adding that nothing  within "this construct                                                               
of what we're talking about"  would preclude anybody, let alone a                                                               
foster parent, from  making a report of  harm to the OCS  or to a                                                               
legislator in his/her legislative capacity.                                                                                     
CHAIR McGUIRE remarked  that the issue is probably  not as clear-                                                               
cut as  that, particularly in  CINA situations  involving ongoing                                                               
1:26:26 PM                                                                                                                    
MS.  KRALY agreed.   She  opined, however,  that the  distinction                                                               
being  made within  the context  of  the statute  is whether  the                                                               
information  has been  independently received  or whether  it was                                                               
received solely  due to  the fact  of being  a foster  parent and                                                               
thus  having access  to  the confidential  information.   If  the                                                               
latter  were the  case  and  the foster  parent  were  to call  a                                                               
legislator and  divulge that information, he/she  would basically                                                               
be waiving  a [biological]  parent's privacy  rights and  well as                                                               
the child's  privacy rights.   The issue becomes one  of ensuring                                                               
that the information  a foster parent has is kept  in the highest                                                               
of confidence, and  if a foster parent has a  concern and calls a                                                               
legislator for assistance, of course  the OCS wants to know about                                                               
the  concern  and be  given  a  chance  to  address it,  but  the                                                               
question then  becomes one of  just how much information  the OCS                                                               
can exchange with  a legislator in response to  a concern brought                                                               
forth  by a  foster parent.    The main  concern is  that if  the                                                               
changes  proposed  by HB  14  take  place, and  the  confidential                                                               
aspects of  a CINA  case are divulged  without first  obtaining a                                                               
waiver  from  the  [biological]  parent,  the  OCS  risks  losing                                                               
federal funding.                                                                                                                
CHAIR  McGUIRE  noted  that  CSHB   14(HES)  no  longer  contains                                                               
reference  to  the  confidential information  about  the  child's                                                               
family.   She mentioned that  although she would trust  Ms. Kraly                                                               
and  Ms. Sandoval  to provide  legislators  with the  information                                                               
they need to assist constituents,  there is no guarantee that the                                                               
same  could be  said of  future departmental  employees; sometime                                                               
things fall through  the cracks, and [the  current limitation] on                                                               
the  kinds  of information  a  foster  parent  can share  with  a                                                               
legislator  could  be  construed  as interfering  with  a  foster                                                               
parent's ability to go to  his/her legislator and seek assistance                                                               
in the same way a biological parent could.                                                                                      
1:29:49 PM                                                                                                                    
REPRESENTATIVE DAHLSTROM relayed  that in the few  cases that she                                                               
has been involved with, the  [biological] parents were willing to                                                               
sign a confidentiality waiver and that  is all that was needed in                                                               
order for her to assist her  constituents.  She said that she was                                                               
reassured that  departmental employees  were not just  giving out                                                               
confidential information  but were  instead making sure  that she                                                               
did actually  have a waiver.   She added that she  is comfortable                                                               
with  the  concept  that  information   in  CINA  cases  be  kept                                                               
CHAIR McGUIRE noted  that the House Health,  Education and Social                                                               
Services  Standing Committee  showed bipartisan  support for  the                                                               
REPRESENTATIVE DAHLSTROM  surmised that whether one  supports the                                                               
bill or not  depends on how the  issue is phrased.   If the issue                                                               
is looked  upon as simply  striving towards  what is in  the best                                                               
interest of the  child, then the proposed change  might be viewed                                                               
in a  favorable light, but if  the issue is looked  upon with the                                                               
knowledge that  not all citizens  use information in  the correct                                                               
way or for the betterment of  the child - and sometimes even have                                                               
ulterior  motives  -  then  the concept  of  using  caution  when                                                               
releasing confidential  information could  seem to be  the better                                                               
REPRESENTATIVE GARA said he has  mixed feelings about [the issues                                                               
raised by  the bill], referred to  a case that came  to light the                                                               
previous  summer,  and  surmised  that the  bill  came  about  in                                                               
response to  that case.   He said  that absent some  showing that                                                               
the OCS is  acting abusively or incompetently, he  is not willing                                                               
to alter the current confidentiality provisions.                                                                                
1:34:33 PM                                                                                                                    
REPRESENTATIVE  COGHILL  made  mention  of a  bill  that  he  has                                                               
sponsored.   He opined that  parents have a  "natural supremacy,"                                                               
but because sometimes  parents do things that they  ought not do,                                                               
foster parents  have been called  upon to take over  the parents'                                                               
duties.   A frustration arises  when legislators are  called upon                                                               
to act  as watchdogs  over some of  the department's  actions, he                                                               
remarked,  adding  that he  is  satisfied  with just  having  the                                                               
ability  to   discuss  issues  of  process.     Issues  involving                                                               
confidential  information will  just have  to be  decided by  the                                                               
courts.   He mentioned that  he struggles with the  issues raised                                                               
by the  bill because  he gets a  lot of calls  by people  who are                                                               
looking for help in navigating the system.                                                                                      
CHAIR McGUIRE indicated that one  of the issues that has recently                                                               
arisen is that of providers  being able to share information with                                                               
each other,  and noted that  yet another bill will  be addressing                                                               
that  issue.   She mentioned  that  one of  her constituents  has                                                               
mentioned  to  her  that  if state  agencies  know  that  certain                                                               
children  in   state  custody  have  behavioral   problems,  that                                                               
information should be  disclosed to school officials  in order to                                                               
ensure the safety of all the children in the school system.                                                                     
REPRESENTATIVE DAHLSTROM  relayed that  she is familiar  with the                                                               
aforementioned  case, and  noted that  media portrayals  of those                                                               
involved in that  case were not accurate, but the  OCS was unable                                                               
address the accusations that were  made against it because of the                                                               
current confidentiality provisions in state  law.  She went on to                                                               
say  she  has never  had  any  conversations with  OCS  employees                                                               
wherein they indicated that they  were unwilling to take steps to                                                               
improve the current system.                                                                                                     
1:41:29 PM                                                                                                                    
REPRESENTATIVE GRUENBERG  referred to AS 47.10.092(c),  and noted                                                               
that it says, "A person who  violates a provision of this section                                                               
is guilty of a misdemeanor,  and upon conviction is punishable by                                                               
a fine  of not  more than  $500 or by  imprisonment for  not more                                                               
than  one year,  or  by both.".    He relayed  that  he would  be                                                               
offering an amendment that would  alter AS 47.10.092(c) such that                                                               
it would say  a violation of it  would also be a  violation of AS                                                               
24.60.060(a), which says:                                                                                                       
     A legislator or legislative  employee may not knowingly                                                                    
     make an unauthorized disclosure  of information that is                                                                    
     made confidential  by law and that  the person acquired                                                                    
     in  the  course  of  official duties.    A  person  who                                                                    
     violates this section is subject  to a proceeding under                                                                    
     AS 24.60.170  and may be  subject to  prosecution under                                                                    
     AS 211.56.860 or another law.                                                                                              
REPRESENTATIVE  GRUENBERG asked  whether there  is currently  any                                                               
requirement for a legislator or  legislative staff member to sign                                                               
a statement of confidentiality.                                                                                                 
MS.  KRALY   offered  her  understanding  that   AS  47  requires                                                               
temporary  assistance information  to  be  kept confidential  and                                                               
provides a  form that must  be signed by legislators  before they                                                               
receive  that confidential  information,  and said  this type  of                                                               
form is  also being used  by the  OCS to ensure  that information                                                               
released  to legislators  under  AS 47.10  is kept  confidential,                                                               
though in such instances the form is not statutorily required.                                                                  
REPRESENTATIVE GRUENBERG opined that it should be.                                                                              
MS.  NOBREGA  clarified  that  the bill  was  not  introduced  in                                                               
response to  the aforementioned case; instead,  it was introduced                                                               
in  response to  a situation  involving a  foster parent  who was                                                               
being   dissuaded   by   OCS  staff   from   contacting   his/her                                                               
legislator's office  regarding difficulties he/she was  having in                                                               
obtaining reimbursement from the OCS.                                                                                           
CHAIR McGUIRE relayed that CSHB 14(HES) would be held over.                                                                     
HB 12 - TVS AND MONITORS IN MOTOR VEHICLES                                                                                    
1:47:11 PM                                                                                                                    
CHAIR McGUIRE announced that the  next order of business would be                                                               
HOUSE BILL NO.  12, "An Act relating to  televisions and monitors                                                               
in  motor vehicles."    [Before the  committee  was the  proposed                                                               
committee  substitute  (CS)  -   with  a  handwritten  alteration                                                               
included  - for  HB 12,  Version 24-LS0058\X,  Luckhaupt, 4/5/05,                                                               
which had been adopted and amended on 4/6/05.]                                                                                  
REPRESENTATIVE GRUENBERG  moved to  adopt the  proposed committee                                                               
substitute  (CS)  for  HB  12,  Version  24-LS0058\R,  Luckhaupt,                                                               
4/11/05, as the work draft.   There being no objection, Version R                                                               
was before the committee.                                                                                                       
1:48:25 PM                                                                                                                    
REPRESENTATIVE GRUENBERG relayed that  Version R now also exempts                                                               
portable cellular telephones; equipment  that displays only audio                                                               
equipment  information, functions,  and  controls; and  equipment                                                               
that  displays only  vehicle information  or controls  related to                                                               
speed, fuel  level, battery charge,  and other vehicle  safety or                                                               
equipment   information.      He  relayed   that   the   language                                                               
specifically exempting  RVs has not  yet been added to  the bill,                                                               
though   industry  representatives   liked  the   model  language                                                               
provided  in members'  packets,  and mentioned  that he  received                                                               
assurance  from  industry representatives  that  any  TV that  is                                                               
positioned in the  front of an RV disconnects once  the engine is                                                               
1:51:07 PM                                                                                                                    
REPRESENTATIVE ANDERSON moved to report  the proposed (CS) for HB                                                               
12,  Version 24-LS0058\R,  Luckhaupt, 4/11/05,  out of  committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There being no  objection, CSHB 12(JUD) was reported from                                                               
the House Judiciary Standing Committee.                                                                                         
SB 105 - OVERTIME WAGES FOR FLIGHT CREW                                                                                       
1:51:48 PM                                                                                                                    
CHAIR McGUIRE  announced that  the next of  business would  be CS                                                               
FOR  SENATE   BILL  NO.  105(L&C),   "An  Act  relating   to  the                                                               
retrospective  application  and  applicability  of  the  overtime                                                               
compensation  exemption for  flight crew  members; and  providing                                                               
for an effective date."                                                                                                         
The committee took an at-ease from 1:52 p.m. to 1:55 p.m.                                                                       
1:55:01 PM                                                                                                                    
BRIAN  HOVE,  Staff  to  Senator   Ralph  Seekins,  Alaska  State                                                               
Legislature, sponsor,  stated on  behalf of Senator  Seekins that                                                               
he was available to answer questions regarding SB 105.                                                                          
1:55:37 PM                                                                                                                    
REPRESENTATIVE GARA referred to  testimony during the bill's last                                                               
hearing  regarding  memoranda  from  the  1980s,  and  questioned                                                               
whether they made it clear  that Hageland Aviation Services, Inc.                                                               
("Hageland  Aviation   Services"),  was   not  required   to  pay                                                               
GREY  MITCHELL,  Director,  Central  Office,  Division  of  Labor                                                               
Standards &  Safety, Department of Labor  & Workforce Development                                                               
(DLWD),  replied  that the  1980  and  1984 memos  were  attorney                                                               
general's  opinions, which  were used  as the  basis of  the DLWD                                                               
interpretation.   He  noted  that  the 1986  memo  is an  opinion                                                               
letter that  was written to  the Alaska Air  Carriers Association                                                               
(AACA)  from  the  deputy  director  of  the  Division  of  Labor                                                               
Standards and  Safety.   Mr. Mitchell  continued:   "This opinion                                                               
letter is written  in such a way  that it appears to  be making a                                                               
policy  type  of  decision  that   conflicts  with  the  attorney                                                               
general's [opinions].  I think that  kind of sums up the conflict                                                               
between these opinions."                                                                                                        
REPRESENTATIVE GARA  asked whether  the 1986 memo  proclaims that                                                               
if  there  is substantial  hauling  of  mail, then  the  overtime                                                               
provisions do not apply.                                                                                                        
MR. MITCHELL said that was correct.                                                                                             
REPRESENTATIVE GARA  asked if Hageland Aviation  Services engaged                                                               
in substantial mail hauling.                                                                                                    
MR. MITCHELL  said he understood that  Hageland Aviation Services                                                               
did haul mail, but did not know to what degree.                                                                                 
1:58:51 PM                                                                                                                    
REPRESENTATIVE  GARA  asked  how  the  aforementioned  1986  memo                                                               
seemingly conflicted with the Department of Law memos.                                                                          
MR.  MITCHELL  said:    "The  1986  memo  essentially  takes  the                                                               
position  of  establishing  the federal  guideline  for  overtime                                                               
eligibility of  employees of air  carriers.  That's a  pretty big                                                               
step for  an opinion letter,  without any regulation  or attorney                                                               
general's opinion to fall back on."                                                                                             
REPRESENTATIVE  KOTT  moved  to   report  CSSB  105(L&C)  out  of                                                               
committee  with individual  recommendations and  the accompanying                                                               
fiscal  notes.   There  being  no  objection, CSSB  105(L&C)  was                                                               
reported from the House Judiciary Standing Committee.                                                                           
HJR 9 - URGE CONGRESS HONOR EXXON VALDEZ JUDGMENT                                                                             
2:00:27 PM                                                                                                                    
CHAIR McGUIRE announced that the  next order of business would be                                                               
HOUSE JOINT RESOLUTION  NO. 9, Urging the  United States Congress                                                               
to honor  the process and judgment  of the federal courts  in the                                                               
case of  the Exxon Valdez  disaster and to refrain  from enacting                                                               
legislation  that  would  affect   the  outcome  of  the  courts'                                                               
resolution of the case.                                                                                                         
2:00:36 PM                                                                                                                    
SUZANNE  HANCOCK,  Staff   to  Representative  Gabrielle  LeDoux,                                                               
Alaska State Legislature,  sponsor, presented HJR 9  on behalf of                                                               
Representative LeDoux.  She explained:                                                                                          
     This  resolution  from  the  Alaska  State  Legislature                                                                    
     would urge  the United  States Congress to  respect the                                                                    
     judicial   process  and   refrain  from   enacting  any                                                                    
     legislation  that  would  alter  the  punitive  damages                                                                    
     awarded to more  than 32,000 plaintiffs as  a result of                                                                    
     the 1989 Exxon Valdez  oil spill, as finally determined                                                                    
     by  the federal  courts.   Nearly  15  years after  the                                                                    
     disaster  and more  than 10  years  after the  original                                                                    
     jury   verdict,  the   plaintiffs  are   still  waiting                                                                    
     resolution  of the  lawsuit.   While the  United States                                                                    
     Congress  considered the  Oil  Pollution  Act of  1990,                                                                    
     ExxonMobil Corporation  sought an amendment  that would                                                                    
     have  substantially reduced  the punitive  damages that                                                                    
     would have  been paid for  the Exxon Valdez  oil spill.                                                                    
     This resolution  urges Congress only to  let the courts                                                                    
     determine this matter.                                                                                                     
REPRESENTATIVE   GRUENBERG   offered   his   understanding   that                                                               
constitutionally,  after  a final  judgment,  there  could be  no                                                               
retroactive changes.   He questioned whether  the committee ought                                                               
to get  a legal opinion in  case another section should  be added                                                               
to HJR 9 to address this issue.                                                                                                 
2:03:01 PM                                                                                                                    
REPRESENTATIVE GARA replied:                                                                                                    
     [ExxonMobil Corporation]  is on  appeal to try  and get                                                                    
     rid of the  punitive damage verdict, get it  set up for                                                                    
     retrial  or rehearing  by the  court.   Once the  final                                                                    
     judgment  disappears, then  they feel  that they'll  be                                                                    
     free to  get Congress to  write the  law in a  way that                                                                    
     will  prevent  the  fishermen  from  getting  the  same                                                                    
     judgment as  they got the  last time. ... I  don't know                                                                    
     if what  they're doing is legal  or constitutional, but                                                                    
     that's how they address your  point.  They're trying to                                                                    
     vacate the final judgment.                                                                                                 
2:03:56 PM                                                                                                                    
REPRESENTATIVE  GARA commented  that  he  thought the  resolution                                                               
should also  ask the  governor to make  a demand  upon ExxonMobil                                                               
Corporation.     He   asked  that   this  idea   be  relayed   to                                                               
Representative LeDoux.                                                                                                          
2:05:01 PM                                                                                                                    
JERRY   McCUNE,  Lobbyist   for  United   Fishermen  of   Alaska;                                                               
President,  Cordova  District   Fishermen  United,  testified  in                                                               
support of  HJR 9.   He commented  that the governor  has already                                                               
called for all parties to settle  this case.  He said, "All we're                                                               
asking is for  the ... courts [to]  rule on this -  win, lose, or                                                               
REPRESENTATIVE  GARA confirmed  that the  governor has  called on                                                               
all parties  to settle the  case.   He explained that  he thought                                                               
the governor should call on ExxonMobil Corporation to pay.                                                                      
2:06:53 PM                                                                                                                    
MATTHEW  D.  JAMIN, Attorney  at  Law,  Jamin, Ebell,  Schmitt  &                                                               
Mason,  stated that  he is  one of  the lawyers  representing the                                                               
plaintiffs in the Exxon Valdez oil spill litigation.  He said:                                                                  
     On  behalf of  plaintiffs' counsel,  we do  support the                                                                    
     resolution  and   we  think  it  is   a  very  sensible                                                                    
     resolution  at this  time.   The  suggestions thus  far                                                                    
     have  been that  there  might  be something  deliberate                                                                    
     that  would affect  the case,  and  certainly that's  a                                                                    
     possibility.   But we are equally  concerned that there                                                                    
     might be  something -  given the  attempts made  in the                                                                    
     federal    legislature   to    change   class    action                                                                    
     legislation, to change  tort legislation, what's called                                                                    
     tort  reform -  ... that  is  not deliberate.   And  we                                                                    
     think that the  legislators' proposed resolution brings                                                                    
     to  everyone's  attention  the   need  to  be  wary  as                                                                    
     legislation is  passed on the  federal side so  that it                                                                    
     does not affect this case.                                                                                                 
CHAIR  McGUIRE, after  ascertaining that  no one  else wished  to                                                               
testify, closed public testimony on HJR 9.                                                                                      
2:08:13 PM                                                                                                                    
REPRESENTATIVE COGHILL  moved to  report HJR  9 out  of committee                                                               
with individual recommendations and  the accompanying zero fiscal                                                               
note.   There being  no objection,  HJR 9  was reported  from the                                                               
House Judiciary Standing Committee.                                                                                             
HB 150 - LICENSING RADIOLOGIC TECHNICIANS                                                                                     
2:08:32 PM                                                                                                                    
CHAIR McGUIRE announced that the  next order of business would be                                                               
HOUSE BILL  NO. 150, "An  Act requiring licensure  of occupations                                                               
relating  to   radiologic  technology,  radiation   therapy,  and                                                               
nuclear  medicine  technology;  and providing  for  an  effective                                                               
date."  [Before the committee was CSHB 150(L&C).]                                                                               
2:08:51 PM                                                                                                                    
REPRESENTATIVE  GARA  moved  to   adopt  the  proposed  committee                                                               
substitute  (CS)  for  HB   150,  Version  24-LS0470\S,  Mischel,                                                               
4/11/05, as the work draft.   There being no objection, Version S                                                               
was before the committee.                                                                                                       
2:09:26 PM                                                                                                                    
REPRESENTATIVE ANDERSON,  speaking as  the sponsor,  relayed that                                                               
the  concept embodied  in  HB  150 has  been  evolving since  the                                                               
1990s.    He  paraphrased  from  the  following  written  opening                                                               
remarks [original punctuation provided]:                                                                                        
     House   Bill  150   will   establish  educational   and                                                                    
     certification standards  for the health  care personnel                                                                    
     in  Alaska who  perform medical  imaging and  radiation                                                                    
     procedures.    Any  radiology   procedure  is  only  as                                                                    
     effective as the person performing it.                                                                                     
     An underexposed chest x-ray  cannot reveal pneumonia or                                                                    
     a malignant  lesion, just as an  inadequate mammography                                                                    
     technique cannot detect breast  cancer.  No matter what                                                                    
     the procedure, the  Radiologic Technologist's knowledge                                                                    
     of  anatomy,  careful   application  of  radiation  and                                                                    
     skillful operation  of sophisticated  medical equipment                                                                    
     are the keys to its  success.  To be clinically useful,                                                                    
     diagnostic imaging exams must be accurate.                                                                                 
     38  states  have   adopted  recommendations  for  state                                                                    
     licensure of  radiology personnel.   Alaska is  not one                                                                    
     of  those states.   Establishing  state standards  will                                                                    
     ensure that Alaskans will have  access to safe and high                                                                    
     quality  radiologic  care.   Licensure  will  establish                                                                    
     radiation protection measures as  well as education and                                                                    
     credentialing   standards   that    will   ensure   the                                                                    
     competency  of  persons   operating  medical  equipment                                                                    
     emitting radiation.                                                                                                        
     To  ensure that  the citizens  of the  State of  Alaska                                                                    
     receive maximum protection from  the harmful effects of                                                                    
     excessive   and   improper   exposure   to   radiation,                                                                    
     licensure must be passed to establish standards.                                                                           
2:12:28 PM                                                                                                                    
REPRESENTATIVE ANDERSON  opined that HB  150 is critical  for the                                                               
safety of  Alaskans.   Passage of  HB 150  would make  Alaska the                                                               
39th  state  to  adopt  legislation regarding  the  licensure  of                                                               
radiology  personnel.   He  noted that  although  there might  be                                                               
arguments  that personnel  in rural  Alaska have  been performing                                                               
radiologic  procedures [without  any  problems to  date], he  can                                                               
provide   examples   of    over-radiated,   under-radiated,   and                                                               
misdiagnosed   cases  that   resulted  from   improperly  trained                                                               
personnel,  generally  in  rural  settings.   The  University  of                                                               
Alaska has worked  to make it easier to enroll  in its Radiologic                                                               
Technology  program,  he remarked,  and  asked  the committee  to                                                               
support the bill, particularly given the changes in Version S.                                                                  
2:16:07 PM                                                                                                                    
JON BITTNER,  Staff to Representative Tom  Anderson, Alaska State                                                               
Legislature,  sponsor, relayed  that members'  packets include  a                                                               
memorandum  that outlines  the changes  in Version  S, which  now                                                               
references "department"  throughout rather  than "division".   He                                                               
indicated  that other  changes include  adding a  new Section  1,                                                               
which  amends   AS  08.01.010  to   include  the   regulation  of                                                               
radiographers;  removing  dental   hygienists  from  proposed  AS                                                               
08.89.100(b)(2); adding  schools of dentistry and  dental hygiene                                                               
to proposed AS 08.89.100(b)(4); adding  the word "current" - with                                                               
regard  to certification  - to  proposed AS  08.89.140(2); adding                                                               
the  words, "or  have demonstrated  experience sufficient  in the                                                               
opinion of the  department to waive the program",  to proposed AS                                                               
08.89.150(a)(3); changing  the words in proposed  AS 08.89.170(c)                                                               
from, "three out  of five years preceding  application", to, "two                                                               
years preceding July 1, 2007".                                                                                                  
2:21:00 PM                                                                                                                    
MR.  BITTNER indicated  that still  other changes  include adding                                                               
the word, "nonrenewable" - with  regard to temporary permits - to                                                               
proposed  AS  08.89.170(d);  changing  the text  in  proposed  AS                                                               
08.89.180(d) to say, "Sponsors approved  by the American Registry                                                               
of  Radiologic Technologists  are considered  approved continuing                                                               
education  providers"; changing  the  time frame  in proposed  AS                                                               
08.89.210  from, "24  months",  to, "one  year",  and adding  the                                                               
sentence,  "The   department  may  require  an   examination  for                                                               
reinstatement";  and adding,  to  proposed AS  08.89.220 -  which                                                               
pertains to fees - new paragraphs (8) and (9), which read:                                                                      
         (8)  adding an area of practice to an existing                                                                         
     (9)  program approval under AS 08.89.130.                                                                                  
2:24:12 PM                                                                                                                    
MR.  BITTNER  indicated  that further  changes  include  changing                                                               
proposed AS 08.89.340(c) to read:                                                                                               
      (c)  The department may summarily suspend a license                                                                       
     before final hearing or during the appeals process if                                                                      
     the department  finds that the  licensee poses  a clear                                                                    
     and immediate danger to the  public welfare and safety.                                                                    
     A  person is  entitled to  a hearing  conducted by  the                                                                    
     office  of administrative  hearings under  AS 44.64.010                                                                    
     with seven  days after the suspension  order is issued.                                                                    
     A person  may appeal an adverse  decision after hearing                                                                    
     to the superior court.                                                                                                     
MR. BITTNER also indicated [that  proposed AS 08.89.340 no longer                                                               
contains a  subsection (e), which  required waiting a  year after                                                               
license   revocation  before   reapplying];   that  proposed   AS                                                               
08.89.990  no longer  contains a  definition for  "division", and                                                               
now    defines    "radiographer"    rather    than    "radiologic                                                               
technologist";  [that Version  S  no longer  exempts proposed  AS                                                               
08.89.340(c)   from   AS   44.64.030(a)(6);  that   the   section                                                               
pertaining  to regulations  no  longer  references the  division;                                                               
that Version  S no longer  contains revisor's  instructions]; and                                                               
that conforming changes have been made to section numbers.                                                                      
2:25:46 PM                                                                                                                    
REPRESENTATIVE  DAHLSTROM   referred  to  the  new   language  in                                                               
proposed  AS   08.89.210  -  "The   department  may   require  an                                                               
examination  for  reinstatement"  -  and asked  how  it  will  be                                                               
determined whether a person should take the examination.                                                                        
MR.  BITTNER  said  his  assumption   is  that  the  Division  of                                                               
Occupational  Licensing will  ultimately  make the  determination                                                               
regarding  whether an  examination  is  warranted, and  suggested                                                               
that  a representative  from the  division  could better  address                                                               
that question.                                                                                                                  
2:27:30 PM                                                                                                                    
DONNA  J.  RUFSHOLM,  R.T., Chair,  Licensure  Committee,  Alaska                                                               
Society  of Radiologic  Technologists (AKSRT),  relayed that  the                                                               
AKSRT  asked Representative  Anderson  to sponsor  HB  150.   She                                                               
explained  that in  1981,  Congress  passed the  Consumer-Patient                                                               
Radiation  Health  and  Safety Act  of  1981,  which  established                                                               
minimum   standards  for   state  licensure   of  personnel   who                                                               
administer ionizing  radiation.   The goal of  establishing those                                                               
standards  was to  minimize  unnecessary  exposure to  radiation.                                                               
Since then, 41 states have  adopted licensure laws, though Alaska                                                               
has yet  to do  so.  Currently,  pending legislation  in Congress                                                               
would  require  all  states  to either  meet  or  exceed  federal                                                               
standards   or   else   risk   losing   Medicaid   and   Medicare                                                               
reimbursement  for   imaging  procedures.     Thus,  HB   150  is                                                               
important,  she  remarked,  because   it  would  establish  state                                                               
standards  and   thereby  remove  the  risk   of  losing  federal                                                               
reimbursement; in lieu of having  its own state standards, Alaska                                                               
would  have  to  comply  with   whatever  standards  the  federal                                                               
government imposed.                                                                                                             
MS.  RUFSHOLM then  posed the  question,  "Why establish  minimum                                                               
standards for personnel who  perform medical imaging procedures?"                                                               
and  responded by  saying that  basically, it  all boils  down to                                                               
quality; safety to the patient, the  operator; and the cost.  She                                                               
went on to say:                                                                                                                 
     We all  know that radiation is  a carcinogen; operators                                                                    
     of medical x-ray equipment  deliver the largest portion                                                                    
     of manmade radiation to the  general public.  Radiation                                                                    
     is safe if  properly applied, but it can  be harmful or                                                                    
     even  deadly if  it's ...  [maladministered].   I think                                                                    
     that's [a] really important  factor ..., that radiation                                                                    
     ...  has   been  recognized  as  one   of  the  leading                                                                    
     carcinogens. ... Delays  [of] diagnosis or misdiagnoses                                                                    
     caused by poor  imaging exams can drive  up health care                                                                    
     costs,   [and]  inaccurate   ...   imaging  can   delay                                                                    
     Accurate  diagnosis  depends  on   a  good  and  useful                                                                    
     medical image; the quality of  [a] medical imaging exam                                                                    
     is only  as good  as the person  performing it.   Right                                                                    
     now  ..., in  Alaska,  anyone can  take x-rays;  [even]                                                                    
     anyone  who's sitting  on the  committee ...  right now                                                                    
     could go  into an office,  if someone would  hire them,                                                                    
     and  take  x-rays without  any  training.   We  require                                                                    
     hairdressers to  be licensed, but ...  we don't require                                                                    
     people  delivering radiation  to patients  to have  any                                                                    
     sort of licensing or educational requirements. ...                                                                         
     There is a report that's  just out ... [by] the Medical                                                                    
     Payment  Advisory Commission  (MedPAC)  -  which is  an                                                                    
     agency that  advises Congress on  health care  policy -                                                                    
     regarding what they called the  overuse, under use, and                                                                    
     misuse of imaging  services.  And on March  17 of 2005,                                                                    
     the   [federal]  House   Ways  and   Means  Committee's                                                                    
     subcommittee on  health conducted a hearing  to address                                                                    
     the MedPAC recommendations  that Congress set standards                                                                    
     for  those  ...  who perform  or  interpret  diagnostic                                                                    
     imaging examinations. ...                                                                                                  
     [A synopsis  indicates that]  Medicare has  an interest                                                                    
     in ensuring  that imaging studies are  done by skilled,                                                                    
     technical staff  using appropriate equipment,  and that                                                                    
     the  "CMS"  -  which  is  Medicare  -  strongly  should                                                                    
     consider setting  standards for at least  the following                                                                    
     areas:    imaging   equipment,  qualifications  of  the                                                                    
     technicians  performing  the   studies,  the  technical                                                                    
     quality  of the  images  produced,  and procedures  for                                                                    
     ensuring  patient safety.   So  this  is Medicare,  and                                                                    
     they're really going to be  setting some guidelines and                                                                    
     standards for  those individuals who  perform radiology                                                                    
MS. RUFSHOLM added:                                                                                                             
     With  HB 150,  we  have recognized  the  fact that  the                                                                    
     rural  areas of  the  state have  different needs  than                                                                    
     what the  urban areas do,  and I think that  in writing                                                                    
     [HB 150]  and working with the  different groups around                                                                    
     the  state, we've  tried to  address those  needs.   We                                                                    
     surely do not want those  services to be discontinued -                                                                    
     that's not the intent of the  bill - we know that those                                                                    
     services  need to  be there,  especially  in the  very,                                                                    
     very remote areas; it's really  imperative that they be                                                                    
     able to  provide radiology  services for  patient care,                                                                    
     and  our concern  is that  we don't  want to  see those                                                                    
     services  discontinued but  we  would like  to see  the                                                                    
     people [who]  deliver those services have  some sort of                                                                    
     And  we've worked  with the  University  of Alaska,  in                                                                    
     Anchorage,  to  provide  an  online  course  for  those                                                                    
     individuals;  there  are   other  online  courses  also                                                                    
     available on the Internet for  individuals to receive a                                                                    
     minimum   of  training   so  that   they  can   protect                                                                    
     themselves  as well  as  the  patient from  unnecessary                                                                    
     radiation.  We've kept the  cost down, [and] we've made                                                                    
     accommodations in the  bill ... so that  people who are                                                                    
     currently taking x-rays can ...  probably be tested out                                                                    
     - they  would be  looked at  for competency,  and would                                                                    
     actually  forgo  the  program ...  if  they  can  prove                                                                    
MS. RUFSHOLM concluded:                                                                                                         
     We've allowed ... a very long  period of time - a four-                                                                    
     year   period  -   for  individuals   to  be   able  to                                                                    
     participate  in the  course if  [that requirement]  ...                                                                    
     was something that they would  have meet ..., and we've                                                                    
     also  made accommodations  [such] that  individuals who                                                                    
     are new coming into the field  would be able to take x-                                                                    
     rays  as  they're  taking  the   first  module  at  the                                                                    
     [University  of Alaska  Anchorage (UAA)]  so that  they                                                                    
     could  go to  work immediately  as long  as they  had a                                                                    
     mentor  - someone  working at  the facility  with them.                                                                    
     So we're doing our best to  try to meet all those needs                                                                    
     and still recognizing  the fact that people  do need to                                                                    
     be educated for their own  safety and the safety of the                                                                    
     public, which  is what  the whole  intent of  this bill                                                                    
2:34:55 PM                                                                                                                    
REPRESENTATIVE GARA  said he's  heard concerns  that even  if the                                                               
UAA  offers a  program, it  will only  have a  certain number  of                                                               
openings available,  as well as  concerns regarding  what courses                                                               
are going to  satisfy the bill's training requirements.   He also                                                               
relayed that  he's been  told that many  of the  people currently                                                               
being  exempted  from  the bill's  requirements  don't  have  any                                                               
experience in taking x-rays, and  so is wondering why such people                                                               
should be exempted.                                                                                                             
MS.  RUFSHOLM first  offered her  belief that  the UAA  will make                                                               
enough  courses available  so  that people  can  meet the  bill's                                                               
requirements,  and  so  meeting  those requirements  won't  be  a                                                               
problem, particularly  given that if  the bill passes  this year,                                                               
it  will be  2007 before  it's  enacted; also,  people will  have                                                               
another two years  to fulfill their education  requirements.  And                                                               
once people fulfill their education  requirements, the state will                                                               
send  in  their names  to  the  American Registry  of  Radiologic                                                               
Technologists  (ARRT),  which,  as  a  courtesy  to  states  with                                                               
limited-scope licensure,  offers an examination  that individuals                                                               
can take,  and passage of  that examination would then  qualify a                                                               
person  as a  "limited-scope" radiographer;  additionally, online                                                               
courses  [currently]  available on  the  Internet  also allow  an                                                               
individual to sit for that examination.                                                                                         
2:39:20 PM                                                                                                                    
REPRESENTATIVE GARA  relayed that he's  been told by  some people                                                               
that  they believe  the UAA  might  only be  able to  accommodate                                                               
about 20  students per year,  and that it  could take as  many as                                                               
three   semesters  to   complete  the   educational  requirements                                                               
proposed by the bill.                                                                                                           
MS. RUFSHOLM  suggested that  UAA staff might  be better  able to                                                               
address that  issue.  She  acknowledged, however, that  she, too,                                                               
has been told  that the UAA might only be  able to accommodate 20                                                               
people during the upcoming fall  semester, but only because it is                                                               
a new  program.  She explained  that the program will  consist of                                                               
three modules,  the first to  be completed  in a minimum  of four                                                               
weeks, with the second and  third modules perhaps being completed                                                               
at the  same time  should UAA  staffing levels  allow.   Thus the                                                               
educational requirements  could be completed  in as few  as eight                                                               
weeks or  as many as twelve  weeks.  She mentioned,  though, that                                                               
she is  not familiar with how  much time the online  courses take                                                               
to complete.                                                                                                                    
2:41:23 PM                                                                                                                    
MS. RUFSHOLM, in  response to the question of  why certain groups                                                               
of people  have been exempted from  the bill, said it  is because                                                               
those  groups  have  their own  boards  and  practice  standards,                                                               
including standards  related to  radiology procedures.   She also                                                               
mentioned  that concerns  offered  by those  practicing in  rural                                                               
areas  and  in  small  clinics  in  urban  settings  regarding  a                                                               
possible  interruption of  services  for  training purposes  have                                                               
prompted the  change in Version S  that allows a person  to begin                                                               
the first  module of the  UAA's program while he/she  is working.                                                               
So as long as  a person has a mentor, an  employer who is willing                                                               
to oversee the person while  he/she is taking x-rays, then he/she                                                               
can take  module one of  the program and  be working at  the same                                                               
time.   That person would,  of course,  also have to  continue on                                                               
with module two [and three] of the program.                                                                                     
REPRESENTATIVE ANDERSON mentioned  that his son was  x-rayed at a                                                               
clinic  after a  bicycle  accident  and was  told  by the  person                                                               
taking the  x-ray that his  arm was probably broken,  but further                                                               
x-rays at  a hospital revealed  that his  arm wasn't broken.   He                                                               
indicated  that this  experience  has furthered  his belief  that                                                               
certification  of  those  taking   x-rays  would  eliminate  such                                                               
REPRESENTATIVE GARA  said he  supports the  concept of  the bill,                                                               
but  some of  its aspects  still raise  questions.   For example,                                                               
should those groups  of people currently being  exempted from the                                                               
bill really be  exempted?  Is the training  such people currently                                                               
get really sufficient?                                                                                                          
2:48:41 PM                                                                                                                    
REPRESENTATIVE PEGGY  WILSON, Alaska State Legislature,  said she                                                               
is  concerned that  the bill  could create  a hardship  for small                                                               
businesses, particularly in rural areas.   She mentioned that [as                                                               
a registered nurse],  she used to work in a  very small clinic in                                                               
Tok, and that  both nurses and the  laboratory technician working                                                               
at  that clinic  were  trained,  on the  job,  to  use the  x-ray                                                               
machine and were then monitored  to ensure that safety procedures                                                               
were followed.   In such settings,  there is a need  to have more                                                               
than one person trained in the  use of the x-ray equipment, since                                                               
it  wouldn't possible  to have  a trained  technician brought  in                                                               
should the person who regularly  takes the x-rays be unavailable.                                                               
Another  of her  concerns centers  on the  fact that  because the                                                               
machines  in rural  areas  of  the state  are  older models,  the                                                               
educational modules  may not addresses  the specifics of  all the                                                               
different  types  of  machines  - particularly  the  older,  more                                                               
complex types  - that are  currently being used in  various areas                                                               
of  the  state.    Additionally,  she opined,  the  cost  of  the                                                               
proposed   educational   requirements  are   quite   prohibitive,                                                               
particularly given  that many small clinics  operate with limited                                                               
2:53:42 PM                                                                                                                    
REPRESENTATIVE WILSON mentioned that  in Tok, the chief emergency                                                               
medical technician (EMT)  also knew how to take  x-rays, and this                                                               
saved clinic employees from having to  come to work in the middle                                                               
of the night in emergency situations.   She pointed out that many                                                               
small communities and  places in rural Alaska aren't  on the road                                                               
system, and opined that the bill  is much needed when it comes to                                                               
the  issue  of  radiation  therapy, but  questioned  whether  the                                                               
restrictions the  bill imposes are  really necessary  with regard                                                               
to  normal,   everyday  x-rays.    Referring   to  Representative                                                               
Anderson's  example regarding  his son,  she noted  that in  most                                                               
situations, the person who takes the  x-ray is not the person who                                                               
reads  it; the  x-ray must  still be  sent off  to be  read by  a                                                               
trained  radiologist.   So  just  because  a person  hasn't  been                                                               
taught to read  an x-ray and so perhaps  misdiagnoses a condition                                                               
doesn't mean  that the  x-ray itself  wasn't a  good x-ray.   She                                                               
said she  questions whether the  state really has a  problem with                                                               
regard to  those taking x-rays,  particularly given that  she has                                                               
not  been shown  any  evidence  of or  been  given  a listing  of                                                               
CHAIR McGUIRE  said she would provide  Representative Wilson with                                                               
the  testimony from  those that  believe problems  are occurring.                                                               
Noting that Representative Wilson  believes that those performing                                                               
radiation  therapy should  be licensed,  Chair McGuire  asked her                                                               
whether  believes that  there are  other types  of radiation  use                                                               
that ought to only be performed by licensed individuals.                                                                        
REPRESENTATIVE  WILSON opined  that anytime  one is  performing a                                                               
procedure  that  is  "all  inclusive"  -  such  as  a  mammogram,                                                               
magnetic   resonance  imaging   (MRI),   or  computerized   axial                                                               
tomography  scan (CAT  scan)  - that  person  should be  licensed                                                               
because  the procedure  is so  specialized,  adding that  usually                                                               
such  people  receive  special  training   in  the  use  of  that                                                               
equipment anyway.  She surmised  that such persons and procedures                                                               
are already covered and so she is not as concerned about them.                                                                  
2:59:53 PM                                                                                                                    
REPRESENTATIVE GARA said he is  wondering whether the bill should                                                               
perhaps focus on procedures other  than x-rays.  He asked whether                                                               
CAT scans and  MRIs expose one to more radiation  than regular x-                                                               
ray machines.                                                                                                                   
REPRESENTATIVE WILSON suggested that  others could perhaps better                                                               
respond to that question.                                                                                                       
REPRESENTATIVE GARA  asked whether registered nurses,  as part of                                                               
their course work, receive training in the taking of x-rays.                                                                    
REPRESENTATIVE WILSON said no.  She  added that she is not saying                                                               
that one  couldn't "give  too many rads"  with an  x-ray machine,                                                               
though  newer models  make doing  so difficult  because they  are                                                               
more  sophisticated and  thus much  safer.   She said  she has  a                                                               
concern  regarding exempting  licensed practitioners,  since most                                                               
of them  often don't have  the expertise needed to  operate x-ray                                                               
machines.   Relying on the  fact that licensed  practitioners are                                                               
held  accountable by  their  boards is  simply  offering a  false                                                               
sense of security, she concluded.                                                                                               
3:03:32 PM                                                                                                                    
CHAIR   McGUIRE  characterized   the   distinction  between   the                                                               
operation of  x-ray equipment and  the diagnosis of x-rays  as an                                                               
important one.                                                                                                                  
REPRESENTATIVE  WILSON noted  that even  in Wrangell,  all x-rays                                                               
are sent  to a  certified radiologist  for formal  diagnosis, and                                                               
the doctors  only offer  their belief  regarding what  the x-rays                                                               
truly shows.  She then noted that  page 2, line 16, says in part,                                                               
"(A)  the direct  supervision of  a  licensed practitioner",  and                                                               
pointed out  that in remote  areas, a  person could be  under the                                                               
direct  supervision of  someone in  another town.   Referring  to                                                               
page 4,  line 22, she noted  that the language says  in part, "or                                                               
have  demonstrated experience  sufficient in  the opinion  of the                                                               
department to  waive the program",  and asked  whether department                                                               
personnel are actually going to go  to a remote site to determine                                                               
whether  a  person  is  capable of  operating  the  equipment  in                                                               
question.   Referring to page  9, regarding  disciplinary actions                                                               
and administrative hearings, she noted  that [lines 28-29] say in                                                               
part, "within seven  days after the suspension  order is issued",                                                               
and pointed out that some areas  of the state only get mail every                                                               
other  week, and  so  as much  as  a month  could  pass before  a                                                               
response is received by the  department regarding a person's wish                                                               
to  have an  administrative  hearing take  place; therefore,  the                                                               
seven-day time  frame is  very unfair to  those residing  in some                                                               
parts of the state, she opined.                                                                                                 
3:07:47 PM                                                                                                                    
PAMELA  LaBOLLE,  The Mulder  Company,  Lobbyist  for the  Alaska                                                               
Society   of  Radiologic   Technologists   (AKSRT),  noted   that                                                               
consumers are not  testifying on this bill, and  opined that this                                                               
is because  the public has  been led  to believe that  anyone who                                                               
delivers healthcare to them is  trained, certified, and maintains                                                               
safety  for the  patient  utmost  in his/her  mind.   She  added,                                                               
"Won't they be  surprised when they find out that  the people who                                                               
are  dealing with  radiation, delivering  doses  of radiation  to                                                               
these patients,  have no training," particularly  given that even                                                               
food  service  workers,   beauticians,  cosmetologists,  barbers,                                                               
hairdressers,  and truck  drivers are  required by  the state  to                                                               
have training and become licensed.                                                                                              
REPRESENTATIVE GARA noted that he  has heard both arguments, that                                                               
x-ray equipment can  be dangerous, and that x-ray  equipment - as                                                               
used in a dentist's office - delivers almost no radiation.                                                                      
MS. LaBOLLE  remarked that that dentists,  dental assistants, and                                                               
nurse practitioners have their own boards and proficiency tests.                                                                
3:11:08 PM                                                                                                                    
CLYDE  E. PEARCE,  Radiologic  Health  Specialist II,  Radiologic                                                               
Health, Laboratories,  Division of  Public Health,  Department of                                                               
Health  and  Social  Services  (DHSS),   relayed  that  the  DHSS                                                               
supports the  bill and hopes  that the concerns raised  by "small                                                               
and  rural providers"  can  be  addressed.   With  regard to  the                                                               
question  of why  people in  the  health care  field who've  been                                                               
identified  as  not being  trained  [to  take x-rays]  are  being                                                               
exempted  from  the  bill  while  other  operators  are  not,  he                                                               
acknowledged that  such is of  concern; for  example, physician's                                                               
assistants  (P.A.s) must  do everything  through,  or report  to,                                                               
their  collaborative physician,  and  so if  a  P.A. is  actually                                                               
taking x-rays,  then his/her  collaborative physician  would have                                                               
good  reason   to  be  concerned,   though  the  bill   does  not                                                               
specifically address  that issue.   He offered  his understanding                                                               
that the  purpose of the bill  is to address situations  in which                                                               
no one  is trained.   From the time  a patient enters  a facility                                                               
and the decision to take an x-ray  is made and that x-ray is then                                                               
taken and  read, there ought  to be at  least one person  in that                                                               
chain of healthcare services who is trained, he opined.                                                                         
CHAIR McGUIRE asked  Mr. Pearce to comment  regarding what levels                                                               
of  radiation  exposure  can  be expected  to  occur  in  various                                                               
MR. PEARCE  relayed that  one of  his duties  is to  [measure the                                                               
radiation  levels]of the  various types  of equipment  being used                                                               
around the state,  and said he does see differences.   He went on                                                               
to say:                                                                                                                         
     The  problem   is  that  it's   not  just   the  output                                                                    
     capability of the machine that  we need to be concerned                                                                    
     about, it's  how the machine  is used.   And I  like to                                                                    
     use the  example of  a driver of  an automobile:   when                                                                    
     you look  at the automobile with  seatbelts, and safety                                                                    
     bags,  and tinted  windshields,  and  power brakes  and                                                                    
     steering,  and  all  of [these  kinds]  ...  of  safety                                                                    
     features,  why is  [it] that  40,000  people die  every                                                                    
     year?   It's because of how  it's used.  And  when I do                                                                    
     inspections, I actually rarely find  a problem with the                                                                    
     machine even though I find  many problems with how it's                                                                    
     I  was in  Fairbanks recently,  and 42  percent of  the                                                                    
     repeated films  [and errors]  were due  to positioning.                                                                    
     Now that's not  something you normally even  cover in a                                                                    
     radiation safety  course, but  the person doing  the x-                                                                    
     rays had  no knowledge  of topographic anatomy,  and so                                                                    
     they  didn't  know  exactly where  internal  structures                                                                    
     were and  they were guessing with  the positioning. ...                                                                    
     So  there  is  a  real concern  there  about  excessive                                                                    
     exposures,  due to  how the  equipment's  used, but  in                                                                    
     terms  of procedures  in general,  we have  the routine                                                                    
     films - (indisc.) abdomen,  chest, skull x-ray; there's                                                                    
     a certain amount  of radiation there, and  we can think                                                                    
     of that as a unit of one - whatever it might be.                                                                           
     When you look at  a [computed tomography (CT) scanner],                                                                    
     the   exposure   level  can   increase   substantially;                                                                    
     however, there  are some real diagnostic  advantages to                                                                    
     a  CT  scanner,  and  also  earlier  treatment  can  be                                                                    
     critical in  saving a patient.   When you look  at bone                                                                    
     densitometers, exposures  are very  low.   [With regard                                                                    
     to]  nuclear medicine,  surprisingly,  ... the  patient                                                                    
     receives  less   exposure  than  a   corresponding  ...                                                                    
     medical x-ray  exam.  But all  that aside, as far  as a                                                                    
     comparison, it depends on how they're used.                                                                                
     So  in  the  statistics   that  have  [been]  published                                                                    
     recently,  ... one  of  those shows  [that]  about a  1                                                                    
     percent  rate of  all cancers  in the  U.S. are  due to                                                                    
     diagnostic  x-rays.     Another   one  was   showing  a                                                                    
     diminished  intellectual capacity  as a  result of  the                                                                    
     very young  being exposed to  ... diagnostic  levels of                                                                    
     radiation.  Now these are ...  up in the upper level of                                                                    
     CAT scan.  However, in  my experience, in certain areas                                                                    
     of  Alaska,  I  have  seen  those  levels  exceeded  by                                                                    
     ordinary   radiography  simply   because  of   how  the                                                                    
     equipment was  used.  And I  agree with [Representative                                                                    
     Wilson] that  the older machines  do present  a special                                                                    
     challenge; [however,] newer  machines don't guarantee a                                                                    
     lower  dose -  in fact,  there are  concerns about  the                                                                    
     doses getting  higher.  But  the older machines,  in my                                                                    
     opinion,   require  even   better  foundation   in  the                                                                    
     principles of how to use them safely. ...                                                                                  
3:16:33 PM                                                                                                                    
MR. PEARCE,  in response  to a  question, explained  that anytime                                                               
one uses  radiation, there is  risk, but the physician  is trying                                                               
to strike  a balance  between benefit and  risk.   Although newer                                                               
machines, when  used properly, result in  lower exposure, because                                                               
they  are   digital  and  produce   an  x-ray   that  compensates                                                               
automatically for  overexposure, they also have  the potential to                                                               
result in  higher exposure  to the  patient without  the operator                                                               
being aware  that such is  occurring.   In response to  a further                                                               
question, he  said it is not  true that new x-ray  machines don't                                                               
produce  any  more radiation  than  the  x-ray machines  used  at                                                               
airports for  security purposes; rather, medical  x-ray equipment                                                               
deliberately exposes  patients to radiation,  and does so  with a                                                               
much  larger  beam "and  a  lot  of  scatter from  the  patient."                                                               
Additionally, because of that "scatter",  those who operate x-ray                                                               
machines have  an incidence of  breast cancer three  times higher                                                               
[than those who do not].                                                                                                        
MR.  PEARCE,  in response  to  a  comment,  said,  "I do  have  a                                                               
concern, as a radiation inspector,  [regarding] ... the fact that                                                               
[new equipment] ... may conceal  the exposures and actually allow                                                               
even higher exposures to occur."                                                                                                
3:19:54 PM                                                                                                                    
ED HALL,  P.A., Legislative Liaison, Alaska  Academy of Physician                                                               
Assistants (AKAPA),  indicated that many of  the AKAPA's concerns                                                               
have  already been  addressed through  Version S.   He  said that                                                               
although there have been accusations  that there are people using                                                               
radiological equipment without any  training, none of his medical                                                               
colleagues have heard of any such instances.  He went on to say:                                                                
     We don't  just [pull] people  off the street  and point                                                                    
     them to the  x-ray machine and say,  "Go start shooting                                                                    
     x-rays." ...  There's a guide  book out  that addresses                                                                    
     anatomy,   we   make   sure   that   people   have   an                                                                    
     understanding  of anatomy,  [and] most  of the  clinics                                                                    
     that  I know  of [that]  ... are  using "techs"  ... to                                                                    
     shoot  their  films are  [using  somebody  who is]  ...                                                                    
     either a  community health aide  [or] ...  somebody who                                                                    
     has had some exposure to  anatomy - big, gross anatomy.                                                                    
     And then there's the text  that shows positioning, and,                                                                    
     yes,  ... it  is much  easier nowadays  to use  [modern                                                                    
     equipment]  and   have  the  technique  of   a  certain                                                                    
     exposure that one  would need to use.  So  I would like                                                                    
     everybody  to  recognize  that this  is  just  not  ...                                                                    
     blindly giving  authority to  anybody to  shoot x-rays;                                                                    
     they do have some training.                                                                                                
     As far  as training goes,  I know that  particularly in                                                                    
     the P.A. programs that I'm  aware of and several of the                                                                    
     medical  school programs  that I'm  aware of,  there is                                                                    
     not  a specific  course  on how  to  shoot x-rays,  but                                                                    
     there  are  courses  on  reading  radiography,  and  so                                                                    
     indirectly sometimes  you may get some  knowledge about                                                                    
     shooting x-rays.   But,  yes, I think  if this  bill is                                                                    
     directed  at safety,  ... then  you probably  shouldn't                                                                    
     exempt  any provider  because ...,  even  though we  do                                                                    
     have  a licensing  board that  oversees us,  it is  not                                                                    
     within most  of our  training to know  how to  shoot x-                                                                    
     rays; this  is all knowledge  that is acquired  once we                                                                    
     get into certain situations.                                                                                               
     In my clinic  I've got two nurses and  myself who shoot                                                                    
     x-rays, and ...  one of my nurses has  been through the                                                                    
     training at the [Alaska]  Native Medical Center [ANMC],                                                                    
     and she, basically, trained the  other nurse and myself                                                                    
     as far  as the  appropriate techniques  and positioning                                                                    
     and all the important things that  we do to try to keep                                                                    
     things  safe.   I  am  happy to  see  the changes  that                                                                    
     Representative    Anderson   and    his   staff    have                                                                    
     incorporated;  however, ...  ultimately,  I think  that                                                                    
     this  bill would  be best  if they  could separate  out                                                                    
     basic  radiography from  the other  procedures such  as                                                                    
     MRI and CT testing and  things where you have to inject                                                                    
     - I  think all of  those things defiantly need  to have                                                                    
     some certification.                                                                                                        
MR. HALL concluded:                                                                                                             
     And lastly,  in [regard]  to that  certification, there                                                                    
     has been talk about, if  we have a licensing board that                                                                    
     we respond  to or that  we are accountable  to, [since]                                                                    
     nurses ...  and nurse  practitioners ... all  answer to                                                                    
     the nursing  board, ... the  question has to  be raised                                                                    
     [whether  they  can]  then be  exempt  because  they're                                                                    
     under  a different  licensing board,  and, then,  can a                                                                    
     CNA  [certified  nursing assistant]  -  who  also is  a                                                                    
     licensee of the nursing board -  ... be exempt too.  So                                                                    
     I  think the  more we  talk  about this  bill, I  think                                                                    
     there's  a lot  of  unanswered questions,  but I  think                                                                    
     it's heading  in the right direction,  personally.  And                                                                    
     I  think, professionally,  around the  state, ...  it's                                                                    
     heading in the right direction,  but I still think that                                                                    
     [there  are] limitations  [that's] going  to make  this                                                                    
     very costly for  medicine in Alaska.   And just because                                                                    
     42 other  states do it ...  is not a good  ... [reason]                                                                    
     for  us to  do it  if we  are interested  in access  to                                                                    
     care.  Thank you for your time. ...                                                                                        
3:25:40 PM                                                                                                                    
RONALD L.  DEIS relayed  that his background  is one  of teaching                                                               
radiologic  technology  at  universities,  and that  he  came  to                                                               
Alaska  to  manage  a  radiology   department  [at  an  Anchorage                                                               
hospital].    Shortly  after  his  arrival,  he  began  receiving                                                               
requests to train  those who were taking x-rays  at various local                                                               
offices.   Many of those  requesting the training said  that they                                                               
hadn't any knowledge  of how to take x-rays  before getting hired                                                               
at those local offices and had  often ended up repeating an x-ray                                                               
five,  six, or  even seven  times without  being able  to get  it                                                               
right.  He  said that eventually he approached  the University of                                                               
Alaska  with   the  concept  of   teaching  an   introduction  to                                                               
radiography course, and  has since been teaching  that course for                                                               
the  last  18  years;  additionally,   he  has  been  teaching  a                                                               
[similar] course  at the ANMC,  for the  last 9 years,  to P.A.s,                                                               
nurse practitioners, and community health aides.                                                                                
MR.  DEIS said  that in  spite of  these efforts,  he still  runs                                                               
across those  who've been hired  to work  in an office  or clinic                                                               
and  have  been told  that  their  duties include  taking  x-rays                                                               
regardless of  the fact  that they hadn't  any training.   Again,                                                               
such people  often end up  repeating x-rays multiple times  in an                                                               
attempt to get an  adequate x-ray.  He said that  as a person who                                                               
is  very   familiar  with  the  radiology   procedures  currently                                                               
practiced in  the state, he thinks  that the state needs  to know                                                               
who  is administering  ionizing radiation  and institute  minimum                                                               
educational and clinical standards.                                                                                             
3:28:52 PM                                                                                                                    
BARBARA  HUFF TUCKNESS,  Director,  Governmental and  Legislative                                                               
Affairs,  Teamsters  Local  959, relayed  that  her  organization                                                               
supports both  HB 150 and its  members who work in  the industry,                                                               
for example,  those who work  at South Peninsula  Hospital, which                                                               
does  require certification  of  its radiological  technologists,                                                               
and Providence Kodiak Island Medical  Center, adding that she was                                                               
quite  surprised to  find out  a couple  of years  ago that  such                                                               
certification was not  already a state requirement.   She pointed                                                               
out that  not only are  the state's certified  nursing assistants                                                               
and  phlebotomists  required  to  be certified  -  regardless  of                                                               
whether they  are in  rural or  urban settings -  but so  are the                                                               
state's truck drivers.                                                                                                          
MS. HUFF TUCKNESS surmised that a  lot of people believe that the                                                               
[bill pertains  to] just  x-rays and  mammograms, and  noted that                                                               
since she  has become aware of  the fact that the  state does not                                                               
require certification  of those  using radiologic  equipment, she                                                               
has begun asking those who  are performing those services for her                                                               
whether they are certified.  She added:                                                                                         
     I do not believe that  the public, in general, realizes                                                                    
     the degree and the type  of work that these individuals                                                                    
     are  performing.    And  ...  while  we  supported  the                                                                    
     original version of  the bill, I think  that there have                                                                    
     been some  somewhat reasonable compromises -  there are                                                                    
     probably  some areas  that I  would say  we've probably                                                                    
     gone a  little bit  too far the  other direction  - but                                                                    
     having something on  the books and moving  in the right                                                                    
     direction I  think, both  from an  employee perspective                                                                    
     working  in the  industry as  well as  a public  health                                                                    
     safety issue, I would  encouraged the committee to move                                                                    
     the bill forward.                                                                                                          
3:33:52 PM                                                                                                                    
B.J.  ANDERSON,  Anchorage  Neighborhood  Health  Center  (ANHC),                                                               
first  relayed that  she is  the ANHC's  x-ray manager,  and then                                                               
referred  to  the  provision in  the  bill  addressing  temporary                                                               
permits,  and said  that  they [at  the ANHC]  have  been led  to                                                               
believe that  a person who  wants to  begin training [and]  get a                                                               
limited license  only needs be  enrolled in a program.   However,                                                               
she pointed out,  proposed AS 08.89.170(a)(1) and (2)  say that a                                                               
person  must  have  first  completed the  program  and  taken  an                                                               
examination.   Therefore,  she opined,  the wording  in the  bill                                                               
should be changed to reflect that  once a person is enrolled in a                                                               
training  program and  has a  mentor, then  the person  can begin                                                               
working under a temporary permit.                                                                                               
MS.  ANDERSON  then pointed  out  that  using mammography  as  an                                                               
example of  the type of x-ray  that [this bill would  address] is                                                               
inappropriate  because  mammography  technicians  in  Alaska  are                                                               
already  certified by  the ARRT,  are already  working under  the                                                               
umbrella   of  the   Food  and   Drug  Administration's   (FDA's)                                                               
Mammography  Quality Standards  Act of  1992 (MQSA)  program, and                                                               
are  required  to  have  American   College  of  Radiology  (ACR)                                                               
certification.  She went on to say:                                                                                             
     Any clinician or clinic has  a huge liability providing                                                                    
     healthcare  services,  and  ... they  have  taken  that                                                                    
     seriously by using a mentoring  approach to teach staff                                                                    
     how to safely perform radiologic  procedures.  And so I                                                                    
     think ...  this is  one of  the reasons  why this  is a                                                                    
     very   difficult   bill   in   that   we're   requiring                                                                    
     certification but  we're forgetting  that in  the rural                                                                    
     areas they  are drawing  people from the  community and                                                                    
     teaching them, on  the job training, how  to perform x-                                                                    
     ray radiologic examinations.                                                                                               
     And ... I would say  for the most part, most clinicians                                                                    
     and   clinics  are   very  conscientious   about  that.                                                                    
     Perhaps ...  I can't  speak for  everyone, but  I think                                                                    
     that if this bill goes  through, it definitely needs to                                                                    
     make allowances for that  mentoring-type of approach to                                                                    
     continue, as well as the  professional training that we                                                                    
     could  get through  [the] UAA.   I  don't believe  that                                                                    
     this  bill is  ready to  progress until  some of  these                                                                    
     changes have been implemented.                                                                                             
REPRESENTATIVE GARA  asked how many hours  of on-the-job training                                                               
are  given  to  a  person  before he/she  can  operate  an  x-ray                                                               
MS. ANDERSON  said that is  hard to  estimate, given that  when a                                                               
person is  hired, he/she may  have had previous training  and the                                                               
training  specific to  that facility's  radiologic equipment  may                                                               
not  occur all  at once.   However,  if she  were to  be training                                                               
someone from the ground up, she  relayed, she would be looking to                                                               
enroll  that person  in  the  type of  program  that  the UAA  is                                                               
proposing to provide.                                                                                                           
3:40:19 PM                                                                                                                    
SUSAN  MASON-BOUTERSE,  Executive  Director,  Sunshine  Community                                                               
Health Center, provided written  testimony, which was paraphrased                                                               
by  Beth Little-Terry;  Ms.  Mason-Bourterse's written  testimony                                                               
read  [original punctuation  provided;  contains some  formatting                                                               
     My name  is Susan  Mason-Bouterse, and I  am testifying                                                                    
     in opposition to  HB 150.  I am  the Executive Director                                                                    
     of  Sunshine   Community  Health  Center,   located  in                                                                    
     Talkeetna.    We  are   a  federally  qualified  health                                                                    
     center, serving the  upper Susitna Valley.   We serve a                                                                    
     population   of  about   6,000   people,  including   a                                                                    
     significant number  of visitors  to our state  with the                                                                    
     tourism activities  in this  area.   We are  located 75                                                                    
     miles  from  the nearest  hospital  in  Palmer.   After                                                                    
     hours care is a significant part of our practice.                                                                          
     Our  provider   staff  includes  one   family  practice                                                                    
     physician,   3  physician   assistants,  and   2  nurse                                                                    
     practitioners.    We  offer digital  radiology  at  our                                                                    
     center and  have a contract with  AK Imaging Associates                                                                    
     to provide  our radiology reads,  which we are  able to                                                                    
     do through tele-radiology.  We  are able to obtain stat                                                                    
     reads; our normal turn-around time is 48 hours.                                                                            
     In the  past year, we  performed a total of  52 X-Rays,                                                                    
     the majority  of which  were of  extremities.   We also                                                                    
     perform  a number  of  chest X-Rays.    Our X-Rays  are                                                                    
     performed  by  either  our  providers  or  our  medical                                                                    
     assistants.  We do NOT  require our MA's to be licensed                                                                    
     radiology technicians.   We DO provide  thorough, hands                                                                    
     on  training  for  our MA's,  including  the  areas  of                                                                    
     patient    and   practitioner    safety,   positioning,                                                                    
     equipment operation  and maintenance.  And  none of our                                                                    
     MA's perform X-Rays without  the provider being assured                                                                    
     they are competent and fully qualified.                                                                                    
     I  do not  oppose this  bill in  its proposed  purpose,                                                                    
     which  is  to  ensure  quality of  care  for  patients.                                                                    
     However,  I  do  not   believe  that  simply  requiring                                                                    
     licensure will  ensure that purpose  is achieved.   And                                                                    
     the very likely  impact of this bill  is reduced access                                                                    
     to care  for people  in rural parts  of Alaska  and for                                                                    
     people who  are already challenged in  accessing health                                                                    
     care,  those  without insurance.    In  a rural  health                                                                    
     center such  as ours, we  often are the first  point of                                                                    
     contact  for individuals  seeking health  care.   Being                                                                    
     able   to  offer   radiology   services  provides   the                                                                    
     Opportunity  to   catch  severe   and  life-threatening                                                                    
     diagnoses early                                                                                                            
     Ensuring  that   uninsured  patients  will   be  follow                                                                    
     through  with   specialty  care,  such   as  orthopedic                                                                    
     referrals (we provide the referring  X-Ray and are able                                                                    
     to offer it at discounted fee)                                                                                             
     Reduced costly  emergency transports and  admissions to                                                                    
MS. MASON-BOUTERSE'S written testimony continued:                                                                               
     I  would  like  to  give  you a  couple  of  real  life                                                                    
     examples  of   how  our  ability  to   offer  radiology                                                                    
     provides immense benefits to  our patients:  (these are                                                                    
     scenarios - you will need to ad lib a bit)                                                                                 
     Chest  X-Ray  revealed  lung carcinoma  in  an  elderly                                                                    
     gentleman in our community.   He was not willing to see                                                                    
     a  specialist  or  pursue  any  type  of  referral  for                                                                    
     treatment.   The  diagnosis of  the cancer  is allowing                                                                    
     our staff to  explore options with him  and is allowing                                                                    
     him and  his family  to prepare  for the  difficult and                                                                    
     challenging times ahead.                                                                                                   
     A  woman called  our  after hours  services.   She  had                                                                    
     fallen  and needed  X-Rays.   Unfortunately, our  X-Ray                                                                    
     was down at that time and  she did not follow up and go                                                                    
     to the hospital  for X-Ray.  She also  didn't come back                                                                    
     when we called her the  following week to have her come                                                                    
     in for X-Rays  once our equipment was  functional.  She                                                                    
     called 3  weeks later, complaining  of pain and  was X-                                                                    
     rayed  at  that  time.   Unfortunately,  her  treatment                                                                    
     course by that  time was much more  complex and painful                                                                    
     due  to her  delay in  seeking  care -  the bones  were                                                                    
     fractured and had  begun to heal unaligned -  had to be                                                                    
     re-broken  and re-set,  with  resultant poorer  outcome                                                                    
     than should have been.                                                                                                     
     This bill,  though intended to improve  quality of care                                                                    
     and  ensure  safety,  actually could  severely  curtail                                                                    
     access to care.   It could very likely  have the effect                                                                    
     of making  radiology the sole  domain for  a privileged                                                                    
     few,  mostly urban  sites.    With the  ever-increasing                                                                    
     costs   of  health   care,  I   would  prefer   to  see                                                                    
     legislation that  reduces barriers to care  rather than                                                                    
     increasing  them.   If ensuring  quality  is truly  the                                                                    
     goal  of  this  proposed  legislation,  then  requiring                                                                    
     continuing education  and periodic  proficiency testing                                                                    
     of non-licensed  personnel seems a much  more effective                                                                    
     way  to  ensure  quality and  safety  without  reducing                                                                    
     access to care.                                                                                                            
     Thank you for your consideration of this testimony.                                                                        
3:45:27 PM                                                                                                                    
LORREN J. WEAVER, M.D., Medical  Director, Camai Community Health                                                               
Center, said he  is testifying in opposition to HB  150 on behalf                                                               
of  the Bristol  Bay Borough,  which is  the owner  of the  Camai                                                               
Community Health Center.  He said:                                                                                              
     I  believe having  licensed radiological  technologists                                                                    
     at our  clinic will not significantly  increase safety,                                                                    
     raise  the standard  of care,  or  improve security  of                                                                    
     diagnosis  in  our  setting.   I  understand  that  bad                                                                    
     things happen and that people  can be damaged by people                                                                    
     that  do things  wrong.   We  have  always trained  our                                                                    
     people; I think  it always has been  incumbent upon the                                                                    
     primary care  providers to oversee  the quality  of the                                                                    
     films that are read -  radiologists read them - as well                                                                    
     as [offer]  oversight.  Even  though [Mr.  Pearce] says                                                                    
     that there  are people  that are getting  radiated, I'm                                                                    
     sure that may be happening,  but I think passing a bill                                                                    
     does not change that necessarily.                                                                                          
     For  example,  a chest  x-ray  is  touted to  have  the                                                                    
     radiation equivalent  to one  day's sunlight. ...  In a                                                                    
     limited scope  clinic, I don't believe  that the amount                                                                    
     of radiation,  even though there  may have to be  a few                                                                    
     repeats, is  carcinogenic; I  don't think  that there's                                                                    
     any evidence  presented that extremity films  and skull                                                                    
     films and  spine [films]  produce enough  radiation for                                                                    
     carcinogenic  [results].  ...   I  don't  think  anyone                                                                    
     argues  against the  fact  that  CT, MRI,  mammography,                                                                    
     arteriography,  and ...  multiple  ... other  radiation                                                                    
     therapy [modes]  all should be heavily  governed and do                                                                    
     have  risk,  [but]  I believe  that  [with  regard  to]                                                                    
     simple  scope  procedures  done  in  rural  areas,  the                                                                    
     benefits  far outweigh  the risks  and  the costs  [the                                                                    
     procedures] may actually obstruct.                                                                                         
     We're [home to] the largest  wild salmon fishery in the                                                                    
     world  ..., and  we see  a lot  of trauma.  ... And  in                                                                    
     fact, our  population may grow  from ... 1,200  to well                                                                    
     over 10,000  in the summertime. ...  Most Alaskans know                                                                    
     that [the] fishing industry is  dangerous and has a lot                                                                    
     of  injuries.    [I've]  heard   a  certain  amount  of                                                                    
     anecdotal stories where people's  lives have been saved                                                                    
     by radiology,  and I can  voice that  this is true  - I                                                                    
     can give you  any number of cases  where that happened.                                                                    
     For example,  someone with a pneumothorax,  which means                                                                    
     a ruptured  lung, if  that diagnosis  is not  made here                                                                    
     and a  chest tube [inserted]  ..., the person  will die                                                                    
     before  (indisc.)  we're  approximately 289  air  miles                                                                    
     from anchorage, which is a tertiary care [facility].                                                                       
DR. WEAVER continued:                                                                                                           
     So  stabilization and  radiology  go hand  in hand  for                                                                    
     trauma  cases,  and  I think  it's  important  that  we                                                                    
     maintain  that.     I  think  that   having  radiologic                                                                    
     technologists will not improve  that situations and, in                                                                    
     fact,   we    have   tried   to    recruit   registered                                                                    
     technologists out  here and we usually  get the guffaw:                                                                    
     "You mean go  to rural Alaska?  I don't  think so."  So                                                                    
     ... we  need to face the  reality here and do  the best                                                                    
     we can.   Obviously patients  need to be safe,  [but] I                                                                    
     don't   think    giving   the    [American   Radiologic                                                                    
     Technologists] the responsibility for  how we do x-rays                                                                    
     in rural Alaska  is helpful.  No  one's arguing against                                                                    
     [certification for] more complex procedures.                                                                               
     I think that the other  thing that would happen is, ...                                                                    
     if  we're not  able to  use in-house  people to  do the                                                                    
     radiology,  it will  cost  us  approximately twice  the                                                                    
     amount of  money it would  cost to operate;  this would                                                                    
     probably  mean  that we  would  have  to cut  back  our                                                                    
     services.   We are  ... currently  at ...  24/7/365 day                                                                    
     operations,  ...  [and]  we   have  no  other  hospital                                                                    
     facility  nearby; ...  we're barely  able  to keep  our                                                                    
     doors open with the amount  of technology that we have.                                                                    
     We  are  a  community  health center  which  is  funded                                                                    
     through  the same  federal  grants  that the  [Sunshine                                                                    
     Community Health Center]  in Talkeetna is.   We have to                                                                    
     think about the cost to  patients.  If patients have to                                                                    
     go  to  Anchorage  ... [facilities]  for  simple  x-ray                                                                    
     procedures,  this   will  cost   in  the   hundreds  of                                                                    
     thousands of  dollars for them; that  doesn't mean that                                                                    
     they can't  be safe with  what we do here,  but passing                                                                    
     the bill will not improve that percentage.                                                                                 
3:51:47 PM                                                                                                                    
KAREN  FAGERSTROM, Director,  Village Health  Services, Community                                                               
Health  Services   Division,  Norton  Sound   Health  Corporation                                                               
(NSHC), relayed that  she is trained as an  advanced family nurse                                                               
practitioner,  and  that  she  is  in opposition  of  HB  150  as                                                               
currently written.  She went on to say:                                                                                         
     We  are   currently  in  the  process   of  introducing                                                                    
     radiology equipment in  our area.  We  have one machine                                                                    
     that is  currently in use  and we have three  more that                                                                    
     we'll be  bringing on line  in the next  several years.                                                                    
     Anytime   new  technology   is  introduced,   obviously                                                                    
     training has  to take place  so that the  equipment can                                                                    
     be operated  safely for the  patient and  the operator.                                                                    
     Currently we have  a P.A. who's been  doing x-rays over                                                                    
     a  number  of  years,  and he's  the  one  that's  been                                                                    
     operating  the   machine.    We  now   have  a  [person                                                                    
     associated  with  Community Health  Aide  Practitioners                                                                    
     (CHAP)] who  is learning  to ...  take x-rays;  we sent                                                                    
     her  to the  class  offered by  [Mr.  Deis] along  with                                                                    
     another  "midlevel"  ...,  and   now  they're  back  in                                                                    
     Unalakleet working  [under] the  tutelage of  the other                                                                    
     P.A. and learning how to take x-rays.                                                                                      
     In the villages,  number one, as far as  the Bush goes,                                                                    
     we're basically  going to be  doing simple films.   The                                                                    
     idea  of mammography,  that only  takes place  in Nome,                                                                    
     and  there is  a  licensed,  registered technician  who                                                                    
     simply  does   mammography.     As  far   as  radiation                                                                    
     treatment, MRI, CT, none of  that even exists for Nome,                                                                    
     let  alone is  it ever  going  to exist  in a  village.                                                                    
     Potentially   we're   looking   at   [having]   a   CT,                                                                    
     eventually, here  in Nome, and  that person,  who would                                                                    
     come in  ... [and] operate that  [would] have licensure                                                                    
     and everything needed.                                                                                                     
     I'm  speaking   ...  to  the   portion  of   this  bill                                                                    
     [pertaining] ...  to the people who  would take limited                                                                    
     radiology.   What we did,  in order to get  this person                                                                    
     on line, was started  looking [at] writing policies and                                                                    
     procedures,  and ...  [limit] their  scope of  practice                                                                    
     ... as  it ...  would be  in the  bill; ...  they would                                                                    
     only take  radiology of the chest,  abdomen, and axial-                                                                    
     appendicular skeleton,  and that's basically  what [we]                                                                    
     would  have  them do  out  in  this  area -  we're  not                                                                    
     looking  to have  them  do any  more  than that  [aside                                                                    
     from]  also learning  how to  operate  the new  digital                                                                    
     I  went online  trying  to find  information about  the                                                                    
     classes taught  at [the] UAA,  and I cannot  locate any                                                                    
     information  to  be  able to  download  exactly  what's                                                                    
     included in  that class except  [to find out  that] ...                                                                    
     the  first  credit  hours   [consist  of]  anatomy  and                                                                    
     physiology, [and  that] the second  portion of  the ...                                                                    
     classes that  can be  taken - section  two and  three -                                                                    
     can   be  taken   concurrently.   ...  I've   requested                                                                    
     information, [but]  I've not  received any, and  I have                                                                    
     great hesitation  about being approved for  that class,                                                                    
     [given  that we]  can't even  find  out exactly  what's                                                                    
     being taught in it.                                                                                                        
MS. FAGERSTROM continued:                                                                                                       
     One of  the things,  also, that would  make it  a great                                                                    
     hardship,  is  [that] in  this  bill,  in [proposed  AS                                                                    
     08.89.160], it says, for the  limited person, that they                                                                    
     have to  have a certain amount  of clinical instruction                                                                    
     ...,  [which is  defined as]  hands-on experience  in a                                                                    
     health care setting, under the  direct supervision of a                                                                    
     practitioner    or    fully    licensed    radiological                                                                    
     technologist.  I  have a problem with  that because ...                                                                    
     there  would obviously  be a  certain  number of  hours                                                                    
     that we would  need to be able to train  that person in                                                                    
     Nome,  but  also we  have  a  limited number  of  x-ray                                                                    
     procedures [that] are going to take place.                                                                                 
     ... How long  is that person going ... to  have to [be]                                                                    
     out  of their  villages, here  in Nome  getting x-rays?                                                                    
     ... Is there  a place that we can send  it to the ANMC?                                                                    
     What,  creatively, can  we  do to  get  that person  in                                                                    
     [and] get the training that  they need to safely do the                                                                    
     procedures  but  not be  out  of  their village  for  X                                                                    
     number  of  weeks  to   months  while  obtaining  that,                                                                    
     because [the] CHAPs are the  direct care providers.  So                                                                    
     I agree  with the idea  that there has to  be training,                                                                    
     but how can  we make it more Bush friendly  to get that                                                                    
     training  without making  it [an]  extreme hardship  on                                                                    
     the people who are here in the Bush.                                                                                       
     Also,  with  the  [continuing medical  education  (CME)                                                                    
     requirements],  how does  that relate  ... specifically                                                                    
     for the  CHAPs when they're  doing a limited  amount of                                                                    
     CME?   Is that CME  going to  [be] written for  them as                                                                    
     applicable  to  their  practice?   That's  one  of  the                                                                    
     questions I have that's not  really addressed here. ...                                                                    
     So  ... while  I agree  with  the area  of needing  the                                                                    
     training,  there's  a  number of  specific  issues  ...                                                                    
     [that have] not been  adequately addressed for the Bush                                                                    
     and [would]  potentially make [it] a  real hardship for                                                                    
     us [to] try to meet this bill as it stands.                                                                                
CHAIR McGUIRE asked Ms. Fagerstrom  to provide the committee with                                                               
any  specific suggestions  she has  for improving  the bill  with                                                               
regard to  its educational and mentoring  provisions, suggestions                                                               
other than to simply exempt all those in rural settings.                                                                        
MS. FAGERSTROM relayed that she would pass on Chair McGuire's                                                                   
request to the CHAP directors at their next meeting.                                                                            
CHAIR McGUIRE said she will suggest to the sponsor that he work                                                                 
with [CHAP and NSHC] on an individualized basis.                                                                                
4:00:35 PM                                                                                                                    
LOUISE REED, Diagnostic  Imaging Director, Yukon-Kuskokwim Health                                                               
Corporation (YKHC),  relayed that  the aspects  [of HB  150] that                                                               
the YKHC is most interested in  are the training provisions.  She                                                               
said  she understands  the concerns  expressed by  those in  Bush                                                               
communities  regarding   being  able  to  acquire   the  training                                                               
required to  do the  jobs they've been  assigned.   She mentioned                                                               
that  the  YKHC has  four  outlying  clinics that  provide  x-ray                                                               
services, and that  the YKHC set up its own  [training] program a                                                               
few  years back  when it  started to  set up  x-ray equipment  in                                                               
places like Emmonak,  Saint Marys, Aniak, and Toksook.   The goal                                                               
of that training  program was to ensure that  those taking x-rays                                                               
would have  the training to  do a  good job and  not over-radiate                                                               
the patients;  the students  in that program  came in  from their                                                               
village  clinics to  the  hospital in  Bethel,  and the  trainers                                                               
subsequently kept in daily contact  with them as they were taking                                                               
MS. REED  referred to a  book titled, Radiography  Essentials for                                                             
Limited  Practice, and  characterized it  as an  invaluable tool,                                                             
which anyone  can order and  then take  the exams that  come with                                                               
the book in  order to obtain CME credit, adding  that this is the                                                               
same book  that is being  used in  the UAA class.   Additionally,                                                               
the UAA has just started  a limited radiography program using the                                                               
YKHC's hospital and students from  the YKHC's outlying clinics as                                                               
a beta  test station  for the  rest of the  state.   The program,                                                               
which  started   in  January,  is  delivered   through  "distance                                                               
education" and so students are able  to meet once a week and then                                                               
proceed at their own pace.                                                                                                      
MS. REED relayed that the YKHC  has great hopes that this program                                                               
will set the standard for the  rest of the state, adding that the                                                               
YKHC is very interested in seeing  the bill pass; considers it to                                                               
be doable;  believes that training,  particularly with  regard to                                                               
safety and  radiobiology, is much  needed; and is  concerned both                                                               
about its patients  and the levels of radiation  they are exposed                                                               
to,  and  about staff's  ability  to  take  x-rays that  lead  to                                                               
accurate  diagnoses.   She concluded  by saying  that the  YKHC's                                                               
concern is that  its employees have the training they  need to do                                                               
the job that's expected  of them, and feels that it  is in a good                                                               
position to help get a statewide program instituted.                                                                            
4:06:28 PM                                                                                                                    
CHRIS DEVLIN, Executive Director,  Eastern Aleutian Tribes, Inc.,                                                               
testified in  opposition to  HB 150, opining  that the  bill will                                                               
negatively impact  access to  [health] care  in rural  Alaska and                                                               
increase the cost  of that care without guaranteeing  safety.  He                                                               
noted that his organization has  nine clinics, four of which have                                                               
x-ray [equipment], out  in the Aleutian Islands,  and that x-rays                                                               
are an  essential diagnostic  tool in  the treatment  of injuries                                                               
resulting from accidents in the area's fishing industry.                                                                        
MR. DEVLIN said  his organization ensures that  its employees get                                                               
some training  in the use of  x-ray equipment, and so  to have to                                                               
go through  another state regulatory  process and  licensing will                                                               
only increase costs  and perhaps result in no  x-rays being given                                                               
because  the   current  in-house  training  will   no  longer  be                                                               
considered  sufficient.   Without  providing for  either a  rural                                                               
exception or a "remote safety-net  exception," the bill, which he                                                               
characterized  as  premature,  probably   won't  work  for  rural                                                               
Alaska, he  remarked, reiterating his  belief that the  bill will                                                               
have a negative impact in terms of access to health care.                                                                       
4:08:01 PM                                                                                                                    
CHERYL  KILGORE, Executive  Director,  Interior Community  Health                                                               
Center  (ICHC),  relayed that  she  and  Tammy Wilkerson,  Clinic                                                               
Nurse Manager for the ICHC,  believe in the importance of quality                                                               
of  care and  the  safety  of all  those  who  are involved  with                                                               
radiology.  She said that one  of the ICHC's concerns is that the                                                               
bill could potentially create barriers  to healthcare access, and                                                               
therefore the  ICHC's hope  is that the  originators of  the bill                                                               
will take into account certain aspects  of the bill, one of those                                                               
being that currently the testing  provision is lacking in detail.                                                               
She elaborated:                                                                                                                 
     If  it's  equivalent  to  a  radiology/radiologic  tech                                                                    
     program, then  it isn't  appropriate for  somebody that                                                                    
     has a  limited scope.  I  don't think it is.   However,                                                                    
     ...  it's clear  in  the testimony  so  far today  that                                                                    
     there  is  some  concern  about  the  capacity  of  our                                                                    
     existing  system,  whether  it's  [the]  UAA  or  other                                                                    
     online  courses, to  provide  access to  the number  of                                                                    
     students that might potentially  need to have access to                                                                    
     ...  the online  courses or  get the  minimal education                                                                    
     that's required.  That should be addressed.                                                                                
     It  may  be that  the  course  itself can  be  changed,                                                                    
     although  if it's  dependent upon  [the] UAA  getting a                                                                    
     certain  amount  of  funding   in  order  to  meet  the                                                                    
     requirements of the  students, I can tell  you what our                                                                    
     experience  thus far  - although  we're  moving in  the                                                                    
     right direction  - has been  with nursing, and  that is                                                                    
     [that]  there  are  huge amounts  of  demand  and  very                                                                    
     limited  slots,  the  competition is  fierce,  and  the                                                                    
     funding  will  never  be  there  -  [funding]  that  is                                                                    
     required in order to get  all the students that want to                                                                    
     get through, done.                                                                                                         
     So I'd like there [to  be] some consideration there, in                                                                    
     this bill,  to look  at that  further, because  even if                                                                    
     you  have the  best  case scenario,  where  you had  20                                                                    
     students going  to [the] UAA  every 12 weeks -  which I                                                                    
     think everyone  would agree would be  very aggressive -                                                                    
     we  probably couldn't  meet the  demand.   And,  again,                                                                    
     since we  don't want to create  insurmountable barriers                                                                    
     to care, that area needs to be looked at.                                                                                  
MS. KILGORE continued:                                                                                                          
     The  work experience  requirement,  i.e., three  years,                                                                    
     may  be too  rigorous as  well,  and when  we look  at,                                                                    
     really, what our workforce issues  in this state are in                                                                    
     terms   of   recruiting  healthcare   professionals   -                                                                    
     including radiology techs  - we ... don't  want to make                                                                    
     something  worse  than  it   currently  is,  which  is,                                                                    
     frankly,  in   my  opinion,   already  a   fairly  grim                                                                    
     situation.  We  need to provide, and I'd  like the bill                                                                    
     to consider the bill providing,  funding - and ... this                                                                    
     is really  a legislative  issue - funding  for training                                                                    
     for these  limited radiology imagers, which  I think is                                                                    
     a good conceptual model and  might very well be the fix                                                                    
     to remote, rural areas that have difficulty.                                                                               
     And frankly, even in Fairbanks,  which we'd consider an                                                                    
     urban   area,  we   have   difficulty  attracting   the                                                                    
     radiologists and the radiology  techs.  In fact, that's                                                                    
     why  we  have  this collaboration  going  on,  locally,                                                                    
     where we  have a school  for radiology techs,  and even                                                                    
     then the demand  exceeds the capacity of  the system to                                                                    
     get  them  through.    We're   pleased  that  the  bill                                                                    
     recognizes the need for  limited radiology imagers, and                                                                    
     we'd like  to see,  perhaps, in  the bill  itself, some                                                                    
     "tiering" of activities to  accommodate these issues of                                                                    
     education and experience.                                                                                                  
     For example, if  you're a level one,  that's the basic;                                                                    
     ...  you're scope  is very  limited.   And then  as you                                                                    
     move up  [to] level  two, level  three, you  might have                                                                    
     ...  a  broader  scope,  and  be  working  towards  ...                                                                    
     potentially getting  up to where  you might even  go to                                                                    
     radiology tech  school.   That might be  a way  to deal                                                                    
     with some of these issues  that are definitely going to                                                                    
     affect  those of  us that  provide care  in remote  and                                                                    
     rural  areas.   And we  thank  you very  much for  your                                                                    
     consideration of that approach.                                                                                            
     The other thing I'd like to  just say ... [is, from the                                                                    
     perspective of] being involved in  healthcare in both a                                                                    
     rural and  urban area  for quite a  long time,  even in                                                                    
     the best of situations with  the best of technology and                                                                    
     the most  skilled people, radiology  imaging is  not an                                                                    
     exact  science.   And we  all  know that.   And  that's                                                                    
     where having qualified  people is part of  it, but also                                                                    
     having  a quality  assurance program.    And even  with                                                                    
     that in  place, you  can have  films that  don't detect                                                                    
     things.  So  really we are partners in  the delivery of                                                                    
     And we  had a situation  where we had  a film of  a hip                                                                    
     taken in  the emergency room with  the radiologist, and                                                                    
     the interpretation of the film  - even with a good film                                                                    
     -  was  accurate,  but  it  was  limited  in  that  you                                                                    
     couldn't visualize the  hip fracture on the  film.  And                                                                    
     that's  where, working  as a  team, you  really provide                                                                    
     the very  best, state-of-the-art care.   And I'd really                                                                    
     like to  see more  focus ...  on CME  and relationships                                                                    
     between  different  healthcare  providers  and  boards,                                                                    
     because it would  really improve care in  the long term                                                                    
     for Alaskans in this state.                                                                                                
MS. KILGORE concluded:                                                                                                          
     The  other piece  that I  just  would like  to put  out                                                                    
     there for your consideration  is looking at potentially                                                                    
     focusing  ...  on   providing  funding  for  continuing                                                                    
     medical   education,   in   this   regard,   to   those                                                                    
     professions  that  don't have  this  as  part of  their                                                                    
     [usual] background training.  And  also, if you look at                                                                    
     this  as  a  system  of care,  and  you're  looking  at                                                                    
     providing these  limited radiology  imagers as  part of                                                                    
     the  system, then  you would  want to  feed that  film,                                                                    
     from wherever  it's being taken,  through the  system -                                                                    
     ideally digitally,  but you  could still  manually send                                                                    
     films,  because  we  know there's  a  wide  variety  of                                                                    
     equipment  out  in  the  state   of  Alaska  -  into  a                                                                    
     radiologist, and  get a radiologist to  interpret it in                                                                    
     its  finality.   So thank  you so  much; we  appreciate                                                                    
     your consideration  of our comments, and  are very glad                                                                    
     that  you're looking  at providing  quality of  service                                                                    
     and safety.                                                                                                                
4:16:24 PM                                                                                                                    
TIMO SAARINEN relayed that he  is a registered x-ray technologist                                                               
and CAT scan technologist and  is registered in nuclear medicine,                                                               
and  noted  that  he  started  his  radiological  career  in  the                                                               
military,  via  a  limited  license,  and  so  understands  about                                                               
maintaining   standards   and    fulfilling   limited   licensure                                                               
requirements.    He said  he  supports  HB  150 because  it  sets                                                               
minimal  standards  for   safe,  quality,  diagnostic  practices,                                                               
adding that  he believes all  Alaskans deserve the  same standard                                                               
of  healthcare.    Additionally  he  noted  that  in  the  DHSS's                                                               
recently released eleventh edition  of its report on carcinogens,                                                               
it listed  x-rays as a known  carcinogen.  Patient safety  is the                                                               
main  concern, and  so a  minimal standard  ought to  be provided                                                               
for.   He relayed  that if  it were  left up  to him,  only fully                                                               
registered  x-ray technologists  would be  taking x-rays,  though                                                               
such  could be  a major  problem  in rural  areas; therefore,  he                                                               
concluded, HB  150 is very  good bill that sets  minimal standard                                                               
CHAIR  McGUIRE, after  ascertaining that  no one  else wished  to                                                               
testify,  closed public  testimony  on HB  150  [Version S],  and                                                               
relayed that the bill would be held over.                                                                                       
4:18:25 PM                                                                                                                    
There being no  further business before the  committee, the House                                                               
Judiciary Standing Committee meeting was adjourned at 4:18 p.m.                                                                 

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