Legislature(1997 - 1998)
03/21/1997 03:19 PM House L&C
| Audio | Topic |
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
March 21, 1997
3:19 p.m.
MEMBERS PRESENT
Representative Norman Rokeberg, Chairman
Representative John Cowdery, Vice Chairman
Representative Joe Ryan
Representative Tom Brice
MEMBERS ABSENT
Representative Bill Hudson
Representative Jerry Sanders
Representative Gene Kubina
COMMITTEE CALENDAR
*HOUSE BILL NO. 135
"An Act relating to dental licensing; extending the termination
date of the Board of Dental Examiners; and providing for an
effective date."
- MOVED CSHB 135(L&C) OUT OF COMMITTEE
*HOUSE BILL NO. 137
"An Act relating to veterinarians; extending the termination date
of the Board of Veterinary Examiners; and providing for an
effective date."
- HEARD AND HELD
*HOUSE BILL NO. 136
"An Act relating to the regulation of physical therapists and
physical therapy assistants; extending the termination date of the
State Physical Therapy and Occupational Therapy Board; and
providing for an effective date."
- HEARD AND HELD
*HOUSE BILL NO. 134
"An Act relating to regulation of barbers and hairdressers;
extending the termination date of the Board of Barbers and
Hairdressers; and providing for an effective date."
- HEARD AND HELD
(* First public hearing)
PREVIOUS ACTION
BILL: HB 135
SHORT TITLE: DENTISTS: LICENSING & EXTEND EXAMINING BD
SPONSOR(S): RULES BY REQUEST OF BUDGET AND AUDIT COMMITTEE
JRN-DATE JRN-PG ACTION
02/13/97 334 (H) READ THE FIRST TIME - REFERRAL(S)
02/13/97 334 (H) LABOR & COMMERCE
03/21/97 (H) L&C AT 3:15 PM CAPITOL 17
BILL: HB 137
SHORT TITLE: BOARD OF VETERINARY EXAMINERS; LICENSE
SPONSOR(S): RULES BY REQUEST OF BUDGET AND AUDIT COMMITTEE
JRN-DATE JRN-PG ACTION
02/13/97 334 (H) READ THE FIRST TIME - REFERRAL(S)
02/13/97 334 (H) LABOR & COMMERCE
03/21/97 (H) L&C AT 3:15 PM CAPITOL 17
BILL: HB 136
SHORT TITLE: PHYSICAL THERAPY AND OCCUPATIONAL THERAPY
SPONSOR(S): RULES BY REQUEST OF BUDGET AND AUDIT COMMITTEE
JRN-DATE JRN-PG ACTION
02/13/97 334 (H) READ THE FIRST TIME - REFERRAL(S)
02/13/97 334 (H) LABOR & COMMERCE
03/21/97 (H) L&C AT 3:15 PM CAPITOL 17
BILL: HB 134
SHORT TITLE: BARBERS AND HAIRDRESSERS
SPONSOR(S): RULES BY REQUEST OF BUDGET AND AUDIT COMMITTEE
JRN-DATE JRN-PG ACTION
02/13/97 333 (H) READ THE FIRST TIME - REFERRAL(S)
02/13/97 333 (H) LABOR & COMMERCE
03/21/97 (H) L&C AT 3:15 PM CAPITOL 17
WITNESS REGISTER
CATHERINE REARDON, Director
Division of Occupational Licensing
Department of Commerce and
Economic Development
P.O. Box 110806
Juneau, Alaska 99811-0806
Telephone: (907) 465-2538
POSITION STATEMENT: Answered questions regarding HB 135, HB 137.
KENNETH L. CROOKS, DDS
Chairman, Board of Dental Examiners
P.O. Box 1610
Dillingham, Alaska 99576
Telephone: Not provided
POSITION STATEMENT: Testified on HB 135.
ROBERT WARREN, DDS
625 East 34th Avenue, Suite 202
Anchorage, Alaska 99703
Telephone: (907) 274-7691
POSITION STATEMENT: Testified in support of HB 135.
RICHARD COOK, DDS
President of the Juneau
Dental Society
712 West 12th Street
Juneau, Alaska 99801
Telephone: (907) 586-1188
POSITION STATEMENT: Testified on HB 135.
RANDY WELKER, Legislative Auditor
Legislative Audit Division
P.O. Box 113300
Juneau, Alaska 99811-3300
Telephone: (907) 465-2347
POSITION STATEMENT: Explained HB 137 and HB 136.
PAM TUOMI, DVM
Alaska State Veterinary
and Medical Association
2036 East Northern Lights Boulevard
Anchorage, Alaska
Telephone: (907) 274-5623
POSITION STATEMENT: Testified on HB 137.
DEANNA THORNELL, DVM
P.O. Box 61263
Fairbanks, Alaska 99706
Telephone: (907) 479-2800
POSITION STATEMENT: Testified on HB 137.
PAULINE BENNETT-GANNON, President
Alaska Occupational Therapy Association
1076 Willow Grouse Road
Fairbanks, Alaska 99712
Telephone: (907) 457-6127
POSITION STATEMENT: Testified on HB 136.
MARY MELISSA ROBINSON, Therapist
Committee Chair, Licensing Committee
Alaska Occupational Therapy Association
13350 Westwind Drive
Anchorage, Alaska 99516
Telephone: (907) 345-1004
POSITION STATEMENT: Testified on HB 136.
MARY VAIL, Physical Therapist
Legislative Liaison for the Alaska Chapter
of the American Physical Therapy Association
Address and telephone number were not provided
POSITION STATEMENT: Testified on HB 136.
ACTION NARRATIVE
TAPE 97-26, SIDE A
Number 001
CHAIRMAN NORMAN ROKEBERG called the House Labor and Commerce
Standing Committee to order at 3:19 p.m. Members present at the
call to order were Representatives Rokeberg, Cowdery, Ryan and
Brice.
HB 135 - DENTISTS: LICENSING & EXTEND EXAMINING BD
Number 137
CHAIRMAN ROKEBERG announced the first order of business would be HB
135, "An Act relating to dental licensing; extending the
termination date of the Board of Dental Examiners; and providing
for an effective date."
Number 168
CATHERINE REARDON, Director, Division of Occupational Licensing,
Department of Commerce and Economic Development, was first to come
before the committee. She said the bill was introduced by the
Legislative Budget and Audit Committee (LB&A). She explained all
the bills the committee would deal with today contain elements of
legislative audit recommendations in addition to the extension of
the board's sunset dates. She said while the department agrees
with most of the suggested changes, the ideas were brought forward
from LB&A rather than initiated by the Department of Commerce and
Economic Development. She said HB 135 extends the sunset date to
2003, but it is her understanding that four years is what is
probably considered more appropriate by the Senate.
MS. REARDON informed the committee members that Section 2 increases
the number of public members on the board and decreases the number
of dentists. This was a recommendation of the legislative audit,
as Mr. Welker testified to in the Senate the previous week. The
purpose was that with a nine member board, it was the feeling of
the auditor that two members might bring a more effective public
voice to the board and that perhaps in other times in history they
might have benefited from more public voice. She said currently
there are six dentists, two hygienists and one public member on the
board. The bill would make it five dentists, two hygienists and
two public members.
Number 358
MS. REARDON referred to Section 3 and said it removes a requirement
that the photograph submitted with an application be autographed.
She said it is good idea to remove that requirement since the
application forms are signed anyway.
MS. REARDON referred to Section 4 and said it gives the board more
leeway in allowing dentists to come in by credentials, these are
people who are licensed in other states as dentists. The current
law says that the other state in which the person is licensed has
to have licensing requirements, that are generally equivalent to
those of this state. She said the issue has come up that Alaska is
part of the Western Regional Examining Board, they give what is
called the "WREB" dental exam. There are also several other
regional exams in the country that are not identical. She said she
believes California has its own exam. When it comes to determining
what is equivalent, there are occasions where someone may be coming
from another state and the test they took doesn't have the same
elements as the WREB that Alaska uses, and therefore, the person
isn't eligible for coming in by credentialing. The new language on
page 2, starting on line 20, says that if the reason that the
licensing requirements aren't equivalent because something was
missing on the other state's test that the board may allow the
person to come in for licensure if they demonstrate that they've
had continuing education or hold specialty certification or provide
proof of successful practice in those areas, so as to not exclude
people from practice in Alaska unnecessarily. Ms. Reardon
explained the board currently has a regulation out for public
notice which would give some leeway to the situation. She noted
the public comment period ends June 6.
Number 517
MS. REARDON said Section 5 is a transition section which deals with
the replacement of one of the dentists by a public member. The
transition section says that the next dentist whose term expires
will be replaced by a public member instead of kicking someone off
the board for immediate replacement. Ms. Reardon informed the
committee the bill has a zero fiscal note and was done slightly
different than in the past for board sunset extensions due to a
request from the Senate. She said the department used to show the
ongoing costs of programs. There were usually positive fiscal
notes that showed the money was already in the budget, but was
leading to the necessity of Finance Committee referrals. The
department is doing fiscal notes and it is shown in the analysis
that there is an ongoing cost of regulating dentists which is
already in the budget. Ms. Reardon said in this case, the
department is saying the cost is about $163,200 a year for
licensing dentists.
Number 592
REPRESENTATIVE JOE RYAN asked if dental hygienists are licensed.
MS. REARDON indicated dental hygienists are licensed under the
Board of Dental Examiners.
REPRESENTATIVE RYAN asked if they have to meet national criteria.
MS. REARDON explained there is a national exam. The licensing is
similar to the one set up for real estate or dentists where in
statute there are qualifications for training and examination. It
is very similar to all of their licensing sections.
REPRESENTATIVE RYAN explained the reason he is asking is he has
some friends that are dentists and a circumstance he has heard is
that they were having to pay a lot of people a lot of money who
they didn't feel were qualified to do the job. They wanted more
qualifications and expertise.
REPRESENTATIVE RYAN said a common complaint from people in Alaska
was that there weren't enough dentists or enough competition and
the prices are very high. A lot of people go to Whitehorse or
Seattle. The board is very restrictive in allowing other people to
come into the state. Representative Ryan noted a friend of his in
Fairbanks, Dr. Helmbrick, after six or seven times of taking the
exam before he could qualify, graduated from an accredited school.
He felt it was a case of an old Alaskan tradition, "I'm here, close
the door, don't let anybody else in." He asked if there has been
anything to eliminate that.
MS. REARDON said she wasn't sure what time period Representative
Ryan's friend was having this difficulty. She said she believes
the committee would see in some previous audits and legislative
committee hearings regarding credentialing or licensure that there
have been similar concerns expressed. She said she thinks that
some of the board members, who are on-line, would say that is not
their perspective or way of behaving and that they have been trying
to find ways within their statute to let in qualified people. Ms.
Reardon said if the test his friend was taking was the Western
Regional exam, that is a test that involves not just Alaska, but is
written for all states. She noted the Dental Board members
participate in meetings and examinations by the Western Regional
and are familiar with how the test is written.
Number 847
KENNETH L. CROOKS, DDS, Chairman, Board of Dental Examiners,
testified via teleconference. Dr. Crooks informed the committee
members he has been practicing dentistry since 1971. He said he
left private practice in California in 1977. He then moved to
Alaska and has spent the last 20 years with the Indian Health Care,
Bristol Bay Health Corporation, Dillingham. He was appointed to
the Board of Dental Examiners in February, 1995, and was elected
chairman in December, 1996. Dr. Crooks referred to HB 135
regarding the addition of a second public member and said the board
has discussed this and they are in favor of the idea. He noted the
board has experienced problems with the single public member not
being able to attend all of the meetings. Prior to that person's
resignation, she had difficulty making it to half of the meetings.
Dr. Crooks said personally, he was not aware of reducing the number
of dentists on the board in order to add a second public member and
he doesn't believe that any of the current board members realize
that was even a possibility. Dr. Crooks suggested an additional
position be created in order to add a second public member. He
said he would further suggest that in the last two years, they have
had a budgetary (indisc.) which would make this possible without
any additional funding. He said he knows there was a fee reduction
this year which Catherine Reardon could speak to. Dr. Crooks said
he believes that even with the fee reduction, they could still
(indisc.) being able to pay the travel costs or whatever is
involved with an additional board member.
DR. CROOKS said as far as the second change to the statute dealing
with the problem of the definition of "generally equivalent" in
offering statutory relief from some dilemmas they've had he feels
the current board would embrace this change. It is sympathetic or
symbiotic with the regulation change that they proposed at their
December board meeting. He said, "I think they're fully compatible
and are designed to accomplish the same purpose which is to get out
of a situation where we have had to actually -- within the last
year we have tabled applications from at couple of dentists, at
least two, because we felt that by all our standards and our
background check that these were qualified dentists, eligible for
licensure by credential, but because of the language of the
statutes and regulations, we were not able to grant licensure.
We've tabled those licenses rather than deny them in the hope that
changes could be made. We envisioned it through regulation in
order to all them to get licensure."
Number 1124
CHAIRMAN ROKEBERG asked if the change would satisfy the problem.
DR. CROOKS indicated he would like to see both things happen. He
said he thinks the statute would certainly help, but if the
regulation change goes through it would make more things black and
white where it wouldn't be up to the board to make value
judgements. He said, "The language where (indisc.) demonstration
of continuing education or proof of satisfactory successful
practice involved, no matter how you look at it that calls for
subjective judgement."
Number 1192
CHAIRMAN ROKEBERG said there has been some discussion of
prohibiting the use of amalgam fillings. He asked Dr. Crooks to
comment.
DR. CROOKS said the board has not had discussion about prohibiting
the use of amalgam fillings, but would be confident that the board
would be unanimously against any idea like that. It is the best
material available for a lot of common dental restoration needs.
Number 1254
REPRESENTATIVE RYAN said a couple of dentists have felt that the
qualifications of dental hygienists weren't up to speed for what
they were having to pay them in that they weren't professional
enough. They felt though there should be some stricter standards
set for hygienist's educational background.
DR. CROOKS said the licensure for hygienists in Alaska is very
similar in process to the licensure for dentists, including the
fact that they use a component of the Western Regional Examination
Board for testing of hygienists. He said if the dentists have
questions about the standards of the exams or reviewing, he would
like to hear from them. Dr. Crooks said as far as the specifics of
the Western Regional exam, Dr. Warren who is also on-line, is much
more familiar with the make-up of that exam.
Number 1338
REPRESENTATIVE RYAN said it was a concern that was expressed to him
and he wanted to bring it to Dr. Crooks' attention. He noted he
doesn't know that much about the profession. Representative Ryan
informed the committee he has received complaints from the public
that it is extremely difficult for people who want to come to
Alaska and practice to get licensed. The public opinion is that
there is an "old boy network," kind of protecting the territory.
He said he knows a lot of people in Alaska who have gone somewhere
else where the fee for service was tremendously less expensive than
it is in Alaska.
DR. CROOKS said, "This board, and I'm speaking of the people who
have been there the last two years, were appointed, most of them
anyway, were appointed by the current governor, with the
understanding that the law is -- we could expect (indisc.) to
follow it as closely as possible and the credentialing was a
process that we were encouraged to develop. And as I heard you
say, we have tabled two licensure applications purely because we
could not find it in ourselves to deny licenses to these people who
have appeared qualified. I do not believe that there is any sort
of protection being exercised by the Board of Dental Examiners in
the state."
Number 1455
ROBERT WARREN, DDS, testified via teleconference from Anchorage.
He said he is a practicing dentist and has been in practice for 21
years. He was appointed, under the Sheffield Administration, to
the Board of Dental Examiners in 1981, to fill an unexpired term
and then was reappointed for two additional terms. He noted his
last term expired in 1991. Dr. Warren said he was chairman of the
board in 1987, when Alaska joined the Western Regional Examining
Board. Recently, he has been involved in the American Association
of Dental Examiners which is the national organization that
Alaska's board queries when there are disciplinary questions about
credentialing candidate for licensure. He noted he is the
president-elect. He said the national organization was the
clearinghouse for disciplinary information as it is the agency that
all licensing agencies in the United States report to. Dr. Warren
said he is in favor of the legislature extending the termination
date for the board, but would strongly suggest that if the numbers
on the board have to be changed to make room for a public member
that the board be increased by a member rather than eliminating an
existing dentist position. Dr. Warren explained he was the
president of the board when Alaska joined Western Regional. The
legislative audit report of 1986 and 1987 strongly urged that
Alaska stop giving their own state licensing exam which they had
done for a decade before statehood and since statehood. He said he
believes that is where the Dental Board got "the good old boys"
reputation.
DR. WARREN explained that to affiliate the Dental Board with the
Western Regional Examining Board took statutory changes.
Representative Curt Menard, a dentist from Wasilla, was in the
House at the time and his staff and Dr. Warren helped write the
current statute. He explained what they elected to do, aside from
putting the WREB language in the statute, was to increase the board
of seven members, five dentists, one hygienist and one public
member, to nine members adding another dentist and hygienist. Dr.
Warren said, "The reason for it at the time was in the past we'd
given the examination here in Anchorage. Now our members, because
we are a member of Western Regional, were being asked to be in the
WREB examining pool. And by that, what I mean is at the time the
members of WREB were Arizona, Utah, Montana, Idaho and then also
Alaska, and then New Mexico joined. And at the time, there were
six states and none of these states had dental schools, so the
board members were asked to give the examination on a rotating
basis. Frequently, these exams are two to three days from the day
of travel so it meant as much as a week out of the office, out of
your productive time in your office, if you volunteer to give these
exams out of state. They were frequently given in states that had
dental schools like Loma (Indisc.) in Southern California or
University of Oregon. And so we felt the time constraints on the
Dental Board members, be the hygienists, who also had to get exams
out of state or dentists who (indisc.) out of state. We needed a
few more people to kind of spread that load a little bit more
equally. I think it has served the public well and the citizens of
the state well for a decade and I can see no reason why to change
it at this time."
DR. WARREN informed the committee that WREB has now expanded to ten
states. Several years ago Oregon rejoined. The state of
Washington is currently a member of WREB. The latest states that
have joined are Texas and Oklahoma which almost doubled the amount
of candidates. Dr. Warren said in response to Representative
Ryan's question, this year the WREB is going to examine 1,000
candidates in 12 different exams meaning that if 1,000 pass, they
will be eligible to apply for a new license in Alaska. Dr. Warren
explained Dr. Crooks has been involved in the credentialing process
longer than he has. He said they were just transitioning into the
process when the original statute was written.
Number 1747
REPRESENTATIVE RYAN indicated that he is having his amalgam
fillings replaced with plastic as he has read several articles
discussing different diseases that amalgam fillings can cause. He
said a few years ago he can remember an appointment to the board
when Representative Menard was in the House and this person thought
along the same lines as he does. There was opposition to this
person's appointment because he dared breach the orthodoxy at the
time. He asked Dr. Warren if there is going to be a move again to
chastise people who want an alternative replacement rather than
using a mercury based product in their mouth.
DR. WARREN explained that one of the originators of this philosophy
was a Dr. Hal Hungens from Colorado. He said this past year, Dr.
Hungens' license was revoked by the state of Colorado and after
that the Colorado State Medical Board of Examiners filed a
complaint against a physician (indisc.) and she voluntarily
surrendered her medical license and moved to Alaska. There has
also been a revocation of a license of a dentist in Minnesota doing
the same thing. Dr. Warren said that there has been historical
judgement in California where a California superior court judge
would not receive any testimony portraying that dental amalgam was
a serious health threat. A researcher at the University of
Nebraska has found that there is no evidence to link Alzheimer's
disease to amalgam. He said there is a lot of anecdotal evidence
out there regarding amalgam fillings.
Number 1895
REPRESENTATIVE RYAN said, "My concern is that I would like to see
an individual option be allowed and I would hate to see that anyone
who is practicing and offered this service to the public that there
would be people ganging up on them."
Number 1920
CHAIRMAN ROKEBERG asked Dr. Warren if he would prefer that the
committee amend the bill to the year 2001, for a four year cycle
and then return to the six licensed dentists and one public member.
DR. WARREN said he would recommend that.
Number 1993
RICHARD COOK, Dentist, President of the Juneau Dental Society, said
he thinks most dentists, in general, support the bill as written or
with the modifications. He said he personally doesn't have strong
feelings if another public member is added or not.
Number 2026
CHAIRMAN ROKEBERG closed the public hearing on HB 135. He said he
would like to make an amendment to change the date of 2003 back to
2001. He said he would also like to maintain the six dental
members because of the importance of them being in the (indisc.)
for the actual examination process and maintain the one public
member.
REPRESENTATIVE COWDERY moved the amendment.
CHAIRMAN ROKEBERG asked if there was an objection to the amendment.
Hearing none, the amendment was adopted.
Number 2075
REPRESENTATIVE HUDSON moved and asked unanimous consent to move HB
135, as amended, out of committee with individual recommendations
and a zero fiscal note. Hearing no objection, CSHB 135(L&C) was
moved out of the House Labor and Commerce Committee.
HB 137 - BOARD OF VETERINARY EXAMINERS; LICENSE
Number 2102
CHAIRMAN ROKEBERG announced the next order of business would be HB
137, "An Act relating to veterinarians; extending the termination
date of the Board of Veterinary Examiners; and providing for an
effective date." He asked Mr. Welker to come forward and explain
the bill.
Number 2125
RANDY WELKER, Legislative Auditor, Legislative Audit Division came
before the committee. He said HB 137 works on two sections of
statute. The first relates to the extension date of 2003. He
indicated he expects the committee to amend that for consistency.
The second section of the bill addresses concerns raised on
credentialing. Mr. Welker said the language in HB 137 needs some
work. He said in the Senate Labor and Commerce Committee they
found out that there were more intricacies in credentialing. Mr.
Welker said, "We're at the decision point now of making a policy
call of elevating the standards and the tests that we require of
applicants for credentialing. As it sits now in statute, it is a
very difficult match of requirements in the state you were licensed
in equal to requirements in this state at the time you are
licensed. So it's a very difficult process of matching up
requirements. The board is headed more towards the requirement of
passage of national examinations for continued competency type of
tests. I don't have any problem with that. There is some language
that is being worked on. I don't know whether it has gotten to
you, Mr. Chairman, yet, but there is probably some preferable
language for substituting in this section that would better
address, I think, the needs of credential applicants and also the
concerns of the board."
Number 2229
PAM TUOMI, Member, Alaska State Veterinary and Medical Association,
testified via teleconference from Anchorage. She said she found
the wording relating accrediting awkward. The members of the
Anchorage veterinary community that she has spoke with have all
expressed concern about the elimination of requirements for
graduation from an accredited school of veterinary medicine. She
said they are sympathetic with the need to make the process more
uniform and to recognize the use of the national board's
examinations. She said they feel that the wording in the present
Senate bill is considerably simpler and addresses the credentialing
problem as well as cleaning up (indisc.) in the basic license
provisions. Dr. Tuomi explained a Veterinary Medical Association
meeting is scheduled for the following Tuesday. She said they are
hoping to poll those members and give further testimony at a later
date. Dr. Tuomi said, "We should continue to include the
requirement for graduation from a school of veterinary medicine.
Entirely conceivable, a good academic student might be able to get
sufficient information from (indisc.) medical classes and reading
old tests and other information to pass the national board exam,
but accredited schools of veterinary medicine add the requirement
that those individuals will have had clinical experience and
actually had an opportunity to do surgery and medicine under
supervision. Eliminating that requirement might mean that someone
could simply have book knowledge would be allowed to have a
license."
Number 2410
DEANNA THORNELL, Veterinarian, testified via teleconference from
Fairbanks. She said she agrees that the Senate bill is much
better, but there are also some flaws in it. Dr. Thornell said she
agrees that all veterinarians should graduate from an accredited
veterinary school. That process needs to be kept intact and we
shouldn't step backwards in our qualifications. She discussed the
difficulties with researching a person's credentials that had
graduated in the 1960s.
TAPE 97-26, SIDE B
Number 025
DR. THORNELL explained the National Examination Committee is
actually trying to design clinical competency tests that are
species specific and they should be available by the year 2000.
Dr. Thornell said, "We were feeling that the people that come in
here with credentials should graduate from an accredited school,
pass the NVE and also pass (indisc.) competency test on top of
having some kind of clinical experience or (indisc.) years for
credentials."
DR. THORNELL referred to page 3, line 3, of the Senate's version of
the bill, "Pass a written examination of the state," and said they
need to take the state exam. She said she was hoping that they
would be required to have taken NVE, CVT and have practiced for the
last five or seven years. There will be a few people who have not
taken the clinical competency test who graduated prior to 1981.
She indicated she would be more than willing to work with the
committee on the bill.
Number 137
REPRESENTATIVE BRICE asked if the bill would impact temporary
licenses for veterinarians who come to Alaska for the Iditarod for
the Yukon Quest.
DR. THORNELL said it won't. These are courtesy licenses. The
organizer of the race usually handles the lists of the
veterinarians that they have coming up. She said they are required
to have a current license in another state or in Canada and that
they haven't any disciplinary actions against them.
Number 166
REPRESENTATIVE HUDSON asked how a veterinarian can practice in
Alaska if they are from Washington.
DR. THORNELL explained they would get a courtesy license. She said
the reason they came up with the courtesy licenses is because of
the Exxon oil spill. There were veterinarians coming into the
state that were high priced and really weren't qualified and they
had a lot of disciplinary action in other states. She noted there
weren't a lot. There were very good qualified people that also
came.
DR. THORNELL said, "If you (indisc.) outside and want to come up
and come to one of the races, it's pretty easy not to go ahead and
get one of the courtesy licenses. (Indisc.) know that you're not
any disciplinary action and we'll allow you to come up here and
work. If you want to actually come up and practice in the state of
Alaska and you've practiced in the state of Montana for 20 years,
this is the credentials we're looking at in this particular House
bill. In the past, the wording was so confusing. If you were in
Montana and graduated from veterinary school back in 1970, our
statutes stated that we had to go back to 1970, look up what our
state regulations were on licensing veterinarians at that time and
then that's how you got in. It's whatever the state required at
that time. The problem is nobody put it on record, what 1970
(indisc.) are and the archives are having a difficult time looking
it up. So it's very difficult to answer folks that are calling up
here for credentials exactly what they have to do before they get
up here. So what we're trying to do is make it very simple and
easy and just say have your NVE scores, which everybody has passed
if they are already practicing in another state. If you graduated
from a veterinary school, that's very important. Once again,
everybody should have done is pass the clinical competency test
which everyone is required now from here on out, will be required
from veterinary schools to take, and also have practiced in the
last five or seven years."
Number 319
CHAIRMAN ROKEBERG informed Dr. Thornell that he was reading the
statute and didn't see anything regarding the courtesy license. He
asked if it is in regulation.
Number 342
CATHERINE REARDON, Director, Division of Occupational Licensing,
Department of Commerce and Economic Development, came before the
committee. She explained the centralized licensing statute says
that boards may set up systems for courtesy licenses if they choose
to, by regulation, and this board has. She noted other boards may
not have chosen to set up curtesy licensing systems.
CHAIRMAN ROKEBERG said there is temporary permit provision
currently in statute that is different.
DR. THORNELL explained a temporary permit is designed for someone
that is coming out of school, hasn't taken a national board exam,
are waiting to take our state exam and they have employment here.
She noted the state exam is only offered twice a year, so it's very
difficult for them to wait six months before they start work. If
they have a veterinarian that's going to employ them, the temporary
permit will allow them work until the next test is available for
them to take. That's mainly designed for graduating students just
out of school where they have a way to practice until the exam is
given.
CHAIRMAN ROKEBERG asked Dr. Tuomi and Dr. Thornell to provide some
written comments, particularly relating to CSSB 92. He closed the
public hearing and said it is not the intention of the Chair to
move HB 137 at this time.
HB 136 - PHYSICAL THERAPY AND OCCUPATIONAL THERAPY
Number 425
CHAIRMAN ROKEBERG announced the next order of business would be HB
136, "An Act relating to the regulation of physical therapists and
physical therapy assistants; extending the termination date of the
State Physical Therapy and Occupational Therapy Board; and
providing for an effective date."
Number 456
RANDY WELKER, Legislative Auditor, Legislative Audit Division,
explained HB 136 addresses two elements of statute. The first is
the sunset extension date in Section 1. He explained Section 2 is
a provision that requires applicants to pass an oral examination
administered by the board. When this was put into place, it was
put in to basically demonstrate an ability to speak English. He
said we were often times being mandated to give an oral examination
to Canadians who were very capable of speaking English. Mr. Welker
said at a minimum it has been changed to, "at the discretion of the
board." An option would be to simply delete this requirement as we
don't require doctors and others to demonstrate that they have the
ability to speak English, but we are requiring it of the physical
therapists and occupational therapists. He sat they felt at a
minimum, it would be best left to the discretion of the board on
the various applicants.
Number 539
PAULINE BENNETT-GANNON, President, Alaska Occupational Therapy
Association, testified via teleconference from Fairbanks. She said
she is testifying to amend HB 136 and has also testified earlier in
the week to amend the Senate's version of the bill. She said she
believes the Senate has a committee substitute which incorporates
her suggestions. Ms. Bennett-Gannon said the suggestions that she
will make are in addition to the changes that the committee already
has made. She said the word "or" would be changed to "and" when
speaking of the agency that approves curriculum for occupational
therapists. Ms. Bennett-Gannon said the statute relating to
occupational therapists in this area had "and," whereas statutes
relating to physical therapists, which has very similar wording had
"or." She said, "The reason for this is that in the past, say when
I went to school, the AMA (American Medical Association) was
involved in certifying all their (indisc.) professional curriculums
and it is no longer that professional agencies dealing with
(indisc.) professions has -- part of their organization that does
that credentialing and so we really aren't doing `and' because
`and' really isn't available."
MS. BENNETT-GANNON explained that under AS 08.84.030, section
(b)(1), "and" should be changed to "or." She noted on the
committee substitute there is something left off.
CHAIRMAN ROKEBERG indicated the committee doesn't have the Senate
version of the bill and asked Ms. Bennett-Gannon to address the
House bill.
Number 584
MS. BENNETT-GANNON said her suggestion was that the wording about
the discretion of the board that foreign trade therapists
demonstrate the ability to speak effective English during an
interview also be included for occupational therapists. Currently,
it is only located in the language of the statute that refers to
physical therapists. She referred to discussion earlier in the
meeting about another board and said they have a lot of physical
and occupational therapy foreign schools that do send people to the
United States and they have concerns about whether or not training
is adequate. Ms. Bennett-Gannon said in the past when she served
on the Physical Therapists and Occupational Therapist Licensing
Board they had a case where a foreign-trained therapist was doing
her interview that we require and did not have that ability to
understand an English prescription written by a doctor, etc., and
wasn't able to finish her internship. That (indisc.) would require
some renumbering on that page. She suggested the wording "under
this chapter" be added where it speaks of being licensed as an
occupational therapist. There was a case where someone licensed in
a different health profession decided that what they were doing
could be constituted as occupational therapy. The new wording
would help clarify that situation.
MS. BENNETT-GANNON said, "I also believe that in addition to this
(indisc.) of the board by the (indisc.) trained therapists for
English that perhaps wording to the effect that "testing could be
done if necessary" might be useful. Again, when I served on the
board, it was sometimes frustrating not to adopt a regulation and
not be able to because there wasn't a place to hook it on in the
language in the state."
Number 852
MARY MELISSA ROBINSON, Therapist, Committee Chair, Licensing
Committee, Alaska Occupational Therapy Association, testified via
teleconference from Anchorage. She indicated she is in favor of
the extension of the Licensing Board. The present copy of HB 136
states that the extension would be 2003 and she prefers that date.
She said her organization would be in favor of extending the board
even if it was changed to 2001. Ms. Robinson said she also
supports the change in the language for the effective speaking of
English which is very important when you're relating to a patient's
need when they are describing symptoms. They need to relate not
only to other medical personnel, but to the client and that is an
important piece of being competent in a profession. She said she
would also like to support some of the items outlined in SB 91 (B).
The additional language indicates that a person may not provide
occupational therapy services without being licensed under this
chapter seems self explanatory, but perhaps it is not without the
addition of that under this chapter. She said it couldn't be a
driver's license, they have to be licensed as an occupational
therapist. She said she would like to support the change that
would identify that the American Medical Association no longer is
part of the curriculum approval with the American Occupational
Therapy Association. Although that was in the past, it no longer
is and hasn't been for a few years. She thanked the committee for
listening to her.
CHAIRMAN ROKEBERG asked Ms. Robinson to explain the difference
between physical therapists and occupational therapists.
MS. ROBINSON explained physical therapists treat physical
disabilities differently than occupational therapists do. The
philosophy of an occupational therapist requires they use
adaptation. She they look at what a person is occupied with during
the day. Ms. Robinson said, "The word `occupational therapy' comes
from the things which occupy their day and looks specifically at
what it is in their day that they need assistance to be modified,
to be remediated, to be relieved, to be more functional. We take
a very very functional approach rather than total exercise or
(indisc.) who work with the person of need is one reason why it's
very critical to be able to (indisc.) the receiver of the services
to know what his needs are and how that applies to his life, not
what our goals are, but what the client's needs are."
Number 1159
MARY VAIL, Physical Therapist, Legislative Liaison for the Alaska
Chapter of the American Physical Therapy Association, came before
the committee to testify on HB 136. She said she would like to
endorse the extension of the termination date which she believes
will be 2001 in the final version of the bill. Ms. Vail said she
would also like to support the proposed changes by the occupational
therapists. She said so much of what she does is education as she
needs to educate people on how to take care of themselves and she
does feel that English is a strong part of their communication to
teach patients in what they need to do. Ms. Vail said she agrees
to the changes in the Senate bill.
Number 1224
CHAIRMAN ROKEBERG indicated HB 136 would be held to await the
adoption of changes from the occupational therapists.
HB 134 - BARBERS AND HAIRDRESSERS
Number 1230
CHAIRMAN ROKEBERG announced the committee would address HB 134, "An
Act relating to regulation of barbers and hairdressers; extending
the termination date of the Board of Barbers and Hairdressers; and
providing for an effective date."
Number 1246
RANDY WELKER, Legislative Auditor, Legislative Audit Division, came
before the committee to explain HB 134. He informed the committee
members that the bill makes two changes to statutes. Section 1
relates to the sunset extension date. Mr. Welker said in Section
2 requests a change in the make-up of the board to delete one of
the barber members and replace it with a cosmetologist. Currently,
the board regulates barbers, hairdressers and cosmetologists and
there is no representation on the board from the cosmetology
profession. He said as of June 30, 1996, there were 260 licensed
barbers, 482 licensed cosmetologists and 2,127 licensed
hairdressers. So with almost a two to one ratio between
cosmetologists and barbers, they did not think it was unreasonable
to reduce the current two barber members to one and provide for a
cosmetologist member. There is a transitional section that would
allow for the current barber member to continue until a term
expires or when there is a vacancy for the appointment of a
cosmetologist.
Number 1336
CHAIRMAN ROKEBERG said, "Mr. Welker, I'm trying to look at the
audit. The figures you gave about the various members..."
MR. WELKER explained they are not in the audit. He said he got the
futures from the Division of Occupational Licensing's FY 96 annual
report.
CHAIRMAN ROKEBERG referred changing the membership from a barber to
a cosmetologist and asked if he has received any input from the
board.
MR. WELKER said he would defer the question to Ms. Reardon.
CATHERINE REARDON, Director, Division of Occupational Licensing
Department of Commerce and Economic Development, informed the
committee that the board discussed this at their last meeting.
They agreed it would be a good idea to have a cosmetologist on the
board, but they would prefer to achieve that in another manner.
She said as she understands their preference is to retain the two
barbers, but require that one of the two hairdressers also be a
cosmetologist. There are a number of licensees that are both
hairdressers and cosmetologists. She said in this case
"cosmetologist" means the care of the skin, facials, etc. The
board thought they could retain their two barbers, keep their one
public member and have one of their two hairdressers serve the duel
role of being both the cosmetologist and the hairdresser.
Number 1456
CHAIRMAN ROKEBERG questioned what the name of the board is. He
asked if it is Board of Barbers and the Board of Hairdressers and
Beauty Culture Examiners.
MS. REARDON responded that it is called the Board of Barbers and
Hairdressers.
CHAIRMAN ROKEBERG said, "That is what it is now, but also it does
the licensure for cosmetologists?"
MS. REARDON answered, "It does, skin care as well."
CHAIRMAN ROKEBERG said, "Representative Brice is not here. Maybe
even eventually manicurists - trying to get that bill through."
MS. REARDON said, "There is specifically in statute right now a
prohibition against the board moving into the area of licensing
manicurists. That bill would have changed that instead of
licensure of manicurists."
CHAIRMAN ROKEBERG indicated there seems to be some controversy
about the nature of the bill and the recommendation of the board.
MS. REARDON said she doesn't know if it is a major controversy
because she doesn't know how strongly Mr. Welker feels about the
need to actually remove a barber. She said she thinks both the
board and the sponsor agrees that having a cosmetologist on the
board to offer the expertise about skin care and help with testing
of that subject would be a good thing. She said it hasn't erupted
into a major controversy at this point.
Number 1570
CHAIRMAN ROKEBERG said he has a copy of the January 27 and 28,
1997, minutes from the board where they say that the board felt
that a member could hold both a cosmetologist and a hairdressers
license. Therefore, the board would have two hairdressers, two
barbers and a cosmetologist without losing a barber or hairdresser.
He said there would be two hairdresser, two barbers and a
cosmetologist.
MS. REARDON pointed out one of the hairdressers would also be the
identical person as the cosmetologist. She said if she were to
draft an amendment, on page 1, line 12, it might be changed to
read, "one person licensed as a hairdresser under this chapter."
Then line 13 could read, "one person licensed as both, a
cosmetologist and a hairdresser under this chapter."
Number 1642
REPRESENTATIVE HUDSON said he was looking at the reason why we have
this board in the state and asked if the state assumes any kind of
a liability for all of the occupational licenses. He said if
somebody meets the statutory standards and they turn out be
somebody really dangerous, would the state have any liability.
MS. REARDON responded somebody from the Department of Law could
best answer that. She said her belief is that the state wouldn't
be liable as long as we are, in good faith, carrying out the
statute or attempting to carry out the statute and aren't being
grossly negligent in our behavior. Ms. Reardon noted that issue
has come up in marine pilotage because much more money is at stake.
When a cruse ship is involved in an accident, the insurance company
and the cruse ship company have raised the issue that perhaps the
state is liable for having given the license and required us to
take on this person who was not competent. She said Gail Horetski
has had to look into that topic in more detail. Ms. Reardon said
the state has never been held liable for that purpose to this
point.
REPRESENTATIVE HUDSON suggested maybe that should be included in
statute. He said he would presume that all of the boards
essentially pay for themselves. He asked Ms. Reardon how her costs
in administrating the program are covered.
Number 1810
MS. REARDON said they have both a centralized licensing statute and
individual chapters for each occupation. The centralized licensing
statute applies to all of them. Ms. Reardon said AS 08.01.065,
which is the centralized statute, says that each occupation will
pay for itself. She read from the statute, "The department shall
establish fees so that the total amount of fees collected for an
occupation approximately equals the actual regulatory costs of the
occupation." It then goes on to say that the division will review
and move the fees up and down. She said in this section,
regulatory costs means the costs of the department that are
attributable to regulation of an occupation plus all the expenses
of the board. Ms. Reardon explained that previous to FY 93, there
used to be some general fund support - oil money, and that's all
been withdrawn over time as budget realities hit. So at this
point, the division tracks and bills programs for everything from
attorney general costs of reviewing regulations to the actual board
meeting, travel costs, and the cost of employing her and her entire
division. Ms. Reardon explained the costs of her salary are billed
out on a per capita basis to each of the 35,000 licensees. The
people who actually do more specific work on a specific board area,
such as licensing examiners, keep time sheets. When long distance
phone calls are made, they key in what occupation they are making
the call on. She said it is true that over time the sense of what
costs are caused by regulating occupations has been expanding.
Attorney General regulation review costs used to be something that
was paid out of pure general fund oil money and now it is all
program receipt user fees. The costs of the computer system in the
Division of Administrative Services and some of the costs of the
commissioner's office are being billed out to occupations. That is
a sore part with some of them because some of them feel that the
public protection that is provided, perhaps by enforcement
activities such as legal fees, are not fairly placed on just those
licensees because everyone was protected when they removed an
unsafe doctor. She said the licensees covers all of those costs
and it is about a $5 million budget. Ms. Reardon discussed charts
that she had given the committee members. She noted she would say
that probably an average of four professions come to the
legislature every two years wanting to be licensed.
Number 2038
REPRESENTATIVE HUDSON asked how many people are in Division of
Occupational Licensing.
MS. REARDON responded approximately 62 people. A fair number of
those people are involved in business licensing, which is a tax
that generates surplus. The fee for that is set in statute at $50
every two years. She explained ten people are involved in
investigations of citizen complaints of competence and that type of
things.
REPRESENTATIVE HUDSON referred to when people are investigated and
asked if there is a penalty structure.
MS. REARDON informed the committee that in every occupation there
is grounds for disciplinary sanctions which varies occupation to
occupation. They use the Attorney General to review a charge
document and represent the division in administrative hearings.
She noted they can be appealed to the superior court. Ms. Reardon
said unlicensed activity is a criminal matter because the boards
don't have jurisdiction over people who aren't licensees. If it is
a matter where the division finds out that somebody is practicing
without a license, the district attorney would take the case
through a criminal misdemeanor. If it is a licensee who is
performing incompetently, then it is through the Civil Section of
the Attorney General's office with the department's hearing officer
and the board ultimately decides.
Number 2420
MS. REARDON said the division has a lot of regulations. She said
they follow the APA for their disciplinary procedures. In terms of
each profession, there are a substantial number of regulations
fleshing out requirements, definitions, etc.
TAPE 97-27, SIDE A
Number 001
REPRESENTATIVE HUDSON said, "...I presume at any rate they pretty
much, again, preview the regulations and make certain that the
standards and the procedures and all that type of stuff are ones
that they want, but do you find any complaints against the
regulatory regimen and the various licensures?"
Number 041
MS. REARDON responded, "When there is a board, we have 35 programs,
20 of them have boards, 15 we run on our own and make all the
licensing decisions without the benefit of boards. When there are
boards, it's the board itself that has the regulation writing
adoption authority the department just has a ministerial role and,
so there it's always what the board wanted because they wrote it,
except sometimes the AG's office says `no.' But I suspect that in
every profession there are people out there who don't agree with
all the regulations the way they are written. There are 35,000
licensees. In general, our statutes are very specific meaning -
compared to something like the Department of Health and Social
Services where they might have something saying `You can adopt
regulations to promote the health and welfare of the citizenry of
Alaska,' and they can set up whole programs like AFDC through their
reg authority. With ours, if you look at them, almost always the
legislature has been very specific about exactly what exams people
have to pass, exactly what kind of education they need. So there
really isn't too much leeway to decide there will be new
requirements to be a real estate agent, for example. So we don't
have the opportunity to perhaps go way overboard and overstep
legislative intent the way you might be able to in another area.
But I'm sure that there are people who don't believe credentialing
statute requirements or the regs that go with them are right for
different programs. You think that the wrong amount of education
is being required -- all this type of thing. And in general, if
there is a frustration with the system, I must say it's probably
that people believe our investigations and disciplinary actions are
too slow, not enough disciplinary action."
REPRESENTATIVE HUDSON asked, "Is that because you don't have enough
people?"
MS. REARDON responded, "What bureaucrat would not say `yes' to that
question."
REPRESENTATIVE HUDSON said, "It seems to me like you can draw your
own revenues. I mean we've given you (indisc.) authority to go
ahead and increase -- in most cases."
MS. REARDON said that although it's true that the department could
choose to raise fees and generate $10 million, the check is that
the legislature sets their expenditure authority. If the
legislature says she can spend $5 million, there is no good reason
for her to collect $10 million. She said that is where the check
is. Ms. Reardon explained that in the Governor's budget, a new
medical investigator has been requested. She hope that will be
approved because the division has about 140 open complaints at any
one time. They receive between 500 and 600 new complaints every
years for all of the licensees. Ms. Reardon explained there are
two things that seem to be slowing things. One is investigations
and the other is attorney general time. It has evolved into a
process where most people are accused of things have attorneys
representing them and it becomes a full blown legal process.
Number 340
CHAIRMAN ROKEBERG asked Ms. Reardon to provide the committee with
the numbers of complaints by the boards and the numbers of license
revocation actions. He also asked to provide numbers on the how
many barbers, hairdressers, etc., there are.
MS. REARDON said she would forward the information to the
committee.
REPRESENTATIVE HUDSON said he would also like sort of a budget
breakdown. He asked how much of the total collection goes to the
citizen board member's activities at board meetings. He also asked
how much is paid out in per diem. Representative Hudson said if
the division collects $6 million, how much of that goes towards
board meetings, etc.
MS. REARDON said she would also provide that information. Ms.
Reardon said, "If I could mention one small issue which I will deal
with in the Senate and then perhaps come to you. When it came to
the issue of disciplinary action, in the barbers and hairdressers
statute there is very little language about grounds for
disciplining any licensee. We have this whole structure and very
little enforcement capability for incompetence so -- in fact what
it says is the board may suspend or revoke a license - another type
of permit, for failure to comply with the chapter, but then the
chapter just requires licensing. So I would propose that we add
`or incompetent or unsafe practice' because for example, when
someone comes, which doesn't happen often, but says `I was burned
by some chemical' or something, you look and say well `what part of
the chapter did it say be safe' and legally, it starts crumbling in
front of you. And so if we're going to license 3,000 people and
have this whole set up, I think it might be a good time to
just...."
Number 526
CHAIRMAN ROKEBERG said he has been reviewing Title 8 and is a
little bit disturbed because some of the penalty provisions for
revocations, board memberships and removal of boards, there are a
lot of inconsistencies. There are certain sections in the front
part of the chapter that provides for some general things that
could apply to almost all of the boards and commission. Some of
them have redundant provisions. He said the whole chapter could
use some review.
MS. REARDON said because they way that Title 8 has been developed
with each occupation coming with its own bill over 20 or 30 years,
there are a great number of inconsistencies within it. She
informed Chairman Rokeberg that she does have a draft omnibus
occupational licensing bill in which they are looking for a sponsor
for. She said the bill provides for about 50 percent clean-up.
Number 685
REPRESENTATIVE HUDSON said, "I would just like to say that I
believe of all the testimony that I have heard in the
Administration that this young lady is the most forthcoming honest
and easy to work with that I've run into and I really appreciate
that."
CHAIRMAN ROKEBERG indicated HB 134 would be held.
ADJOURNMENT
Number 728
CHAIRMAN ROKEBERG adjourned the House Labor and Commerce Standing
Committee meeting at 5:05 p.m.
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