04/12/2002 03:25 PM House L&C
| Audio | Topic |
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
April 12, 2002
3:25 p.m.
MEMBERS PRESENT
Representative Andrew Halcro, Vice Chair
Representative Kevin Meyer
Representative Pete Kott
Representative Harry Crawford
Representative Joe Hayes
MEMBERS ABSENT
Representative Lisa Murkowski, Chair
Representative Norman Rokeberg
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 270(L&C)
"An Act extending the termination date of the Board of
Dispensing Opticians; relating to the regulation of dispensing
opticians; and providing for an effective date."
- HEARD AND HELD
HOUSE BILL NO. 471
"An Act relating to the definitions of 'net income' and
'unrestricted net income' for purposes of determining the amount
of the Alaska Industrial Development and Export Authority's
dividend to the state; relating to communities within which
rural development loans may be made by the authority; and
providing for an effective date."
- MOVED CSHB 471(L&C) OUT OF COMMITTEE
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 282
"An Act relating to prescription drug benefits under a group
health care insurance plan."
- FAILED TO MOVE CSSSHB 282(L&C) OUT OF COMMITTEE
PREVIOUS ACTION
BILL: SB 270
SHORT TITLE:DISPENSING OPTICIANS:EXTEND BD/REGULATION
SPONSOR(S): RLS BY REQUEST OF LEG BUDGET & AUDIT
Jrn-Date Jrn-Page Action
02/01/02 2089 (S) READ THE FIRST TIME -
REFERRALS
02/01/02 2089 (S) L&C, FIN
02/14/02 (S) L&C AT 1:30 PM BELTZ 211
02/14/02 (S) Moved CS(L&C) Out of
Committee
02/14/02 (S) MINUTE(L&C)
02/19/02 2222 (S) L&C RPT CS 3DP 1NR SAME TITLE
02/19/02 2222 (S) DP: STEVENS, DAVIS,
TORGERSON;
02/19/02 2222 (S) NR: AUSTERMAN
02/19/02 2222 (S) FN1: (CED)
03/25/02 (S) FIN AT 9:00 AM SENATE FINANCE
532
03/25/02 (S) Moved Out of Committee
MINUTE(FIN)
03/25/02 2517 (S) FIN RPT CS(L&C) 5DP 3NR
03/25/02 2518 (S) DP: KELLY, AUSTERMAN, OLSON,
WILKEN,
03/25/02 2518 (S) LEMAN; NR: DONLEY, GREEN,
WARD
03/25/02 2518 (S) FN1: (CED)
03/28/02 (S) RLS AT 8:30 AM FAHRENKAMP 203
03/28/02 (S) -- Time Change --
03/28/02 (S) MINUTE(RLS)
04/02/02 2589 (S) ADVANCED TO THIRD READING
UNAN CONSENT
04/02/02 2589 (S) READ THE THIRD TIME CSSB
270(L&C)
04/02/02 2589 (S) PASSED Y18 N- E2
04/02/02 2589 (S) EFFECTIVE DATE(S) SAME AS
PASSAGE
04/02/02 2593 (S) TRANSMITTED TO (H)
04/02/02 2593 (S) VERSION: CSSB 270(L&C)
04/02/02 2586 (S) RULES TO CALENDAR 4/2/02
04/02/02 2588 (S) READ THE SECOND TIME
04/02/02 2588 (S) L&C CS ADOPTED UNAN CONSENT
04/03/02 2770 (H) READ THE FIRST TIME -
REFERRALS
04/03/02 2770 (H) L&C, FIN
04/12/02 (H) L&C AT 3:15 PM CAPITOL 17
BILL: HB 471
SHORT TITLE:AIDEA LOANS AND DIVIDEND/AEA LOANS
SPONSOR(S): REPRESENTATIVE(S)GREEN
Jrn-Date Jrn-Page Action
02/19/02 2314 (H) READ THE FIRST TIME -
REFERRALS
02/19/02 2314 (H) CRA, L&C
03/26/02 (H) CRA AT 8:00 AM CAPITOL 124
03/26/02 (H) Moved CSHB 471(CRA) Out of
Committee
03/26/02 (H) MINUTE(CRA)
03/27/02 2701 (H) CRA RPT CS(CRA) NT 6DP
03/27/02 2701 (H) DP: KERTTULA, HALCRO, SCALZI,
03/27/02 2701 (H) MURKOWSKI, MEYER, MORGAN
03/27/02 2701 (H) FN1: ZERO(CED)
04/12/02 (H) L&C AT 3:15 PM CAPITOL 17
BILL: HB 282
SHORT TITLE:PRESCRIPTION DRUG INSURANCE BENEFITS
SPONSOR(S): REPRESENTATIVE(S)COGHILL, FATE
Jrn-Date Jrn-Page Action
01/14/02 1948 (H) PREFILE RELEASED 1/4/02
01/14/02 1948 (H) READ THE FIRST TIME -
REFERRALS
01/14/02 1948 (H) L&C, HES
01/18/02 2003 (H) SPONSOR SUBSTITUTE INTRODUCED
01/18/02 2003 (H) READ THE FIRST TIME -
REFERRALS
01/18/02 2003 (H) L&C, HES
01/18/02 2003 (H) REFERRED TO LABOR & COMMERCE
04/12/02 (H) L&C AT 3:15 PM CAPITOL 17
WITNESS REGISTER
HEATHER BRAKES, Staff
to Senator Gene Therriault
Joint Committee on Legislative Budget & Audit
Alaska State Legislature
Capitol Building, Room
Juneau, Alaska 99801
POSITION STATEMENT: Testified on behalf of the sponsor of SB
270, the Joint Committee on Legislative Budget and Audit.
JAMES ROTHMEYER, Chair
Board of Dispensing Opticians
PO Box 84290
Fairbanks, Alaska 99708
POSITION STATEMENT: Testified on SB 270.
CATHERINE REARDON, Director
Division of Occupational Licensing
Department of Community & Economic Development
PO Box 110806
Juneau, Alaska 99811-0806
POSITION STATEMENT: Testified on SB 270 in support of the
extension of the Board of Dispensing Opticians.
PAT DAVIDSON, Legislative Auditor
Legislative Audit Division
Alaska State Legislature
PO Box 113300
Juneau, Alaska 99811-3300
POSITION STATEMENT: Answered questions regarding SB 270.
ROBERTA RAWCLIFFE, Public Member
Board of Dispensing Opticians
c/o Alaska USA Mortgage
851 USA Circle
Wasilla, Alaska 99654-7188
POSITION STATEMENT: Requested amendments to SB 270.
LAURA ACHEE, Staff
to Representative Joe Green
Alaska State Legislature
Capitol Building, Room 403
Juneau, Alaska 99801
POSITION STATEMENT: Testified on behalf of the sponsor of HB
471, Representative Green.
BOB POE, Executive Director
Alaska Industrial Development and Export Authority (AIDEA);
Alaska Energy Authority (AEA)
813 West Northern Lights Boulevard
Anchorage, Alaska 99503
POSITION STATEMENT: Testified on HB 471.
REPRESENTATIVE JOHN COGHILL
Alaska State Legislature
Capitol Building, Room 102
Juneau, Alaska 99801
POSITION STATEMENT: Testified as one of the sponsors of HB 282.
GERALD BROWN, Pharmacist
PO Box 70196
Fairbanks, Alaska 99707
POSITION STATEMENT: Testified that he has problems with [CSSSHB
282, Version J].
NICOLE SALINAS
National Accounts
Account Executive
Aetna US Healthcare
600 University Street, Suite 1400
Seattle, Washington 98101
POSITION STATEMENT: Testified in opposition to SSHB 282.
ROGER MORTEMORE, Pharmacist
(No address provided)
Fairbanks, Alaska
POSITION STATEMENT: Expressed the need to rewrite SSHB 282.
JACK McRAE
Premera
Blue Cross Blue Shield of Alaska
(No address provided)
POSITION STATEMENT: Responded to earlier questions regarding
SSHB 282.
ANGIE LeBOEUF, Pharmacist
(No address provided)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SSHB 282.
DAN HEINCY, RPL
Associate Director
Government Affairs
Merck & Co, Inc.
6930 Boardwalk Drive
Granite Bay, California 95746
POSITION STATEMENT: Testified on SSHB 282 on behalf of Merck-
Medco Managed-Care L.L.C.
ROBIN PHILLIPS, Staff
to Representative Lisa Murkowski
Alaska State Legislature
Capitol Building, Room 408
Juneau, Alaska 99801
POSITION STATEMENT: Answered questions regarding SSHB 282.
ACTION NARRATIVE
TAPE 02-55, SIDE A
Number 0001
VICE CHAIR ANDREW HALCRO called the House Labor and Commerce
Standing Committee meeting to order at 3:25 p.m.
Representatives Halcro, Meyer, Kott, and Crawford were present
at the call to order. Representative Hayes arrived as the
meeting was in progress.
SB 270-DISPENSING OPTICIANS:EXTEND BD/REGULATION
[This is a verbatim transcript.]
VICE CHAIR HALCRO: Senate Bill 270, Board of Dispensing
Opticians. We'll welcome to the committee Heather Brakes from
Senator Therriault's office. Heather, welcome to the committee.
Number 0070
HEATHER BRAKES: Thank you, Mr. Chairman and members of the
committee. My name is Heather Brakes, staff to Senator
Therriault and the Legislative Budget and Audit Committee, which
is the sponsor of Senate Bill 270. Senate Bill 270 was drafted
based on an audit ... conducted by the Legislative Audit
Division and released by the Budget and Audit Committee on
January 24th, 2002. The audit had several concerns about the
board. One of those concerns was addressed in Recommendation
Number 1 on page 7 of the audit report that's in your packet.
The auditor stated in part, the disparity between the number of
people who become licensed and the number of people registering
to be apprentices suggests the 6,000-hour requirement for
apprenticeship "may unduly prohibit people from getting
licensed." The auditor suggested the board reconsider the
necessity of the 6,000-hour requirement.
MS. BRAKES: On page 13 of the audit, a table shows the number
of both licensed dispensing opticians and those that have
registered as apprentices. On page 15 of the report, the board
response does agree with the auditor's recommendation, although
in doing so, the board then wanted to add an $800 correspondence
course to that requirement. We have not included that in our
legislation and feel it would be a hardship to the employee and
... may even be shifted onto the employer.
MS. BRAKES: Recommendation Number 2 of the audit addresses the
board's state exam. The prior audit ... finding made in the
1995 sunset review recommended that the board improve the
objectivity and consistency of the state's exam. After finding
again that the board's exam process was flawed in several of the
cases selected for review by the auditors, the auditors suggest
the board give serious consideration to discontinuing the
practical exam and require applicants to pass the nationally
recognized examinations offered. Those examinations are
incorporated in Senate Bill 270.
MS. BRAKES: The auditors continue to be concerned about the
apparent subjectivity or error-prone nature of the exam. On
page 11, fourth paragraph down, the auditors found in part:
"The board has not resolved the prior sunset audit
recommendation related to the state practical examination. The
objectivity and consistency of the state practical examination
did not improve over the current sunset review period, resulting
in successful challenges by applicants who originally were
determined to have failed the test." The board has offered
several solutions to the problem, we feel at this time -- none
of which fully resolve the situation.
MS. BRAKES: Under the Auditor Comments section of the report,
the auditor makes the assessment that moving to a "register"
system and eliminating the board may have merit. Although
Senate Bill 270 does not do that, it is something the
legislature may wish to consider in the future. Currently, 22
states license through regulatory boards; the remaining either
use a register system or do not regulate dispensing opticians at
all. With that, Senate Bill 270 extends the board for three
years, in contrast to the normal four-year extension. It
reduces the number of apprenticeship hours from 6,000 to 3,000
and accepts an associate's degree in opticianry ... in place of
any of the apprenticeship hours. It removes the state's
practical exam and replaces it with acceptable passage of the
national examinations. And with that, I would conclude my
testimony. Pat Davidson, the legislative auditor, is here to
answer any specific questions to the audit, and Catherine
Reardon is here as well.
VICE CHAIR HALCRO: Thank you very much, Heather. Any questions
for Ms. Brakes? Seeing none, Catherine I'm going to hold you
till last. Let's go [to] teleconference, to the Fairbanks LIO
[Legislative Information Office], James Rothmeyer. Mr.
Rothmeyer, are you online?
JAMES ROTHMEYER: Hello.
VICE CHAIR HALCRO: Yes. If you could state your name and
affiliation for the record, please, and please keep your
testimony to under three minutes.
MR. ROTHMEYER: Certainly. My name is Jim Rothmeyer. I'm the
Chair of the State Board of Dispensing Opticians.
VICE CHAIR HALCRO: Did you have any testimonies, Mr. Rothmeyer,
or were you just ...?
MR. ROTHMEYER: Yes, I had a couple of comments and testimony.
VICE CHAIR HALCRO: Please proceed.
Number 0442
MR. ROTHMEYER: In regards to the ... 6,000-hour requirement,
just reducing the hours from 6,000 to ... 3,000 hours makes not
much sense to me without adding an education-and-training
program such as the Career [Progressions] Program by the
National Academy of Opticianry. And just reducing the
apprenticeship hours, these applicants would undoubtedly [be]
even worse-prepared and trained than they are now. As far as
the state examination goes, it's a key element in having
applicants demonstrate their ability, or lack of, in performing
routine tasks needed to ensure their proper accuracy, and in
some cases, the safety standards of spectacles/materials
dispensed. I think we need to ... be able to have professional
oversight, peer review, to maintain quality and standards that
the public expects and deserves. Thank you.
VICE CHAIR HALCRO: Thank you very much, Mr. Rothmeyer. Is
there any questions? Seeing none, next we'll go to the Mat-Su
LIO. Roberta Rawcliffe, are you online? Roberta Rawcliffe. We
will come back to the Mat-Su LIO. Catherine Reardon. Heather,
if you'll just stay at the table, that'd be great.
Number 0538
CATHERINE REARDON: Thank you. For the record, this is
Catherine Reardon, Director of the Division of Occupational
Licensing in Department of Community and Economic Development.
And my division staffs the Board of Dispensing Opticians. I
will try to be brief and yet mention a few issues I think may be
relevant to this legislation. The division does support the
extension of the Board of Dispensing Opticians. And there are
two remaining issues that Mr. Rothmeyer referred to. And with
your indulgence, I'd ask you to ... consider amendments that
relate to them that -- I realize it's not my role to offer
amendments, but to consider this possibility, and there is some
text that you have on the table.
[The two amendments provided by Ms. Reardon read as follows,
with original punctuation:
Amendment No. 1
Page 3, line 13:
Insert a new paragraph to read:
(4) has successfully completed a career
progression program required by the board in
regulation;
Renumber the remaining paragraph
Page 3, line 14
Amend to read:
(b) Graduation from an associate degree program in a
recognized school or college of opticianry may be
substituted for [4,000 OF THE 6,000 HOURS OF
EXPERIENCE REQUIRED BY (a)(2)] the requirement of
(a)(2) and (a)(4) of this section.
Page 3, line 31
Add a new section to read:
AS 08.71.165. Assistants.
A person who is not a licensed dispensing optician may
assist a licensed physician, optometrist or dispensing
optician. The person may perform dispensing optician
tasks that have been specifically delegated by, and
are performed under the direct supervision of, the
licensed physician, optometrist or dispensing
optician. The person may not use a title including
the word "optician or "opticianry."
Amendment No. 2
Page 2, line 19
After "shall" add "pass a practical examination given
by the board and"
Page 2, line 24
After "shall" add "pass a practical examination given
by the board and"
Delete Sections 2 and 6
(end of Ms. Reardon's proposed amendments)]
Number 0563
MS. REARDON: These two issues are the ... practical exam. The
board feels the practical exam is important to ... determine if
people are qualified to work as dispensing opticians, because
the written national examinations, although good, are written
tests, and they'd like to know that the applicants have the
ability to use the machinery that's involved and do the
practical skills. There have been difficulties at times in
administering the practical exam in an exactly equivalent manner
- not through any bad intent, but through sometimes the
difficulty of creating the exact same situation with equipment
for applicants. But the board feels that they've been working
to improve the exam, that they should be able to continue
offering it or to contract out to the private sector to offer
it.
MS. REARDON: If ... the committee feels that the practical exam
should be permitted to continue for the next three years, I do
have draft language that would - ... if you have my text, it's
called Amendment 2 - ... do that. Another alternative, either
with that or instead of it, is perhaps a letter of intent that
would say that the board should study the options for practical
exams for the next couple years - two years - and report back to
the legislature so that those recommendations could be
considered in the next audit process. The point of doing that
would be that it would kind of keep the idea of a practical exam
alive, give the board a task to try to find a fair, easy-to-
administer practical exam. The idea ... would come back again
at the next sunset audit and wouldn't be lost to history, and
would give the board the ability to feel like it was still able
to engage in the debate over the exam, even if you eliminate it
for the next couple of years. And that's what the one-paragraph
letter of intent says.
Number 0704
MS. REARDON: The other important issue was referred to by Mr.
Rothmeyer, ... the board's desire that applicants for licensure
get some education in addition to their apprenticeship hours.
The bill reduces apprenticeship hours by half. A thousand hours
is about six months. So the apprenticeship is going from three
years to a year and a half. And the board would be okay with
that if ... there were some education that was going to be
required. There is a program called the Career Progression
Program - there's a pamphlet there on it, on the table - which
is a correspondence course that the board feels would really
improve the knowledge of applicants for dispensing optician
licenses, and would prepare them to better pass the ... national
exam. It is $800, as referred to by Ms. Brakes. The initial
proposal by the board had been to require this of all
apprentices, but the new proposal is that it be required to get
a license.
MS. REARDON: But here is the significant difference: that
today, if you're going to work as an assistant to an
optometrist, of a ophthalmologist or an optician, if you are
going to do "dispensing optician" in a supervised capacity, as
an assistant - you must register as an apprentice. The proposal
here is to do away with that requirement that you're going to be
an apprentice. If you don't wish to be an apprentice and you
don't wish to work towards licensure, you ... don't have to.
That's a big concession on the part of the board, because this
has been an age-old battle between the optometrists and the
opticians: that optometrists' employees have to register as
opticians.
Number 0812
MS. REARDON: This - what I have here is Amendment 1 - would say
that you can be an assistant without being an apprentice, but if
you choose to go on and work towards licensure, sign yourself up
as an apprentice and take the Career Progression Program. And
the reason this is a significant kind of perhaps solution to
situations that have been going on with opticianry is because at
the current time it seems like -- the law reads that you have to
have a dispensing-optician license to do dispensing opticianry
unless you are a student - kind of like a student hairdresser
can cut hair - unless you are an apprentice. But that
apprentice system seems to have evolved from being students who
want to be licensed to being techs, paraprofessionals - like
your pharmacy tech or a vet tech, people who don't necessarily
want to go on. But because the system was set up anticipating
that apprentices were people who wanted to go on, there hasn't
been a way for people who want to stay techs and just have this
job of being a tech. To do it legally, we were forcing them to
get apprentice licenses, causing tension with the optometrists
and the physicians who also employ these techs.
MS. REARDON: And so this offering would say, "Recognize that
... a lot of people who are apprentices now are really techs,
don't want to get a license, let them not pay us money; let them
just be techs under supervision. But the ones who really are
apprentices and who really do want to train up, have them take
the Career Progression Program, get the education as well as
this reduced number of hours so they will be better qualified to
pass the test." And I ... want to set that before you, because
it ... seems like a - in certain ways to me - a major concession
of something that has been a long battle. And it is my
understanding, kind of through a third source, that this [is]
something that the board can ... accept. So ...
VICE CHAIR HALCRO: Thank you. Any questions for Ms. Reardon?
Representative Crawford.
Number 0928
REPRESENTATIVE CRAWFORD: Thank you, Mr. Chairman. It seems to
me that we're on uncharted ground here, and that there could be
some unintended consequences if we ... go this way. I mean,
it's definitely going to be a change. How do we compare with
other states? And do they have techs? Do they have
apprentices? Is 6,000 hours ... the norm or 3,000 hours the
norm? ... How do we compare with other ... states?
MS. REARDON: Through the chair, Representative. I believe that
quite a few other states do have an apprenticeship requirement
to get licensed. I think the leg [legislative] auditor may be
more knowledgeable, but I've heard her testify in the past about
the length of time for apprenticeship. But they do ... vary
from state to state, that at our current 6,000 hours prior to
this bill, which reduces it 3,000, ... we're probably towards
the upper end, but we're in the range that ... states that have
licensing boards tend to require ... more towards the upper end.
States with registration maybe tend to go towards the lower end.
And so, ... by coming under 3,000 hours, we're definitely at the
upper end anymore of apprenticeship requirements. But most do
require apprenticeship.
MS. REARDON: I think that the Career Progression Program is
becoming increasingly kind of popular in the states. Mr.
Rothmeyer may be able to speak to that because he's the chair of
the board. But ... it's a correspondence course that's been
developed by ... the profession. And I think that there wasn't
really a good way of getting people trained up. There wasn't a
real good correspondence course before that, so I think it's
going to be more and more appealing. And I think, in terms of
the techs -- I use the word tech or assistance; it's really an
unlicensed person who is doing delegated supervised work, and
use the term tech because I thought it might help everyone
understand it. I don't know in how many states you're allowed
to do any dispensing opticianry without having the dispensing-
optician license, but I do know that there are several states
who don't require any dispensing-optician license. So, if that
gives you any comfort? It's ... not a profession that is
required to have a license in every state, like doctors or, you
know, or dentists or something like that. I know you want to
keep moving, so....
VICE CHAIR HALCRO: Any other questions for Ms. Reardon? Ms.
Brakes, did you have a comment?
Number 1072
MS. BRAKES: Yes, thank you, Mr. Chairman. Representative
Crawford: on page 7 of the audit, under "Findings and
Recommendations", the auditor says currently 22 states regulate
opticians through the use of a licensing board. The remaining
states either utilize a registration system or [do not] regulate
them...." And then it goes on to talk about apprenticeship
programs; some have requirements as low as 2,000 or 3,000 hours.
MS. REARDON: With your final indulgence. You know, if you were
so inclined, you might ... hold it over and look at these, see
if you want to do a CS or something. I know it's a lot to have
to decide in three minutes, being thrown at you by me, but....
VICE CHAIR HALCRO: Let me ask, Ms. Brakes, as the sponsor's
representative: have you had a chance to look at these
amendments in any prior committees?
MS. BRAKES: No, these were just handed to me right before the
meeting started.
VICE CHAIR HALCRO: Any comments on them, or their impact on the
legislation?
MS. BRAKES: Actually, I would like to have Pat Davidson maybe
answer.
VICE CHAIR HALCRO: Pat, would you come to the table, please?
Thanks.
Number 1137
PAT DAVIDSON: For the record, Mr. Chairman, my name is Pat
Davidson, Legislative Auditor. I, too, just took a look at
these. And while I ... probably have more questions than
answers with regard to this, one of them has to do with
assistance. And as Ms. Reardon said, there has been conflict
between ophthalmologists, optometrists, and dispensing opticians
with regard to supervision requirements of the ... dispensing
optician apprentices. It's ... unclear to me right now, the
suggested wording regarding assistance. It talks about having
these individuals under the direct supervision. Since these are
people who are not licensees, aren't apprentices of a dispensing
optician, who would be setting the criteria for what direct
supervision means? Right now, because they're the apprentices,
it's the dispensing-opticians statutes and regulations that
define how these people are to be supervised. When you move
them out of being apprentices of the Dispensing Optician Board,
does that mean the direct supervision needs to be defined in the
statutes for the ophthalmologists, the optometrists, as well as
dispensing opticians? Those are just questions that I have
looking at this. So -- and I apologize for raising questions
instead of providing answers.
VICE CHAIR HALCRO: And that's certainly okay, judging the
lateness of the receipt of these amendments. Let me ask you:
Ms. Reardon indicated that another option might be to provide a
letter of intent - in addition, obviously, as we pass the
extending the sunset date - a letter of intent saying the board
should take a look for the next two years at the practical exam
and the benefits thereof. Does that sound like maybe a better
alternative than ... taking the amendment direction?
MS. DAVIDSON: Mr. Chairman, it probably doesn't ... stick out
very well in the report, but when we say that this is a prior
audit finding, this means this is an issue that has been before
the board for not only this last four-year period, but the four-
year period before. So, this isn't anything that has been
dropped. It isn't anything new to the board. This is something
they knew we had concerns with years ago. We look at it; it's
not improved. The legislation takes the action and says, "Okay,
you've had eight years. We're moving away from a practical exam
to a national exam." And yes, we are moving from a practical to
more of a written exam.
MS. DAVIDSON: But there are alternatives, if you're concerned
about the quality of work that they're doing. There would be
ways to put requirements on the type of work that they need to
do, whether or not the individual supervising them has to sign
off that, in their belief, they do meet the requirements and can
fulfill these things. There's different ways to get around
having a practical exam. And, as I said, it has [been] before
the board, and it's nothing new.
Number 1326
VICE CHAIR HALCRO: Ms. Brakes, since these amendments have been
dropped on you today, would ... it be better, maybe, if we gave
you a couple of days to work with the department in taking a
look at these amendments and how they fit into, obviously, the
piece of legislation you've been working through ... for a while
now? Would that be a better alternative? It seems to me that
we're kind of caught off guard by these amendments, and it's
kind of a change in direction. Would that work a little bit
better for you? And then possibly we could bring the bill up
next week. ... Would that be okay?
MS. BRAKES: Yes, Mr. Chairman.
VICE CHAIR HALCRO: Okay, because I certainly don't want ... to
rush the discussion, and I want to give the sponsor time to take
a look at ... the amendments. Do we have any other questions
for either Ms. Brakes or Ms. Davidson? Thank you very much.
We're going to go back online now to Mat-Su. Roberta Rawcliffe.
Roberta, welcome to the committee. If you could state your name
and affiliation for the record, please.
Number 1370
ROBERTA RAWCLIFFE: Certainly, Mr. Chairman and the members of
the House Labor and Commerce Committee. I'm Roberta Rawcliffe
and the publicly appointed member of the Board of Dispensing
Opticians.
VICE CHAIR HALCRO: And did you have any comments, or were you
just online to answer questions, ma'am?
MS. RAWCLIFFE: No, I do have a few comments, if I could have a
few moments of your time.
VICE CHAIR HALCRO: Absolutely. Please proceed.
Number 1395
MS. RAWCLIFFE: Appreciate it. I was appointed by Governor
Knowles to the board on March 8, 1999, to represent the public
interest as it relates to opticianry. I'm a mortgage banker by
trade, but I take my appointment and my obligation to the public
in this matter very seriously. And that's why I'm here. And I
would ask the committee to amend SB 270 in the following ways
for the following reasons. Number one, Section 1, AS
08.03.401(c)(9): I would ask that the committee consider making
the sunset date for the State Board of Opticianry coincide with
the June 30th, 2006, date of the State Board of Optometry, since
they are like industries and have like ... obligations to the
public - that those dates would be concurrent.
MS. RAWCLIFFE: Additionally, I would like to put in my two
cents on the examination. I believe that the practical
examination should be retained for the public good. Now, I've
been on the board since '99, and the board has been working
very, very hard at trying to iron out the problems that ... were
inherent in the way the exam had been designed. There's been a
total redesign of the exam for this year, taking into
consideration the legislative auditor's recommendations and
findings that there was ... a fair amount of subjectiveness in
the examination. The way it had been written before, it was
prone to interpretation and it was prone to mathematic errors on
the part of the board members as they were grading it. And as a
result, there were ... three ... disputes over what these scores
were and whether or not those people who had sat for the
examination shouldn't be "delighted." The examination, the way
it's being administered next week on Thursday, is ... totally
redesigned so that the subjectiveness of the answers is taken
out, and the questions are now multiple-choice. And the ...
lenses and whatnot which will be set before the examinees are
all lab-tested so there's no going to be in question as to
whether or not these are or aren't the readings that someone
might otherwise make.
MS. RAWCLIFFE: From the public's standpoint, I think that the
practical examination is necessary because it's very easy for
someone ... to be "book smart" and not ... necessarily have the
practical skills to carry out their duties. And in the case of
issuing glasses or lenses or any other eyewear including contact
lenses, it seems reasonable to me, as a nonindustry person, that
someone could pass the written examination and be signed by a
supervisor who does or doesn't necessarily watch everything that
goes in and out of the shop, especially if it's a shop that
doesn't do a lot of its own work but sends things out to the
laboratory to be done. In that case, if someone comes in with
some eyewear that needs to be created for them, if that person
doesn't have a practical, hands-on experience to do it, how do
we know that what they're doing is correct? And in the case of
small children, if those lenses are done poorly, they can do
irreparable harm. So I disagree with the ... notion that book
learning is sufficient.
Number 1559
MS. RAWCLIFFE: Secondly, on the apprenticeship issue: as a
board, we have discussed waiving, possibly, the mandatory
registration for those who don't want to be licensed. The issue
comes down to what you call them and what are their duties, as
Ms. Reardon raised that issue. If all they want to do is
clerical work or help customers choose frames, or hand over
lenses which have already been checked out by the optician or
the licensed apprentice to prove that they are indeed the
prescription which was ordered by the optometrist or the
ophthalmologist, I have, personally, no problem with that. And
I think it makes good sense; there's no point in taking someone
who doesn't have the desire to move forward in the field and
making them quit their job if they haven't sat for an
examination after 6,000 hours of work.
MS. RAWCLIFFE: On the other hand, if you have someone who has
been an apprentice for 6,000 hours and they still can't pass the
examination, there's something radically wrong. And as a public
person, I think it's good that they are weeded out, right then
and there, you know, rather than just being people who are
basically being used as sales people. So, ... my personal
belief is that if there were two levels of people in the shop:
... the licensed people, whether it's the opticians or the
licensed apprentices; and ... those people who fill in as a
clerical or a sales function, ... and they have no impact on the
actual lenses that are -- or the reading of the prescription and
the manufacturing of those lenses. I have absolutely no problem
with that. I can't speak for other members of the board,
directly. But the consensus in our last meeting was fairly
positive, and I think that might be something that the auditor
would find of interest, since it was one of the major concerns
in the last legislative audit.
Number 1653
MS. RAWCLIFFE: Finally, I'd like to say that the Career
Progression Program, which is ... basically a distance-learning
program for those who would like to become licensed in Alaska,
is, I feel, a very necessary and very worthwhile course. I've
seen one course which is ... currently available on the market
and is excellent. Because we live so far away, there is no
school of opticianry in Alaska. Many states have schools of
opticianry, and some of the states that don't require ...
apprenticeships are fortunate enough to have schools of
opticianry ... in their state, so that those people who want to
make this a career can get the schooling. We don't have that
opportunity to afford the people here, so this is the next best
thing we could do. We looked at the number of hours for an
apprentice to be able to sit for an examination, and felt that
it is excessive if all they're doing is working for 6,000 hours
or three years. Why not also have them put in the time into the
Career Progression Program so that they could sit for the
examination sooner, and hopefully increase the number of
licensed opticians in the state, which further benefits the
public good. And that is about all I have to say, and I
certainly appreciate your giving me the opportunity, sir, to do
it.
VICE CHAIR HALCRO: Well, thank you for your testimony. We
appreciate you being with us today. Is there any questions?
Seeing none, Representative Kott, you had a question for, I
believe, ... either Ms. Davidson or Ms. Brakes.
Number 1722
REPRESENTATIVE KOTT: I had a question for Ms. Reardon.
Catherine, on the Amendment 2, at the bottom, it says, "Delete
Sections 2 and 6". Is that the intent, to delete the section
dealing with the ... duties and powers of the board, or have I
missed something?
MS. REARDON: Through the chair, Representative. No, that would
mean that ... the current powers-and-duties statute would not be
changed. There'd be no need to amend it, because the purpose
for Section 2 was to take the word "examine and" out. And so,
if we were going to keep the examination, you wouldn't need to
be eliminating that. And the same thing with Section 6: the
purpose of Section 6 being in the bill was to eliminate the term
"examination fee". If we weren't going to have the exam, you
wouldn't need that section.
REPRESENTATIVE KOTT: Thank you for that clarification.
VICE CHAIR HALCRO: Any other questions for Ms. Reardon? Seeing
none, what we will do is we will set this bill aside until such
time as the sponsor and the department have had time to sit down
and reconcile the amendments and wait for further word. So, I
really appreciate everybody being here, and we'll just put this
aside for now. [SB 270 was held over.]
HB 471-AIDEA LOANS AND DIVIDEND
[Contains discussion of HB 492; this is a verbatim transcript.]
VICE CHAIR HALCRO: We are going to change the order of the
agenda. I understand we have a testifier who has to catch an
airplane, who is on teleconference on an offnet site. So next
we will go to House Bill 471, which is an act regarding AIDEA
programs. And I believe we need to adopt the CS [committee
substitute]. The chair would entertain a motion to adopt the
CS.
REPRESENTATIVE MEYER: Mr. Chair.
VICE CHAIR HALCRO: Representative Meyer.
Number 1801
REPRESENTATIVE MEYER: I move that we adopt CS for House Bill
Number 471(CRA), F version.
VICE CHAIR HALCRO: Is there any objections? Seeing none, we're
operating under Version F. Ms. Achee, welcome to the committee.
Number 1814
LAURA ACHEE: Thank you very much. For the record, my name is
Laura Achee. I am staff for Representative Joe Green. This
bill came out of a conversation; the Alaska Industrial
Development and Export Authority asked us to sponsor a bill to
make some necessary changes to help keep their operation flowing
smoothly. I believe that Bob Poe is online to answer the more
technical questions, but I'd actually -- if you'd like, I can go
through the bill and explain it in English before he explains it
in "accountingese."
VICE CHAIR HALCRO: Please, go right ahead.
MS. ACHEE: Okay. There are two additions to the bill that are
in the form of a CS or an amendment before you, and I'll let Bob
touch on those. I'll just stick to what's in the bill as it
passed out of the House Community and Regional Affairs
Committee. Section 1 changes the maximum loan amount for the
bulk fuel revolving loan fund. There's a number of communities
in rural Alaska that in order to afford to keep their houses and
go about their daily business, must purchase their fuel when its
available to them and they have to purchase it in bulk. As was
explained to me - and this makes a lot of sense - if you had to
pay for your next year's Enstar gas bill, you probably couldn't
do it right out-of-pocket, and it's the same for these folks.
So this fund provides them with upfront loans that they can then
pay back over time. The limit of $100,000, with the rise in
fuel costs and transportation costs, simply wasn't enough to
meet the needs of the users, and so they've upped that. Also,
there is a $5 million federal grant that's going into this fund,
and so they will be able to fund, as I understand it, all of
their requests for loans next year that are expected.
Number 1882
MS. ACHEE: Section 2 and Section 3 make a necessary change to
statute. The way that AIDEA does its financial statements is
governed by the Governmental Accounting Standards Board (GASB)
of the federal government. And they have made some changes in
the terms that these groups can use on their statements. Our
statute calculates the dividend that AIDEA pays to the State of
Alaska general fund based on values that are on their year-end
statement. And now that the GASB board has said that they can
no longer use those terms, it leaves us with an empty definition
in statute [for] net income and unrestricted net income.
MS. ACHEE: So, this would change statute, that instead of
directing whomever's reading it to go to the audited financial
statement and look for that term, it actually puts real
definitions in for net income and unrestricted net income. The
change in the assets is now how it's read. Also, due to a
change in the accounting practices - and I'm going to let Bob
correct me if I'm wrong - but as I understand it, at the end of
the year, AIDEA looks at their net profits, and the dividend
that they pay to the state is paid out of that. And under the
change, they would then have to record that payment on the next
year's financial statement as an expense, thereby actually
declaring it twice and, as a result, lowering their payment for
the next year to the State of Alaska, and so forth and so on.
So, what the second change in Section 2 and 3 does is it
excludes the amounts that are paid to the State of Alaska;
they'll still be in the ledger, but they'll only be recorded
once and they won't affect future dividend payouts.
Number 1959
MS. ACHEE: Section 4 makes necessary changes to the rural
development initiative fund. This is a fund that provides
commercial loans to those people who are out in rural Alaska,
places where lending agencies who base their standards on Lower
48 standards might not believe that the risk is advisable. And
so, it provides an opportunity for people to have businesses in
rural Alaska that wouldn't necessarily have another way to do
so. The problem is that under the current guidelines, a lot of
folks are qualifying for "rural" who are really just kind of
falling right outside some of our major population centers. And
so while technically they're rural, they aren't really the
people that this loan was designed for, and they probably have
other loan options. And so this change in statute would tighten
up the restrictions and get those loans to the people that they
were intended for. And with that, I'd be happy to answer any
questions.
VICE CHAIR HALCRO: Any questions for Ms. Achee? Seeing none,
thank you. Let's go online to offnet, Bob Poe.
Number 1998
BOB POE: Yes, Mr. Chairman. Thank you, I appreciate you
adjusting your schedule a little bit; I was getting a little
worried there. I thought Laura did an excellent job in walking
through the provisions of this bill. We do have some folks
online to answer questions if the committee has any. We have
Valerie Walker, who's AIDEA's CFO, and she can go through any
accounting questions you might have. We also have Brian
Bjorkquist, who's the Assistant Attorney General who assists
AIDEA in a variety of matters, and he can speak both to the RDIF
- Rural Development Initiative Loan Fund - guidelines as well as
the amendments that I believe ... the committee members may have
in front of them. I would point out that the increase in the
bulk fuel revolving-loan-fund maximum amount also is important
because we've been working with the Denali Commission for some
time and have increased the capacity of a number of fuel [tank]
farms out in rural Alaska.
MR. POE: Certainly, ordering in bulk is the most economic way
to get fuel and the best way to lower costs in rural Alaska.
So, we're finding that [$]100,000 frequently didn't cover the
cost, and [$]200,000 will allow us to do that. And the other
important thing is, that I just want to mention, there's a $5
million grant coming to ... AIDEA from the ... USDA, and that
will enable us to be able to make these loans. The dividend
definition is an important one, and the changes ... here are
designed to have the dividend program work just as [it] has so
successfully since 1996. Since that time, AIDEA has provided,
either in payment or commitment to pay, $128 million in
dividends - and actually, Mr. Chairman, as of AIDEA's board
action yesterday, it's really about $129 million. What this
change does is allows us to continue to pay those dividends the
same as we have in the past. And I think Laura did an accurate
job of describing the problem of double-counting dividends, as
GASB would require under the new rules. Mr. Chairman, would you
want me to speak to the proposed amendments?
VICE CHAIR HALCRO: Yes. Hold on just a second; let me make
sure all of the committee members see those in those packets.
There's ... an amendment in there; it looks like a page ... and
a quarter. Just make sure everybody's on the same page. Okay,
go ahead, Bob.
Number 2117
MR. POE: Thank you, Mr. Chairman. You adopted the CS [CSHB
471(CRA)] at the beginning of this discussion, and the CS
reflects an amendment that happened in the previous committee,
which added in this rural bulk fuel revolving-loan-fund change.
And that came from an earlier bill. There were two other
provisions in that earlier bill, HB 492. Both of these
provisions were designed to clean up a couple of problems with
the AEA - the Alaska Energy Authority - legislation. The first
was to deal with a liability issue. Right now in the law, it
says that AEA shall train rural electric operators, not "may"
but "shall".
MR. POE: Now, we just received our budget caps in the Senate
yesterday, where it received an "UNAPNA" (ph), an unallocated
reduction to the circuit rider program we have in AEA. That
further reduces our ability to do training at all, let alone can
we assure that we train every operator in rural Alaska.
Unfortunately, recently a man in rural Alaska had an accident in
a power system and damaged his hands and arms, and was, I
believe, successful in suing the State of Alaska - and Brian
Bjorkquist can clean this up for me - ... saying that we had a
responsibility to train him, and since we didn't, there was an
asserted liability. What we want to do is change this provision
in the law from "shall" to "may". We still believe it's
important to train rural electric operators, and we'll do
everything we can to train as many as we can. But this
provision of "shall" simply leaves us open for liability that we
don't really have any way to effectively protect the state
against.
MR. POE: The second change is including the word "construction"
in the enabling legislation for the Alaska Energy Authority. As
you probably know, we work as a partner with the Denali
Commission in building bulk fuel tank farms and rural power-
systems upgrades. Now, all of this construction we do through
private-sector construction managers. We don't actually get out
there and pound nails or drive pilings or anything like that.
But we are actively involved in causing that construction to
happen, and we wanted to make sure that in our enabling
legislation there was no question about our ability to do what
we're already doing. So, those ... are those two provisions.
And I'd ask Brian Bjorkquist or Valerie Walker if they would
correct anything ... I may have said a little inaccurately, Mr.
Chairman.
VICE CHAIR HALCRO: Thank you for your testimony, Bob. Any
questions? Seeing none, we have Mr. Bjorkquist online. Did the
committee members have any questions for Mr. Bjorkquist? Seeing
none. Representative Crawford.
Number 2242
REPRESENTATIVE CRAWFORD: Thank you, Mr. Chairman. Just for my
own edification here, who is responsible for the training of
these employees that work out in rural Alaska?
MR. POE: Through the chair, Representative Crawford, we are.
The real question isn't, "Do we have that responsibility because
we feel we do"; it's just, "Are we adequately funded to
accomplish the full range of that responsibility". And we would
argue that we aren't. And ... we understand why reductions are
happening this year, but we received an additional reduction,
and that makes it even harder to live up to the "shall" language
in the law. We don't want to shirk our responsibility, and we
don't want to have this change imply that we don't want to
continue to train rural electric operators; it's just that we
probably can't live up to the rigid interpretation of "shall"
versus "may".
VICE CHAIR HALCRO: Any other questions? Is there anybody else
online that wishes to give testimony on House Bill 471? Is
there anyone in the committee that would like to give testimony
on House Bill 471? Seeing none, I will close public testimony.
Would ... committee members please mark the amendment you have
in front of you Amendment Number 1. And the chair would
entertain a motion and/or any discussion.
[Amendment 1 to CSHB 471(CRA), with original
punctuation, read as follows:
Page 1, line 2:
Following "Authority;":
Insert "precluding legal action concerning
certain technical assistance to rural utilities;
relating to powers of the authority;"
Page 2, following line 1:
Insert new bill sections to read:
"* Sec. 2. AS 42.45.400 is amended by adding a new
subsection to read:
(c) This section does not create a duty in tort,
and may not be the basis for an action against the
state, the authority, or the officers, agents, or
contractors of either for damages, injury, or death.
* Sec. 3. AS 44.83.080(10) is amended to read:
(10) to enter into contracts with the United
States or any person and, subject to the laws of the
United States and subject to concurrence of the
legislature, with a foreign country or its agencies,
for the financing, construction, operation, and
maintenance of all or any part of a power project or
bulk fuel storage facility, either inside or outside
the state, and for the sale or transmission of power
from a power project or any right to the capacity of
it or for the security of any bonds of the authority
issued or to be issued for the project;
* Sec. 4. AS 44.83.080 is amended by adding a new
paragraph to read:
(16) to make grants or loans to a person and
enter into contracts or other transactions regarding
the grant or loan:
Renumber the following bill sections accordingly.
Page 2, line 27:
Delete "secs. 2 and 3"
Insert "secs. 5 and 6"
(end of Amendment 1)]
Number 2303
REPRESENTATIVE MEYER: Mr. Chairman, I'll move Amendment Number
1.
VICE CHAIR HALCRO: Representative Meyer. Amendment Number 1
has been moved. Is there any objection? Is there any
discussion? Seeing none, Amendment Number 1 is adopted, which
brings the bill back before us, amended. What is the will of
the committee? Representative Kott.
Number 2316
REPRESENTATIVE KOTT: Mr. Chairman, if nobody else is going to
step up to the plate, I guess I'll make the motion. Mr.
Chairman, I would move that we move out of committee CS for
House Bill Number 471(CRA) as amended, [with] individual
recommendations and accompanying zero fiscal note.
VICE CHAIR HALCRO: Any objections? Seeing none, [CSHB]
471[(L&C)] is moved from committee.
MR. POE: Thank you, Mr. Chairman.
VICE CHAIR HALCRO: We're going to take a brief at-ease.
VICE CHAIR HALCRO: For the record, next on the ... [ends
midspeech because of tape change].
HB 282-PRESCRIPTION DRUG INSURANCE BENEFITS
[This is a verbatim transcript.]
TAPE 02-55, SIDE B
Number 2382
VICE CHAIR HALCRO: ... House Bill 282, "An Act relating to
prescription drug benefits under a group health care insurance
plan," sponsored by Representatives Coghill and Fate.
Representative Coghill, welcome to the committee, sir.
REPRESENTATIVE COGHILL: Thank you, Mr. Chairman.
VICE CHAIR HALCRO: We do have a [proposed committee substitute
for the] sponsor substitute in front of us, Version L, and the
chair would accept a motion to adopt it as our working document.
Oh, I'm sorry, excuse me, it's ... Version J.
REPRESENTATIVE MEYER: Mr. Chairman.
VICE CHAIR HALCRO: Representative Meyer.
Number 2312
REPRESENTATIVE MEYER: I'd move CS for Sponsor Substitute for
House Bill 282, J version [22-LS1066\J, Ford, 2/5/02], before
the committee.
VICE CHAIR HALCRO: Any objections? Seeing none, Representative
Coghill, welcome to the committee, sir.
REPRESENTATIVE COGHILL: Thank you, and thank you for adopting
this version. This has been kind of an exercise in learning for
me as well. So, I've gone through three different versions just
to ... get where I'm at right now, before I even had a hearing.
The way this whole thing started was, my wife takes a continued
medication, on thyroid medicine. And throughout the course of
the pharmaceutical journeys, we were paying a copay for
prescriptions. Doctors had been prescribing 90 days at a time,
and just about a year ago it began -- the practice started where
we had to pay a copay for every month now, instead of for the
90-day prescription. They said that ... was the change in the
insurance plan. I got to thinking about it - and I know that
the insurance companies have a little different view than I do -
but it's really cost shifting, is what it amounts to. And the
contract kind of changed in midstream on our part.
REPRESENTATIVE COGHILL: So, I thought, well, I should at least
ask the question why. And it really led to the discussion here,
which brings us to AS ... 21.54.155, which would be a new
section saying that [a] health care insurance plan that is
providing a group market plan may not impose a supply limit for
a prescription if the supply limit is lower than the supply
limit prescribed by the prescription. Really, what I'm asking
is that if a doctor prescribes for a certain amount, then the
doctor should know and it should be appropriate that, for
example, if I get a 90-day prescription for a blood-thinning
medicine, that I should be able to get that filled. I know that
this is going to be open for debate, and I think we'll hear some
of the debate. And I'm open to some amendment if it makes it
better, quite frankly.
REPRESENTATIVE COGHILL: In the discussion with some of my
pharmacy buddies, part number one came into view, and that is
that pharmacists would go through the process of filling a
prescription ... and even be paid by the insurance company, and
they would agree that it was properly paid, only to find out
later, upon review of their books, they decided that they didn't
want to pay at that level and go back and change it after they'd
already paid it. Once again, that is not my battle, but I
decided I'd put it. Certainly, you'll hear, probably, pros and
cons on ... each one of that.
REPRESENTATIVE COGHILL: To me, it's a matter of fairness, and
so I ... folded in the best I could with language. I would
certainly submit to your thinking on the matter. Even on ...
Section 2, on the supply limit, really my intention is if a
doctor prescribes for 90 days, that it should be 90 days. And
if the ... wording is not as artful as it can be, I'm open to
amendment. I know that there are those who ... will come to
some amendments. In fact, I see one right in front of me. So,
... that's my whole intent, very simple. Insurance companies
certainly are ... very powerful, and it's a consumer-protection
item. And then it's a matter of, can they work with the doctors
on the timeliness of prescriptions. So, with that, I think
you'll hear some testimony, both pro and con. And if you'll
take that testimony, I'll get a chance to peruse this amendment
that was just put in front of us, which I've never seen -- this
looks like a different bill.
VICE CHAIR HALCRO: Any questions for Representative Coghill?
Representative Crawford.
Number 2151
REPRESENTATIVE CRAWFORD: Thank you, Mr. Chairman. ... As an
ironworker, we're under the Iron Workers Health Trust and we get
a month of coverage for each hundred hours that we work. If we
were to ... get a prescription that says for 90 days or 180
days, but we only have a month of coverage actually coming to
us, ... there's the possibility there that ... the insurance
company would have to pay for more than they were liable for if
this ... wording were to go ... through. And I don't know how
to fix that.
REPRESENTATIVE COGHILL: Well, and I understand that. First of
all, at the time that you got the prescription, certainly, I
would imagine that that would be the time of payment.
Certainly, the insurance is picking up a portion of the
prescription cost; so are you. And once again, that would be --
just from my estimation, and I would be open to further
testimony, ... it would seem to me like you pay for it when you
buy it. And if you buy within the month that you're insured,
then so be it. I mean, that would be my guess. And I would ...
defer to those ... who know that ... technicality better than I.
REPRESENTATIVE CRAWFORD: I have the same condition myself, with
the thyroid medicine. And I know that they ... can write it for
180 days, but they will only fill 30 days at a time because
that's how the insurance prefers it, each month of eligibility.
But if ... it were to be changed in this manner, it seems that
the health care trust would be liable for the whole 180 days, if
I understand this.
REPRESENTATIVE COGHILL: And that would be the way I understand
it. If you bought it at the time you were covered, then I think
that would be a fair assessment.
Number 2058
VICE CHAIR HALCRO: Any other questions? Representative
Coghill, let me ask you, ... [paragraph] (1), where it talks
about a penalty against pharmacists. Part of the concern ... is
that -- as I read your sponsor statement, it gives the incident
that occurred in Fairbanks where a local pharmacy was audited.
What we've heard from some in the pharmaceutical industry is
that when they go in and do these audits, sometimes either the
pharmacy has either misunderstood or misrepresented to the
health insurance company exactly what the doctor said, and these
audits catch these. So, in the case where it's a
misunderstanding, that's one thing, and ... it's a genuine
mistake. In the instance where there is a ... miscommunication
... and it is the pharmacist's fault, do you have any heartburn
-- I mean, I think it's only fair that we should put a condition
in here that says if the audit reveals that the pharmacy, in
fact, was responsible for the error, and not the ... health care
company or the ... doctor, if it was the pharmacy's problem,
then they should be held liable. I mean, to me that only seems
fair.
REPRESENTATIVE COGHILL: Sure. And ... I would go along with
that, that sense of fairness. And ... I think, as it was
portrayed to me, that that was certainly open for discussion.
It was my understanding that there was further appeal processes,
but if we need to make it emphatic in this, I would be open to
that.
Number 1991
VICE CHAIR HALCRO: And the second ... point, where it talks
about a supply limit for a prescription if the supply limit is
lower: like probably a lot of my colleagues, ..., I have a
prescription. And when we come down here in January through
May, ... my doctor writes the prescription for a year, but every
30 days I've got to call. Especially in this day and age with
technology - where I can pick up the phone at any time of the
day or night and call Fred Meyer, Carrs, and fill a prescription
over the phone through their automated system, and go in the
next morning and pick it up, you know - it seems to me that
there are certain cost-containment protections ... built into
this, only giving somebody a 30-day supply.
VICE CHAIR HALCRO: In addition, ... I've had the case where ...
you've prescribed medicine and it works good for the first three
... [or] four weeks, and ... you start to show some side
effects. And ... maybe the doctor comes back in, and you go
back to your doctor, and the doctor says, "Well, we need to take
you off of this; let's get you on something else." But I've
already filled a 90-day prescription at my pharmacy. Then what
I do with the remaining 60 days' worth of medication, ... I'm
certainly not going to return those to ... the pharmacy; ...
they, in good faith, can't resell those. So, it seems that to
be -- that although from a consumer standpoint, it is a little
bit of a burden to have to call every 30 days and get your
prescription renewed, but from a cost containment and even ...
as far as an overall health benefit, there does seem to be some
justification for that 30-day limit. Comment on that and all.
Number 1934
REPRESENTATIVE COGHILL: And I appreciate that. And I can see
that scenario as a realistic scenario. I don't know, though,
through experience, that doctors would prescribe, especially if
they anticipated that type of .. an adjustment. But even if
they did, I would think that they would ... certainly try to
time that adjustment. One of the things that I'm concerned
about is, certainly those of us who travel, those who have to go
and live in different parts, ... where you can't go every month
and show up or go in to do your copay -- so, you might want a
90-day supply. And I just can't imagine a doctor would use that
indiscriminately. I can understand that there are costs
involved. But I also understand that, for me, whereas we were
paying $10 copay for a prescription, now I'm paying an extra $20
for that prescription, because I'm having to go back every month
and pick that up, with ... an extra part of copay that my
insurance plan has outlined. So, certainly there is a cost
savings to somebody, but it's not to me.
VICE CHAIR HALCRO: Any other questions for Representative
Coghill? Seeing none, thank you very much, and stick real
close. Let's go online first to Fairbanks, Mr. Gerald Brown.
Mr. Brown, are you with us, sir?
Number 1866
GERALD BROWN: Yes, I am, and thank you very much for allowing
me to speak to you.
VICE CHAIR HALCRO: Mr. Brown ..., if you could state your name
and affiliation for the record, please.
MR. BROWN: My name is Gerald Brown ...; I'm a pharmacist; I
work in Fairbanks. I'm also on the ... Alaska Pharmaceutical
Association Board. I am not representing the board today. I'm
... representing just the profession, as a pharmacist here
today. I would like to speak to this bill. I ... have some
problems with the new, amended version. ... As a pharmacist,
we've been listed as the number-one trusted profession in the
nation ... since the mid-'80s through the mid-'90s. And because
of that, the public trusts pharmacists very much. This bill is
not about reimbursement, per se. This bill is -- the intent is
to help the public.
MR. BROWN: We are concerned about the public being able to get
medication on a timely basis in an easy method, and in
convenient forms that they can get for travel or remote
locations or inaccessibility to pharmacies, especially in the
state of Alaska. What we were having problems with is that the
insurance companies want to refuse the delivery to mail orders,
and it's ... intending, through economic incentives, to drive
the prescription filling not from [an] in-state and local basis
but to out-of-state, offsite basis. We feel this is not right;
this is not good health care. And to say that it is under the
guise of saving health care costs is a misnomer. We feel that
... this bill, as it has been amended here, does not take into
consideration those ... factors.
Number 1783
MR. BROWN: We like the first version a little bit better, but
there are some problems with that also. What we were trying to
do is to match up to being able to fill, if there is a mail-
order provision, to be able to fill the same quantities of the
mail order and the same copay so that everything is on the same
basis. There is an economic disincentive to be able to only get
30 days locally, while you can get 90 days via mail order. And
then, for instance, like the North Star Borough here allows a
30-percent copay locally, but 20-percent copay Outside at a
mail-order place. And we don't believe that that's fair, and
it's usury to the ... public. We believe that ... on the
original bill [SSHB 282] there was a provision (3) that said for
a supply limit, that does not necessarily need to be there, but
we want to have it so that there is an option for regress and
allowance for review by the ... patient to the insurance
company, to allow for special situations such as remote location
and special situations where a supply limit may need to be more
than 30 or 90 days.
MR. BROWN: I have a lady who lives 90 miles outside of Tok off
on a snowmobile trail, ... and she's only able to come in about
every six months, and it's a long travel just to get to the post
office in Tok. We would like to be able to let her get her
medication once or twice a year, so that she could get that but
she would have to apply to the insurance company for special
waivers on that. We feel that that's a practical solution. We
don't feel that you should be able to get ... necessarily a 90-
or 180-day supply because you happen to go South for the winter
or you happen to be Outside visiting your relatives, or
whatever. That, to me, is not a consideration. But we feel
that ... we need to have some convenience for those people who
live in Eagle who have a road closed for six to nine months out
of the year. We think that it is important that we can have
those changes, and they have an option to do that.
Number 1662
MR. BROWN: We want to be able to fill the cost, ease, and
supplies of the mail orders ... without ... the economic
disincentives that the insurance companies are putting on the
clients here. We feel that the ... companies that are touting
these mail-order services are actually our government. And what
this is saying to me is that the government doesn't want to do
business with businesses within the state; they want to shuffle
business to the ... Outside mail-order places. We feel that
that is extremely unfair, and that we have the University of
Alaska, ... the Fairbanks Northstar Borough, and the school
district - just for examples here locally - who are saying that
we don't want you to have business here in the state, we want
you to use the mail-order business. And we feel that that's bad
health care policy because there's nobody there to help look for
drug interactions, help to look for questions and problems with
the prescription, or to answer questions if there is a problem
with a particular medication. And I can give you numerous
examples of how that has and can occur in filling prescriptions
here in Alaska and in Fairbanks.
MR. BROWN: Remember, the National Chamber of Commerce says for
every dollar that you spend within the state, it multiplies four
to seven times. If we send a dollar out to a mail-order place,
that's a dollar lost to the economy. That mail-order business
does not pay business taxes here in Alaska, yet the businesses
within the state do pay taxes; we do contribute to local
nonprofit groups, charity groups. We donate to the University
of Alaska. We donate to the school district in ... monetary
firms. We sponsor hockey and soccer teams within the community.
We are good business partners within the community.
VICE CHAIR HALCRO: Mr. Brown.
MR. BROWN: Yes.
VICE CHAIR HALCRO: Could you please summarize?
MR. BROWN: Okay. We feel ... that we'd like to have this
legislation so that we can fill those same quantities, so, at
least to the customers, ... we are helping them, and ... to them
we're the same as if we were the mail order, also, and we can
provide those services the same.
VICE CHAIR HALCRO: Thank you for your testimony, sir. Is there
any questions? Seeing none, we will go to our offnet site,
Nicole Salinas.
NICOLE SALINAS: Yes, I'm here via teleconference.
VICE CHAIR HALCRO: If you could state your name and affiliation
for the record, and please keep your testimony to three minutes
or less.
Number 1545
MS. SALINAS: Sure, I'll do my best. Chairman Halcro and
members of the House Labor and Commerce Committee, my name is
Nicole Salinas. I am part of Aetna's national account team
responsible for the state of Alaska. And, again, thank you for
letting me testify on this bill via teleconference this
afternoon. Aetna does oppose HB 282 because it is designed to
take away any incentive for insured Alaskans to use mail order
as a means of purchasing maintenance prescription drugs. The
use of mail order does benefit consumers by providing
prescription drugs at a lower cost than could be obtained at
local pharmacies. While our covered ... members do have their
choice of purchasing drugs locally or by mail order,
prescription plans are often set up with a differentials in
copayment and differentials in quantity limits. Without these
differentials, there would be very little incentive for
individuals to use mail order, except ... the convenience of
receiving drugs at their home. The results of the bill would be
more business and profits for local pharmacies, but at a
substantially higher cost to the insurance plan and, therefore,
the smaller employer groups.
MS. SALINAS: Today, drugs represent a component of health care
costs which is increasing at the highest rate both nationwide
and in Alaska. Aetna and other insurers do their best to
mitigate this cost increase by using their national purchasing
power to negotiate favorable financial discount arrangements
with large pharmaceutical vendors like Express Scripts,
Walgreen's, or Wal-Mart to provide maintenance drugs at a lower
cost than could be obtained by individual employer groups
locally. Pharmacists in Alaska currently fill over 85 percent
of drugs covered under insurance plans. We make special
arrangements to allow pharmacists in rural communities to
receive reasonable compensation from Aetna for the service they
do provide our customers locally. To increase the pharmacist's
business to 100 percent will result in significant cost
increases to Alaskans for their prescription drug coverage. We
urge the committee members to oppose the bill as currently
drafted.
VICE CHAIR HALCRO: Thank you very much. Any questions for Ms.
Salinas? Seeing none, we'll go to Roger Mortemore.
Number 1426
ROGER MORTEMORE: Yes. My name is Roger Mortemore and I'm a
pharmacist in Fairbanks, and I'm also on the Board of Directors
of the Alaska Pharmaceutical Association. But as Mr. Brown
said, I'm also just addressing the profession. And basically,
in the interest of time, I'll say pretty much I agree with
everything that Mr. Brown has said. But you were discussing
about if you have coverage for just one month at a time and you
get [a prescription for] three months. That also applies if you
mail it off; even if you have coverage for just one month, you
are going to be able to get three months from the mail-order
pharmacy, what would be an additional incentive such as in
Section 1, part (1), of what Ms. Salinas said for Aetna.
MR. MORTEMORE: Aetna is rather cooperative as insurance
companies go; there are several others that are not as
cooperative -- and if there could be some wording that could
help say that exceptions could be made. And my other comment
was in regard to the part (3) of the bill [SSHB 282]. I am in
full agreement of changing that one completely, saying, like, a
90-day supply. And my opinion would be to rewrite the bill ...
with changing some of the amendments in support of HB 282.
VICE CHAIR HALCRO: Thank you for your testimony, Mr. Mortemore.
Is there any questions? Seeing none, we'll go to Jack McRae.
Number 1347
JACK McRAE: Hi, I'm Jack McRae with Premera, and we own Blue
Cross Blue Shield of Alaska. And I'm at a major disadvantage
because I don't have Version J in front of me, and I haven't had
a chance to see it yet. And ... if the chair agrees, maybe I'll
respond to some of the questions that were brought up, if that's
acceptable.
VICE CHAIR HALCRO: Absolutely. Go ahead, sir.
MR. McRAE: We insure 80,000 lives in Alaska. And in relation
to the 30-day and the 90-day issue, we do require [a] 30-day
prescription limit if they go to a pharmacist. (Indisc.) in
Alaska, we've been doing business there before statehood. We
recognize the differences in Alaska, and ... through all of our
group plans, a person can go in and get 90-day supply of a drug
either through the pharmacist or through mail order - the 30-day
period - but they can get 90 days, but they would pay three
copays. For example, if it's on our formulary and you went into
a pharmacist in Alaska and purchased the pharmaceutical product,
you'd pay $30 for the three months. To do mail order on that
same drug through our Merck-Medco [Managed-Care L.L.C.] system,
you'd pay a $20 copay. So you'd still get a 90-day supply.
MR. McRAE: So, our practice in our group plans in Alaska has
been, for quite a while, to prescribe a 90-day supply. And if
that's not happening, then it must be a misinformation, because
we just checked this today. In relation to the issue of mail
order versus pharmacy, our concern up there is to keep cost
down. Drugs are the, on a percentage basis, ... fastest growing
percentage of health care when you look at hospital fees and
physician fees; it's just going up faster than anything else.
And we believe ... that if we were not able to use the mail-
order system on ... our multistate basis, it would be about a
30-40 percent increase in the cost of drugs because of the
contracts we're able to ... have with Merck-Medco, our mail-
order ... prescriber.
Number 1238
MR. McRAE: In relation to ... going over a 90-day period, we do
have a concern there, that was brought up earlier, that there's
a situation where somebody either quits an employer or moves on
for some reason, and they get billed more than 90-days. There
can be a tendency to do that just before they know they're
moving on. So, we do like the limit of 90 days, but in Alaska
we do use 90 days. Again, going back to the one issue of mail
order: we are very concerned that if mail order is eliminated
or, with some of the language that was up there, it would be no
advantage for mail order - that it would be a cost driver for
our 80,000 subscribers up there. So, with that, if there's any
questions, I'd be more than willing to respond.
VICE CHAIR HALCRO: Any questions to Mr. McRae? Mr. McRae, let
me ask you, with regards to this supply limit, ... did you say
it's currently 90 days?
MR. McRAE: It's currently 90 days both through a pharmacy in
Alaska and through mail order in Alaska.
VICE CHAIR HALCRO: Okay. And ... you said you do not have
Version J in front of you?
MR. McRAE: I do not have ... Version J, I'm sorry.
VICE CHAIR HALCRO: Subsection (2) says, ... "a supply limit for
a prescription if the supply limit is lower than the supply
limit described in the prescription." Would it be possible or
practical for us to identify or add on that there is a 90-day
limit?
MR. McRAE: Yeah, that would be acceptable from our standpoint.
As you're aware, Mr. Chair, ... a lot of times a doctor will
prescribe less than ... 30 days or 15 days, some much smaller
amount to 90. But to limit to 90 would be an advantage just
from our standpoint.
VICE CHAIR HALCRO: Okay, great. Thank you. Any questions for
Mr. McRae? Seeing none, we'll go to Angie LeBoeuf.
Number 1139
ANGIE LeBOEUF: Hi, I'm Angie LeBoeuf from Anchorage, and I'm a
pharmacist, and I'm also the President of the Alaska
Pharmaceutical Association, speaking on behalf of myself as a
pharmacist. And I want to support HB 282. In the world of
retail pharmacy, we're frequently presented with the situation
of trying to explain the insurance to the customers. They don't
understand why their policy requires that they use mail order
outside the state to get a better copay, and it's an
inconvenience for the consumer, and they're angry with the
situation. Many times, they'll get only a 30-day limit if they
use a local pharmacy versus a 90-day if they go Outside. It's
not only an inconvenience for them when they try to use the mail
order; the medication often arrives late, so they've already run
out of medicine. So, they come to the local pharmacy to try to
get the medications, to get them through until their other
prescription comes in.
MS. LeBOEUF: In cases like this, often they have to pay cash
for the small quantity because the insurance may not allow for
them to get an early fill. It's an early fill to the insurance
because the mail order already filled and mailed it, but it's
late. And so, then, this presents the pharmacy with the task of
trying to get a hold of the doctor to get a prescription because
the prescription was mailed Outside, so that they can ... help
the patient get through. Other times, they may have questions
about their medication, and they can't get the information they
need in a timely manner. And, again, [in] these situations, the
patient will call the local pharmacy, who did not fill the
prescription. And there is also a risk of medications not
properly maintained at the correct temperature. So you have a
stability question through mail order. I think that ... for
these reasons, it's in the best interest of the consumer to
allow equal access and equivalent copays and quantities from the
insurance.
MS. LeBOEUF: And addressing the cost-containment issue that was
brought forward regarding a 30-day supply or a 90-day supply,
many times in the ways prescriptions are paid there is a
dispensing fee. And so if they get a 90-day supply, then
there's one dispensing fee, whereas if they have to get [a] 30-
day supply at the local pharmacy, and they do that ..., then the
insurance is really paying more because they're having to pay
three dispensing fees. And so, I think ... it's not a bill
about money and ... the insurance can save so much money by
using the Outside source, but rather that ... it's just better
for the patient if they use the same pharmacy that can check for
interactions and give personal care and consultation to the
patient. Thank you.
VICE CHAIR HALCRO: Thank you. Is there any questions? Thank
you very much for your testimony. Is there anybody here in the
room that wishes to give testimony on House Bill 282? Seeing
none, is there anybody else online that remains, that would wish
to give testimony on House Bill 282?
Number 0945
MR. BROWN: May we add to our comments or to our testimony?
VICE CHAIR HALCRO: Is this Mr. Brown?
MR. BROWN: Yes, it is.
VICE CHAIR HALCRO: Yes, Mr. Brown, very briefly, sir.
MR. BROWN: The comment about whether the ... dispensing fee is
more expensive to the insurance company: the fact that the
dispensing fee is only between a $1.75 and $2.75, you can divide
that for one 30-day supply or you divide it over ... 90 days;
that dispensing fee doesn't change. And so it actually saves
the insurance company money. ... The insurance company
determines what the cost is. So, the cost should be the same or
relatively the same basis ... as the mail order is basing their
cost off. So, it should be the same cost.
VICE CHAIR HALCRO: Thank you very much. Any questions? We do
have one more person in the committee room here that wishes to
give testimony. Why don't you come to the table. If you could
state your name and affiliation for the record, please. Welcome
to the committee, Dan.
Number 0888
DAN HEINCY: Thank you. My name is Dan Heincy. I'm am also a
pharmacist, but I happen to work for Merck & Company, which owns
Merck-Medco mail-order pharmacy, and we also own PAID
Prescriptions, which is the fiscal intermediary who pays the
claims for many local pharmacies as well as for the claims for
the state of Alaska. Without revealing terms of contracts, ...
my colleagues who are out in retail pharmacy are not seeing
something that is going on. There is a difference in the cost
to insurance companies as to whether or not they use the local
pharmacy or whether they use a mail-order pharmacy, whether it's
Merck-Medco or it's any other mail-order pharmacy.
MR. HEINCY: And typically what happens here is that when they
go to the local pharmacy they've negotiated a rate that includes
an average wholesale price, less a discount, plus a dispensing
fee. When ... that insurance company negotiates a contract with
a mail-order pharmacy, they typically get a better discount
rate; they get the average wholesale price, plus an even deeper
discount off of the cost of ingredients. So immediately there
are savings to the insurance company or the employer or ...
whoever has contracted for this service. So they immediately
save on the differential in the ingredient cost, and ...
frankly, my colleagues in the private sector complain about the
dispensing fees that they get.
MR. HEINCY: The pharmacists who work for Merck-Medco - and we
are the largest pharmacist employer in the United States; more
pharmacists work for us than any other group - bottom line for
those guys is they even get a lower fee too. So, it's not only
less ingredient cost, but it's also a lower dispensing fee. So,
the bottom line is whoever is paying for the drug benefit saves
money if it happens to go through mail order. And we feel that
we deliver ... very good, quality pharmaceutical services. All
of our pharmacists are members of professional societies and are
licensed in multiple states - just as I am licensed in multiple
states, too.
VICE CHAIR HALCRO: Any questions for Mr. Heincy? Seeing none,
thank you for your testimony. With that, we will close public
testimony. ...
Number 0739
VICE CHAIR HALCRO: The chair would like to propose a couple of
amendments, which I think the first two to the existing bill,
[paragraph] (1), where it talks about "a penalty against a
pharmacist if the penalty results for the pharmacist's
accurately filling a prescription", et cetera. I believe that
there needs to, as we discussed in committee with ... the
sponsor -- Representative Coghill, if you'd like to come to the
table and join us, that'd be great. If we could put a provision
in there, and I have some language I'd just like to read ...,
you might actually -- I don't know if everybody has this here,
but I can certainly make copies. Basically, what we're going to
say is, we're going to say you can't penalize a pharmacist, ...
provided the pharmacist did not provide inaccurate information
to the health care insurance plan administrator when the claim
was filed. So, if it is genuinely not his fault and these
claims ... are uncovered -- or these discrepancies are uncovered
through the audit procedure - if, in fact, ... it is not the
pharmacist's fault - then they shouldn't be held liable. But in
the case where inaccurate information was provided, then I think
there certainly needs to be ... some accountability there. And
I would just propose that to the committee. And we'll make
copies of that. And we'll open that up for discussion.
Actually, ... once we get that in writing, I will move that as
an amendment.
[Later labeled Amendment 1, the written amendment
dated 04/02/02 was to SSHB 282, rather than Version J.
An upper portion that just quoted the existing
language in SSHB 282 is omitted here. The lower
portion read as follows, with original punctuation:
Amend as follows:
Page 1, Section 1. Section 21.54.155,(1),(2),(3),
Lines 4 through 14.
Section 1. AS 21.54 is amended by adding a new
section to read: Sec. 21.54.155. Prescription drug
benefits. A health care insurance plan sold in the
group market that provides prescription drug benefits
may not impose
(1) a higher copayment amount or lower supply limit
for a prescription drug purchased from a pharmacy in
this state than the copayment amount or supply limit
imposed for a prescription drug purchased by mail
service pharmacy, as long as the in state pharmacy
agrees to the same price, reimbursement, terms,
conditions, and services as the mail service pharmacy;
(2) a penalty against a pharmacist if the penalty
results from the pharmacist's accurately filling a
prescription for which the pharmacist received written
or electronic approval from the health care insurance
plan administrator provided the pharmacists did not
provide inaccurate information to the health care
insurance plan administrator when the claim was filed;
or
(3) a supply limit for a prescription if the supply
limit is lower than the supply limit described in the
prescription. [This would allow [a] pharmacist to fill
any quantity at all as long as that's what the doctor
writes on the prescription. So a patient could get
365 days supply or more in one fill. This does not
make sense in light of everyone trying to contain
prescription cost. What happens if the patient
becomes ineligible two weeks [later]?]
(end of Amendment 1; short note at bottom omitted)]
VICE CHAIR HALCRO: Representative Coghill could you speak to
that. Does the sponsor have any objections to that amendment?
Number 0647
REPRESENTATIVE COGHILL: No, I was open to the language that was
proposed. I think that what ... I was looking for was some
degree of equity. And I think if there is a discussion on if it
was properly filled out, properly reported, I think that's
appropriate. I understood that; certainly, I would think that
an insurance company would have a claim if they found anything
that was out of the ordinary or fraudulent, but I think we're
expressing it very emphatically.
VICE CHAIR HALCRO: Sure. And I think ... you bring up a very
good point in the bill: we certainly don't want pharmacists to
be penalized if, in fact, it was not their mistake. But in the
case where something was misrepresented, I think ... it
certainly sounds like we need some kind of a fallback.
REPRESENTATIVE COGHILL: One of the things that was brought to
my attention over this was the paper trail sometimes is very
difficult because sometimes doctors go by way of phone, by way
of fax, by way of delivering an actual prescription. And it's
the ... auditable ones that can create some problems.
VICE CHAIR HALCRO: And I raised that question earlier today in
a meeting, and it seems to me that -- because I do that quite a
bit, call my doctor in Anchorage and ask him to call in a
prescription locally here. And I asked about that: ... how do
you get a paper trail from a phone conversation? And it's my
understanding that most pharmacies either fax the doctor back or
ask them to fax down a written prescription so they keep it on
file. So, there is some kind of a paper trail. So, ... in that
kind of a case, it would be covered.
VICE CHAIR HALCRO: You will see the amendment language is
actually towards the bottom of the page, the bold language under
[paragraph] (2), where it's just very clear. It states:
"provided ... the pharmacist did not provide inaccurate
information to the health care insurance plan administrator when
the claim was filed", and then end.
Number 0511
VICE CHAIR HALCRO: So, with that, I would move Amendment Number
1. Is there any objection? Seeing none, Amendment 1 is
adopted.
Number 0499
VICE CHAIR HALCRO: The second amendment I would offer would be
on ... page 1, line 11, after "prescription", you would insert
"with a maximum limit of 90 days". And that goes to the
testimony that we heard, that currently that is their limit.
And I think there is a good ... reasoning for a ... 90-day
limit. There's, certainly, as we discussed ... the case where
your medication changes. If you filled a 90-day prescription
and you need to ... change your medication, what do you do with
that, not to mention the fact that if you get a year
prescription and they fill it for a year, ... what happens in
three months if you change jobs, have a different health care
provider; therefore, ... your former health care coverage is not
paying, you're no longer ... under that policy, and you would
certainly benefit from the remaining prescription. I think 90
days is equitable, and a very good compromise.
Number 0432
VICE CHAIR HALCRO: And with that, I would move Amendment Number
2. Is there any objection? And Representative Coghill, any...?
REPRESENTATIVE COGHILL: I'm not going to object to it. I'm
going to do some checking. It sounds to me like it's an
industry standard, sounds like something we would be amenable
to, and I will just follow through with those who have testified
both pro and con to get a feel for it. But at this point, I'm
not going to object to it.
Number 0394
VICE CHAIR HALCRO: All right. Okay. So, Amendment Number 2,
without objection, is adopted.
VICE CHAIR HALCRO: Amendment Number 3 is before the committee
in a more lengthy form. If we could mark this Amendment Number
3, and I would move Amendment Number 3. Is there objection?
[Amendment 3, 22-LS1066\J.1, Ford, 4/12/02, read as
follows:
Page 1, line 1, following "Act":
Insert "requiring that the cost of contraceptives
be included in certain health care insurance coverage,
and"
Page 1, following line 3:
Insert a new bill section to read:
"* Section 1. AS 21.42 is amended by adding a new
section to read:
Sec. 21.42.410. Coverage for contraceptives.
(a) Except with respect to limited benefit health
care insurance or health care insurance purchased by a
religious employer, a health care insurer that offers,
issues for delivery, delivers, or renews in this state
a health care insurance plan that provides coverage
for prescription drugs on an outpatient basis shall
provide coverage for any prescribed drug or device
approved by the United States Food and Drug
Administration for use as a contraceptive. The
coverage required under this section is subject to
standard policy provisions applicable to other
benefits, including deductible or copayment
provisions, within the constraints of (b) of this
section.
(b) An insurer may not impose on a person
receiving prescription contraceptive benefits a
(1) copayment, coinsurance payment, or fee
that is not equally imposed on all individuals in the
same benefit category, class, coinsurance level, or
copayment level receiving benefits for prescription
drugs; or
(2) reduction in allowable reimbursement
for prescription drug benefits.
(c) This section may not be construed to
(1) require coverage for prescription
coverage benefits in a contract, policy, or plan that
does not otherwise provide coverage for prescription
drugs;
(2) preclude the use of closed formularies
if the formularies include oral, implant, and
injectable contraceptive drugs, intrauterine devices,
and prescription barrier methods;
(3) require an insurer to provide coverage
for abortion.
(d) A health care insurance plan that, under (a)
of this section, is exempt from providing coverage for
contraceptives must contain a written notice that
prescription contraceptives are not included under the
policy.
(e) In this section,
(1) "limited benefit health care insurance"
means accident and sickness insurance designed,
advertised, and marketed to supplement major medical
insurance, including accident only, Civilian Health
and Medical Program of the Uniformed Services
(CHAMPUS) supplement, dental, disability income, fixed
indemnity, long-term care, Medicare supplement,
specific disease, vision, and other accident and
sickness insurance other than basic hospital expense,
basic medical-surgical expense, or major medical
insurance;
(2) "religious employer" means an employer
(A) with a primary purpose of instilling
religious principles;
(B) that primarily employs individuals who
share the religious principles of the employer;
(C) that primarily serves individuals who
share the employer's religious principles; and
(D) that does not receive public funding."
Page 1, line 4:
Delete "Section 1."
Insert "Sec. 2."
(end of Amendment 3)]
Number 0380
REPRESENTATIVE HAYES: I'll object for discussion.
VICE CHAIR HALCRO: Representative Hayes has objected for
purposes of discussion. And I will tell the committee that one
of the reasons why I have forwarded this, it actually struck me
this morning when I was reading the sponsor statement for House
Bill Number 282. And I will read a couple of sentences from the
sponsor statement. The first sentence is, "This legislation
addresses concerns over certain prescription drug coverage
inequities". There is a second sentence in the sponsor
statement that talks about the intent of House Bill 282 "is to
promote fairness and balance in prescription drug benefits." In
the state of Alaska, contraceptives, birth control pills for
women, are not required to be covered by health insurance plans,
while ... for men, Viagra is.
VICE CHAIR HALCRO: And I think if there is any kind of
inequity, that's certainly an inequity. And certainly, those of
us will agree that ... the women of this state should certainly
have the benefit of their birth control being covered under
their health plans. I've talked to a number of insurance health
care providers who begrudgingly will tell you that it's not that
... big of an expense. The traditional ... opposition to this
is more of "it's another mandate." But I think for all of us
who want to do our part in preventing unwanted pregnancies, I
think this certainly is a very good step in helping the women of
this state have equitable health care coverage with their
contraceptives being covered. And with that, once again, the
amendment has been moved. Is the objection maintained?
Representative Meyer.
REPRESENTATIVE MEYER: Obviously, this amendment is [a] little
... different than your other two - not that I'm opposed to it,
but it ... changes the scope of the bill. And I'd like to hear
from the sponsor as to whether or not he ...
VICE CHAIR HALCRO: Certainly. Representative Coghill.
Number 0234
REPRESENTATIVE COGHILL: Well, certainly this changes the whole
scope of the bill. And it is a policy call, and I object to the
policy call. I understand the concern. I have been unashamedly
an opponent of abortion. I have been unashamedly proactive in
teaching and preaching abstinence. This particular bill would
require that abortions be covered by insurance. I object.
That's on page 2, line 3 [of Amendment 3]. The whole concept of
the contraception, I'm certainly not against that debate. I
just ... would ask that you don't amend this bill so that have
to deal with that issue; it's way beyond the scope of what I
wanted to do in this bill. And I would ask that you please
don't amend it into this bill.
REPRESENTATIVE MEYER: Mr. Chairman.
VICE CHAIR HALCRO: Representative Meyer.
REPRESENTATIVE MEYER: As a follow-up. I appreciate the thrust
of the bill, bringing in ... line 6 ... on page 2. Obviously,
the whole issue of abortions is a very emotional and sensitive
issue. And I don't believe it really should be part of this
particular bill 0 maybe an issue or bill separate, so that we
can discuss it ... on its own merits. But I think to piggyback
that big of a issue on a fairly simple bill is ... too much, Mr.
Chairman.
Number 0111
VICE CHAIR HALCRO: Just a correction for the committee. If you
will look at page 1, line 24, it says, "This section may not be
construed to provide the following". So, in fact, there's no
coverage for the things that were mentioned by the committee and
the sponsor. So, it just is women's oral contraceptives.
REPRESENTATIVE MEYER: Okay, that's much better.
REPRESENTATIVE COGHILL: Thank you for that clarification.
Obviously, the amendment was just dropped on me moments ago.
So, I appreciate that. This would include what is ... RU486, I
would take it.
VICE CHAIR HALCRO: I believe it is for contraceptives. I'm not
quite sure about emergency contraceptives, but it would be,
traditionally, birth control pills.
REPRESENTATIVE COGHILL: And I would ask, please, don't make me
carry that type of language.
REPRESENTATIVE MEYER: Mr. Chairman.
VICE CHAIR HALCRO: Representative Meyer.
Number 0038
REPRESENTATIVE MEYER: Do ... other states cover contraceptives?
I mean, I agree with the analogy of the Viagra versus the
contraceptives, and certainly there is an inequity there. And
maybe we should drop Viagra; I don't know. But I was just
wondering ... what other states do.
VICE CHAIR HALCRO: There are two states -- this debate is
underway in several state legislatures. ...
TAPE 02-56, SIDE A
VICE CHAIR HALCRO: ... The State of Texas covers
contraceptives.... At this time, maybe what I might be able to
do is invite Robin Phillips to the table. And she might be able
to tell the committee a little bit more about it.
Number 0040
ROBIN PHILLIPS: Thank you, Mr. Chairman. My name is Robin
Phillips; I'm the staff person to Representative Lisa Murkowski.
We are carrying a similar bill. And just to answer a few of the
questions: currently, there are 24 states that offer
contraceptive coverage. There are 17 states looking at it -
similar to the State of Alaska - that are looking to include
contraceptive coverage. The type of coverage ... that we're
looking for, according to this amendment, is FDA-approved
contraceptives; that, I believe, does include emergency
contraceptives, but I would have to look at that further just to
double check. I do believe that the emergency contraceptive is
FDA-approved.
VICE CHAIR HALCRO: Representative Meyer.
REPRESENTATIVE MEYER: Just a follow-up. Ms. Phillips, you said
that this is similar to another bill you're carrying?
MS. PHILLIPS: There's ... currently a House bill and a Senate
bill that are both ... being offered that includes the language
similar to this amendment.
REPRESENTATIVE MEYER: Thank you, and if I may follow up, Mr.
Chairman. I thought there was, that had dealt with
contraceptives, because I remember talking to my staff about
that. So with that in mind, why do we need to include it in
this bill?
Number 0146
VICE CHAIR HALCRO: I will answer that question, Representative
Meyer. The fact is that it's been very difficult for us to even
get a hearing in any of these committees. And it is the
chairman's position that this state legislature needs to start
protecting the women in this state. And I feel that this is an
opportunity to amend a bill that is completely germane in its
title, in its scope. And it is an amendment that is completely
in order and conducive to not only Title 21 but, as I said, the
sponsor statement, where we talk about promoting fairness and
balance in prescription drug benefits; this certainly achieves
that for the women of this state. And I think it's time that we
do that.
REPRESENTATIVE MEYER: Mr. Chairman, if I may follow up?
Certainly, you have the right to make that amendment. But as
you said, the two bills on their own, both on the Senate and the
House side, ... have been stalled. So what I'm afraid of is, by
putting this amendment on ... Representative Coghill's bill,
that we'll just simply be stalling his bill too. And I don't
think ... that's fair or appropriate to do that to ... the
sponsor.
VICE CHAIR HALCRO: And Representative Meyer, I would respond by
pointing out that this bill goes back to the HES committee.
And, as is ... the legislative process, committees amend bills
every day. And, certainly, when this bill goes to the HES
committee, ... if the committee so chooses, they can take this
out and replace it with language desired by the sponsor. But in
this committee, we all sit and look at these bills, and this is
an amendment that I feel, once again, is ... not only germane to
the title and the scope of what the sponsor has proposed, but it
is certainly just overall good health policy for the State of
Alaska.
REPRESENTATIVE MEYER: And if I may follow up, Mr. Chairman.
And, again, it's -- certainly you have that right to make that
amendment. But I don't agree with making an amendment in one
committee just so that another committee can take it out. So, I
will ... object also.
VICE CHAIR HALCRO: Representative Crawford.
Number 0293
REPRESENTATIVE CRAWFORD: Thank you, Mr. Chairman. I ... would
very much like to see contraception covered as well as Viagra
and all. But I ... do have some heartburn with ... what the
sponsor of the bill has said in ... making this bill cover
emergency contraception as well. I would ... like to go ahead
and have this amendment go forward, but I don't want to do that
against the will of the sponsor, with the emergency
contraception.
VICE CHAIR HALCRO: Would you like to propose an amendment to
the amendment, Representative Crawford?
REPRESENTATIVE CRAWFORD: I would.
VICE CHAIR HALCRO: Please proceed.
Number 0350
REPRESENTATIVE CRAWFORD: Conceptual amendment to ... remove ...
emergency contraception coverage. (Indisc.) I guess ... in
line 5 [of Amendment 3], after "barrier methods".
VICE CHAIR HALCRO: ... We could slip that in ... page 2, line 5
[of Amendment 3], after "barrier methods", eliminate the
semicolon, ",or emergency contraceptives". Is there any
objections to the amendment to the amendment? Representative
Meyer.
Number 0418
REPRESENTATIVE MEYER: I'll object just for discussion and
clarification. Emergency contraception, ... is that the
"morning after pill"? ...
VICE CHAIR HALCRO: Ms. Phillips.
MS. PHILLIPS: ... To answer that question, through the chair,
... there's a few different varieties, I believe. And I
apologize for not having the types in front of me, and I can get
you those. But I believe that includes what is considered the
"morning after pill," and ... there is also, I believe, another
form that is prescribed by a doctor. But ... all contraceptives
are prescribed by doctors, but ... I believe it is called the
"morning after pill," is the one. And I'll get you those ...
titles. I just, unfortunately, don't have them in front of me.
VICE CHAIR HALCRO: Is there any continued objection to the
amendment to the amendment?
REPRESENTATIVE MEYER: Well, ... I guess I'd like to speak to the
sponsor, if I may.
VICE CHAIR HALCRO: Certainly, go right ahead. Representative
Coghill.
REPRESENTATIVE COGHILL: Certainly that makes me feel a little
more comfortable, although I can commit to you that I will work
vigorously to get this whole amendment out. It's not an issue
that I want to carry, quite frankly. And certainly I understand
what it's like to have bills heard. I've got one sitting in
this committee that will probably never see the light of day.
And it's very tempting to amend it into another bill, but
protocol being as it may, I was reluctant to do that. So,
certainly, this carries a different subject matter, and for the
amendment to the amendment, I appreciate that. I will not speak
against the amendment to the amendment.
Number 0540
VICE CHAIR HALCRO: Thank you, Representative Coghill. And ...
just for the committee's notice, actually, if we could -- we're
adopting it conceptually because from what I understand from the
Division of Insurance, that is not an appropriate place. A more
appropriate place would be in ... Section 1, between lines 10
and 14, somewhere in there. So, we will adopt it conceptually,
but the drafter will have to find the appropriate place for it
because that, apparently, is not the appropriate place for it.
REPRESENTATIVE MEYER: Mr. Chairman, I'll ... maintain my
objection. I think it's -- we're at a point now where I think
it's more of a principle. Obviously, the sponsor of this bill
is not comfortable with contraceptives being part of this bill.
We sprung this on him last-minute; I don't think that's fair or
right. Certainly, that's your prerogative. But I know ... I'd
hate to have that done to one of my bills, and since we do have
two other bills, both in the Senate and the House side, that has
that same subject that you're trying to get incorporated here, I
frankly don't think it's necessary. So, I'll maintain my
objection.
VICE CHAIR HALCRO: Objection to the amendment to the amendment?
REPRESENTATIVE MEYER: Correct.
VICE CHAIR HALCRO: Any other further comment? Representative
Kott.
Number 0630
REPRESENTATIVE KOTT: And Mr. Chairman, I think I'm going to
have to side with my partner in crime that sits across from me.
I think we're going down a slippery slope here in trying to
define a term of art that has no definition; at least I haven't
seen any evidence produced that emergency contraceptives means
this. Is this a general term of art that is used within the
insurance industry? Is it used by physicians? I just haven't
heard that term before. So, I think we're trying to come up
with a broad term of art that has no definition, unless we
define what ... I would believe would be the normal nonemergency
contraceptives - define those and then, by exclusion, the rest
are emergency. I don't see how you could head down this path.
VICE CHAIR HALCRO: In speaking to that, Representative Kott, I
would simply point out that emergency contraceptives clearly
would be the "morning after pill" or RU486, whatever you want to
call it. There's nothing else out there that I know of that's
FDA-approved that is considered an emergency contraceptive. And
so, I don't believe we're going down a slippery slope. I
believe it's very clearly defined. We can certainly leave it to
the drafter to encompass if there is more than one ... emergency
contraceptive .... But the committee -- the amendment is very
clear in its nature. Representative Hayes.
Number 0720
REPRESENTATIVE HAYES: Thank you, Mr. ... Chair. You know, it's
a shame that we have to look at this ... in an amendment in this
committee when you have two bills out there to adjust this. And
... the thing I think about the most is, when I look at this
discussion, is the fact that when we had a bill on prostrate
cancer, it zoomed through this building. And when we had a bill
on breast and cervical cancer, it took almost till day 121 to
pass out of this building.
REPRESENTATIVE HAYES: I just I think it's a shame, not to
folks' motives, but it does seem a little strange to me that you
have very few women legislators in here and you have a lot of
male legislators. And something that affects men can go through
this building really quickly, and something that affects women
takes forever or is not heard. I think that is ultimately a
shame. It's a shame that we're not hearing the bill in ...
whatever committees that it's being held in. But the amendment,
as much as I hate to admit it, it actually does fit into what
you put out here. I didn't even realize that until the chairman
mentioned it. The amendment actually does fit in your bill. I
know you would vigorously fight to pull this out, and I
understand that, because I understand where you're coming from.
But it actually does make with this legislation.
Number 0825
VICE CHAIR HALCRO: Is there any other comments on the amendment
on the amendment? Let's take a roll call vote.
COMMITTEE SECRETARY: Representative Meyer.
REPRESENTATIVE MEYER: Nope.
COMMITTEE SECRETARY: Representative Kott.
REPRESENTATIVE KOTT: No.
COMMITTEE SECRETARY: Representative Crawford.
REPRESENTATIVE CRAWFORD: Yes.
COMMITTEE SECRETARY: Representative Hayes.
REPRESENTATIVE HAYES: Yes.
COMMITTEE SECRETARY: Chairman Halcro.
VICE CHAIR HALCRO: Yes. So, the amendment [to Amendment 3]
passes 3 to 2. Back on the main amendment; is there further
discussion? Could we get a roll call vote, please?
COMMITTEE SECRETARY: Representative Kott.
REPRESENTATIVE KOTT: No.
COMMITTEE SECRETARY: Representative Crawford.
REPRESENTATIVE CRAWFORD: Yes.
COMMITTEE SECRETARY: Representative Hayes.
REPRESENTATIVE HAYES: Yes.
COMMITTEE SECRETARY: Representative Meyer.
REPRESENTATIVE MEYER: Nope.
COMMITTEE SECRETARY: Chairman Halcro.
VICE CHAIR HALCRO: Yes. And so the amendment [Amendment 3 as
amended] passes 3 to 2. It is adopted. That brings the bill
before us. Is there any other amendments? Seeing none, what is
the will of the committee?
Number 0850
REPRESENTATIVE CRAWFORD: I move the bill.
REPRESENTATIVE KOTT: I'll object.
VICE CHAIR HALCRO: There's objection to moving the bill.
Discussion.
REPRESENTATIVE MEYER: Mr. Chairman, ... I just think that
you've changed the sponsor's bill dramatically with that
amendment. And, again, I'm not opposed to adding
contraceptives. I agree with Representative Kott: there's
different kinds of contraceptives. You know, the ones I'm
familiar with, that my wife [uses], are the ones that you take
to prevent pregnancy, and ... now there's others that you take
the morning after. The discussion for this is not in Labor &
Commerce; I think the discussion for contraceptives is more
appropriate in HES. And that's where the bills are, and that's
where the bills should be discussed. I don't think this
amendment or this discussion is appropriate in Labor & Commerce.
VICE CHAIR HALCRO: Any other discussion? Well, ... I'll just
say this: it's funny because, you know, it seems in this
building when we address legislation, we tailor our arguments to
whatever the topic is and whether we support a bill or we oppose
a bill. About two weeks ago, I remember we had a Senate bill in
here that was opposed not only by everybody that testified, but
even the Federal Trade Commission. And when we amended that
bill, ... the comment was made, with this amendment, the bill is
moot. And the sponsor sat at the end of the table and said that
he was going to do everything he could to put that language back
in. This committee voted to move the bill forward with no
objections. There [were] no concerns. There was no, "Hey, I
don't think this is appropriate." We just did it.
VICE CHAIR HALCRO: The ... idea that this is inappropriate is
... baseless. This is appropriate. We are talking about health
care coverage for a specific part of health care. That's what
we are talking about. This is the Labor & Commerce Committee.
We've had bills in this committee in the last three years.
We've talked about mental health coverage. We have talked about
coverage for diabetes. We've talked about breast and cervical
cancer. We talk about health care coverage on various items,
every year in this committee, and this is no different. I know
this discussion and this topic makes some uncomfortable, but you
know what: it is time that this legislature start protecting
the women of this state.
VICE CHAIR HALCRO: This amendment derives out of frustration
that for the last three years that I've been in this
legislature, there has been a prescription-equity bill on file,
every single year. And it has gone nowhere. And just because a
few committee chairmen refuse to hear it - on the basis of
ideology, completely overlooking not only the health benefits
but the economic cost savings - is unbelievable. It is pure bad
business. This amendment is germane. It is something that is
well within the purview of this committee. And I think it's
about time we start to recognize these issues and deal with
them, rather than just sweep them under the rug and pretend
they're not there until we sign out at the end of the session.
Number 1045
REPRESENTATIVE MEYER: Mr. Chairman, if I may follow up. I
don't disagree with what you're saying, and I don't disagree
with your frustration for trying to get this issue heard. I
think the better place would've been to go to those chairmans of
the Senate and the House and say, "Hey, look, why aren't you
hearing this bill? I think it's important." Maybe get up and
do some special orders on the floor or whatever. But I think to
ambush poor Representative Coghill here with this amendment to
his small, simple bill, I frankly think was not right. But
that's my opinion.
VICE CHAIR HALCRO: I respect and appreciate your comments.
But, once again, this is the legislative process, Representative
Meyer. And in all my years in the business in this building, I
can't tell you how many times I've had a bill go before the
committee and it came out dramatically different than the way it
came in. That's the process, and that's why we're all
individually elected and sit on these committees. Is there any
other discussion? Representative Kott.
Number 1093
REPRESENTATIVE KOTT: Thank you, Mr. Chairman. You're ...
correct in your assessment. This is the democratic process;
this is how a bill becomes law. Oftentimes, we don't want to
know how it gets to the end. But when we sit through these
laborious hearings, you get a pretty good appreciation for what
goes on. My only concern, Mr. Chairman, is I haven't sat on any
of these committees in the last two or three years. This is a
major policy call. We haven't heard the impact on insurance
rates, haven't heard from industry. In general, when we've had
these particular matters before us, whether it was cervical,
breast cancer, prostrate, we had a full-blown hearing on that
issue. So we knew the impact, knew what kind of drugs were out
there. They're just so many things that ... I don't have the
information and access to, I can't make a conscientious, good
statement to support it.
VICE CHAIR HALCRO: And ... once again, I would respect your
comments too. But I would, once again, point to how many
[times] we've sat in individual committees when pieces of
legislation have been before us or amendments have been
proposed, and those bills have been ushered out of committee
with little or no discussion. And so, just because ... we are
uncomfortable with this topic doesn't make the proposal of this
amendment or the adoption of that amendment any different than
any of the other uncomfortable or ... poorly discussed issues
we've had before us. And this, on its merits, is a ... health
issue. It is a Labor & Commerce issue. And it certainly is
one, I believe, that is important to the health of the women in
this state. Representative Crawford.
Number 1179
REPRESENTATIVE CRAWFORD: Thank you, Mr. Chairman. We're five
men sitting here deciding an issue that affects women. And each
and every one of us sitting here, I'm sure, abhors abortion.
This is a way to ... head off many unwanted pregnancies and the
need for abortions. I think this is ... time that we should
have this discussion and move this bill on further so that ...
we can continue this discussion. I'm sorry for Representative
Coghill being the ... recipient of ... it, but ... it's a policy
call I'd like to have us discuss and move on. Thank you, Mr.
Chairman.
Number 1240
VICE CHAIR HALCRO: Any other committee discussion? Seeing
none, we'll take a roll call vote for moving the bill [CSSSHB
282, version 22-LS1066\J, Ford, 2/5/02, as amended] from
committee.
COMMITTEE SECRETARY: Representative Crawford.
REPRESENTATIVE CRAWFORD: Yes.
COMMITTEE SECRETARY: Representative Hayes.
REPRESENTATIVE HAYES: Yes.
COMMITTEE SECRETARY: Representative Meyer.
REPRESENTATIVE MEYER: Nope.
COMMITTEE SECRETARY: Representative Kott.
REPRESENTATIVE KOTT: Nope.
COMMITTEE SECRETARY: Chairman Halcro.
VICE CHAIR HALCRO: Yes. So, the bill [CSSSHB 282(L&C)] moves
on a vote of 3 to 2 from committee.
REPRESENTATIVE KOTT: Mr. Chairman.
VICE CHAIR HALCRO: Representative Kott.
REPRESENTATIVE KOTT: As a matter of policy, I believe to move
the bill out of this committee you need four votes, the majority
of the total membership. To move an amendment, you need a
majority of the quorum, which would be four. So you can move an
amendment on a 2-to-1 -- or a ... 3-to-1 vote. To move the bill
out, you need four votes.
Number 1259
VICE CHAIR HALCRO: I don't believe that's correct. I think
we've had this discussion in the past. I think you need a
majority of the quorum to move a bill from committee. With
that, there's nothing further. We will meet again Monday, 3:15
[p.m.]; the chairman will be back at that time. And with that,
we're adjourned at 5:20 [p.m.]
[It was later decided that CSSSHB 282(L&C) failed to move out of
the House Labor and Commerce Standing Committee.]
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