Legislature(1999 - 2000)
04/12/2000 03:25 PM House L&C
| Audio | Topic |
|---|
* 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
April 12, 2000
3:25 p.m.
MEMBERS PRESENT
Representative Norman Rokeberg, Chairman
Representative Andrew Halcro, Vice Chairman
Representative Lisa Murkowski
Representative John Harris
Representative Tom Brice
Representative Sharon Cissna
Representative Jerry Sanders
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 177(L&C)
"An Act relating to insurance trade practices; and providing for
an effective date."
- MOVED HCS CSSB 177(L&C) OUT OF COMMITTEE
CS FOR SENATE BILL NO. 34(FIN)
"An Act relating to tattooing, body piercing, and ear piercing;
relating to other occupations regulated by the Board of Barbers
and Hairdressers; relating to fees charged by the Board of
Barbers and Hairdressers; and providing for an effective date."
- MOVED HCS CSSB 34(L&C) OUT OF COMMITTEE
HOUSE BILL NO. 121
"An Act relating to patients' rights under a health care
insurance plan or contract providing coverage for dental care,
and prohibiting certain practices by health care insurers
relating to dental care."
- MOVED CSHB 121(L&C) OUT OF COMMITTEE
CS FOR SENATE BILL NO. 297(L&C) am
"An Act relating to the licensing of chiropractors and to
disciplinary actions against chiropractors."
- MOVED CSSB 297(L&C) am OUT OF COMMITTEE
PREVIOUS ACTION
BILL: SB 177
SHORT TITLE: INSURANCE TRADE PRACTICES & ACTS
Jrn-Date Jrn-Page Action
5/16/99 1517 (S) READ THE FIRST TIME - REFERRAL(S)
5/16/99 1517 (S) L&C
1/18/00 (S) L&C AT 1:30 PM BELTZ 211
1/18/00 (S) Heard & Held
1/18/00 (S) MINUTE(L&C)
2/29/00 (S) L&C AT 1:30 PM BELTZ 211
2/29/00 (S) Moved CS(L&C) Out of Committee
2/29/00 (S) MINUTE(L&C)
3/01/00 (S) RLS AT 11:30 AM FAHRENKAMP 203
3/01/00 (S) MINUTE(RLS)
3/01/00 2476 (S) L&C RPT CS 1DP 3NR 1AM SAME TITLE
3/01/00 2476 (S) NR: MACKIE, TIM KELLY, HOFFMAN;
3/01/00 2476 (S) DP: DONLEY; AM: LEMAN
3/01/00 2476 (S) ZERO FISCAL NOTE (DCED)
3/22/00 2692 (S) RLS TO CALENDAR AND 1 AM 03/22/00
3/22/00 2693 (S) READ THE SECOND TIME
3/22/00 2693 (S) L&C CS ADOPTED UNAN CONSENT
3/22/00 2693 (S) ADVANCED TO THIRD READING UNAN
CONSENT
3/22/00 2693 (S) READ THE THIRD TIME CSSB 177(L&C)
3/22/00 2693 (S) PASSED Y19 N1
3/22/00 2694 (S) EFFECTIVE DATE(S) SAME AS PASSAGE
3/22/00 2697 (S) TRANSMITTED TO (H)
3/23/00 2661 (H) READ THE FIRST TIME - REFERRALS
3/23/00 2662 (H) L&C, JUD, FIN
4/10/00 (H) L&C AT 3:15 PM CAPITOL 17
4/10/00 (H) Heard & Held
4/10/00 (H) MINUTE(L&C)
4/12/00 (H) L&C AT 3:15 PM CAPITOL 17
BILL: SB 34
SHORT TITLE: BD OF BARBERS ETC/TATOOS; BODY PIERCING
Jrn-Date Jrn-Page Action
1/21/99 49 (S) READ THE FIRST TIME - REFERRAL(S)
1/21/99 49 (S) L&C, FIN
4/22/99 (S) L&C AT 1:30 PM BELTZ 211
4/22/99 (S) MOVED CS(L&C) OUT OF COMMITTEE
4/22/99 (S) MINUTE(L&C)
4/23/99 1061 (S) L&C RPT CS 3DP 1NR NEW TITLE
4/23/99 1061 (S) DP: MACKIE, HOFFMAN, LEMAN; NR:
DONLEY
4/23/99 1061 (S) ZERO FISCAL NOTE (DEC)
3/21/00 (S) FIN AT 9:00 AM SENATE FINANCE 532
3/21/00 (S) Heard & Held
3/31/00 (S) FIN AT 9:00 AM SENATE FINANCE 532
3/31/00 (S) Moved CS(Fin) Out of Committee
3/31/00 (S) RLS AT 12:00 PM FAHRENKAMP 203
3/31/00 (S) MINUTE(RLS)
3/31/00 2812 (S) FIN RPT CS 3DP 1DNP 3NR NEW TITLE
3/31/00 2812 (S) DP: TORGERSON, PHILLIPS, LEMAN;
3/31/00 2812 (S) DNP: GREEN; NR: PARNELL, PETE KELLY,
3/31/00 2812 (S) WILKEN
4/03/00 2838 (S) FISCAL NOTES (DEC, DCED)
4/04/00 2856 (S) RLS TO CALENDAR 04/04/00
4/04/00 2857 (S) READ THE SECOND TIME
4/04/00 2858 (S) FIN CS ADOPTED UNAN CONSENT
4/04/00 2858 (S) ADVANCED TO THIRD READING UNAN
CONSENT
4/04/00 2858 (S) READ THE THIRD TIME CSSB 34(FIN)
4/04/00 2858 (S) PASSED Y15 N4 E1
4/04/00 2859 (S) EFFECTIVE DATE(S) SAME AS PASSAGE
4/04/00 2859 (S) TAYLOR NOTICE OF RECONSIDERATION
4/05/00 2887 (S) RECON TAKEN UP - IN THIRD READING
4/05/00 2888 (S) PASSED ON RECONSIDERATION Y18 N1 A1
4/05/00 2888 (S) EFFECTIVE DATE(S) SAME AS PASSAGE
4/05/00 2888 (S) TRANSMITTED TO (H)
4/06/00 2884 (H) READ THE FIRST TIME - REFERRALS
4/06/00 2885 (H) L&C, FIN
4/12/00 (H) L&C AT 3:15 PM CAPITOL 17
BILL: HB 121
SHORT TITLE: DENTAL CARE INSURANCE
Jrn-Date Jrn-Page Action
3/03/99 341 (H) READ THE FIRST TIME - REFERRAL(S)
3/03/99 342 (H) L&C, FIN
3/19/99 (H) L&C AT 3:15 PM CAPITOL 17
3/19/99 (H) HEARD AND HELD
3/19/99 (H) MINUTE(L&C)
3/24/99 (H) L&C AT 3:15 PM CAPITOL 17
3/24/99 (H) FAILED TO MOVE OUT OF COMMITTEE
3/24/99 (H) MINUTE(L&C)
1/26/00 (H) L&C AT 3:15 PM CAPITOL 17
1/26/00 (H) <Bill Hearing Canceled>
4/12/00 (H) L&C AT 3:15 PM CAPITOL 17
BILL: SB 297
SHORT TITLE: BOARD OF CHIROPRACTIC EXAMINERS
Jrn-Date Jrn-Page Action
3/27/00 2746 (S) READ THE FIRST TIME - REFERRALS
3/27/00 2746 (S) L&C
4/04/00 (S) L&C AT 1:30 PM BELTZ 211
4/04/00 (S) Moved CS(L&C) Out of Committee
4/04/00 (S) MINUTE(L&C)
4/05/00 (S) RLS AT 11:30 AM FAHRENKAMP 203
4/05/00 (S) MINUTE(RLS)
4/05/00 2871 (S) L&C RPT CS 4DP NEW TITLE
4/05/00 2871 (S) DP: MACKIE, TIM KELLY, LEMAN, HOFFMAN
4/05/00 2871 (S) ZERO FISCAL NOTE (DCED)
4/06/00 2904 (S) RLS TO CALENDAR AND 1 OR 04/06/00
4/06/00 2906 (S) READ THE SECOND TIME
4/06/00 2906 (S) L&C CS ADOPTED UNAN CONSENT
4/06/00 2906 (S) AM NO 1 ADOPTED UNAN CONSENT
4/06/00 2906 (S) ADVANCED TO THIRD READING UNAN
CONSENT
4/06/00 2907 (S) READ THE THIRD TIME CSSB 297(L&C) AM
4/06/00 2907 (S) PASSED Y20 N-
4/06/00 2909 (S) TRANSMITTED TO (H)
4/07/00 2909 (H) READ THE FIRST TIME - REFERRALS
4/07/00 2909 (H) L&C
4/12/00 (H) L&C AT 3:15 PM CAPITOL 17
WITNESS REGISTER
SENATOR DAVE DONLEY
Alaska State Legislature
Capitol Building, Room 508
Juneau, Alaska 99801
POSITION STATEMENT: Testified as sponsor of SB 177, Version K.
SENATOR JOHNNY ELLIS
Alaska State Legislature
Capitol Building, Room 9
Juneau, Alaska 99801
POSITION STATEMENT: Testified as sponsor of SB 34, Version V.
JANICE ADAIR, Director
Division of Environmental Health
Department of Environmental Conservation
555 Cordova Street
Anchorage, Alaska 99501
POSITION STATEMENT: Testified on SB 34, Version V.
DAVID LLOYD
Alaska Hepatitis C Coalition
P.O. Box 3372
Anchorage, Alaska 99510
POSITION STATEMENT: Testified on SB 34, Version V.
GAIL MCCANN, Owner/Operator
Electrolysis Clinic
532 Lee Drive
Fairbanks, Alaska 99709
POSITION STATEMENT: Testified on SB 34, Version V.
CATHERINE REARDON, Director
Division of Occupational Licensing
Department of Community and Economic Development
P.O. Box 110806
Juneau, Alaska 99811-0806
POSITION STATEMENT: Answered questions on SB 34, Version V and
testified on CSSB 297(L&C) am.
JANET SEITZ, Staff
to Representative Norman Rokeberg
Alaska State Legislature
Capitol Building, Room 24
Juneau, Alaska 99801
POSITION STATEMENT: Answered questions on SB 34, Version V.
PATRICIA SWENSON, Staff
to Representative Con Bunde
Alaska State Legislature
Capitol Building, Room 501
Juneau, Alaska 99801
POSITION STATEMENT: Presented HB 121 on behalf of sponsor.
SHARON CLARK, Staff
to Senator Mike Miller
Capitol Building, Room 119
Juneau, Alaska 99801
POSITION STATEMENT: Read sponsor statement for CSSB 297(L&C) am.
DR. LOREN MORGAN, President
Alaska Chiropractic Society
541 West Thirty-sixth Street
Anchorage, Alaska 99524
POSITION STATEMENT: Testified on CSSB 297(L&C) am.
MITCH GRAVO, Lobbyist
Alaska Chiropractic Society
170 Botanical Circle
Anchorage, Alaska 99515
POSITION STATEMENT: Testified on CSSB 297(L&C) am.
ACTION NARRATIVE
TAPE 00-47, SIDE A
Number 0001
CHAIRMAN NORMAN ROKEBERG called the House Labor and Commerce
Standing Committee meeting to order at 3:25 p.m. Members present
at the call to order were Representatives Rokeberg, Halcro,
Harris and Brice. Representatives Murkowski, Cissna and Sanders
arrived as the meeting was in progress.
SB 177-INSURANCE TRADE PRACTICES & ACTS
CHAIRMAN ROKEBERG announced the first order of business would be
CS FOR SENATE BILL NO. 177(L&C), "An Act relating to insurance
trade practices; and providing for an effective date."
REPRESENTATIVE HALCRO made a motion to adopt the proposed
committee substitute (CS), Version K [1-LS0902\K, Ford, 4/11/00],
as a work draft. There being no objection, it was so ordered.
Number 0102
SENATOR DAVE DONLEY came forward to testify as the sponsor of SB
177, Version K. He stated that he does support Version K of the
bill. There are two changes in the bill. The first changes the
standard for a third-party claimant. This change occurs on page
3, lines 3 through 6, and reads:
(B) a third-party claimant regarding a claim in
which liability is not at issue to litigate for
recovery of an amount due under an insurance policy by
offering an amount that does not have a reasonable
basis in law and fact [THOSE INSUREDS];
SENATOR DONLEY explained that it is a different standard,
suggested by representatives in the industry, who wanted it to
also apply to a first-party [claimant]. However, he supports its
applying to a third-party claimant, the change made [in Version
K].
He indicated the second change occurs in Section 6, which adds
"or imply" on page 3, line 29. Section 6 now reads:
(b) The provisions of this section do not create or
imply a private cause of action for a violation of this
section.
SENATOR DONLEY commented, "We all agree that we're not trying to
create a private cause of action by any of these changes."
CHAIRMAN ROKEBERG pointed out that SB 177, Version K, has two
further committees of referral, and he would like to move the
bill out of committee.
Number 0290
REPRESENTATIVE BRICE made a motion to move the proposed House CS
for SB 177, Version K, out of committee with individual
recommendations and the attached fiscal note.
CHAIRMAN ROKEBERG objected for the purpose of discussion. He
said he had asked the commissioner of the Department of Community
and Economic Development to draft some language regarding
"sideboards on the single-act investigation." Due to the limited
time, he indicated he would take the issue up in the House
Judiciary Standing Committee. He withdrew his objection.
REPRESENTATIVE HALCRO also objected for the purpose of
discussion. He said:
I know the hour is late, and the days in the session
are late, but, ... like I said yesterday on the floor,
I've got a real hard time when we put these things in
the laundry chute and let them go, and we don't have
time to digest before they move out of committee.
And it's becoming increasingly on a regular basis that
we do that in this committee, and I just have some real
hard times with that. I'd like to spend some more time
on this bill.
CHAIRMAN ROKEBERG restated that the bill has two more committees
of referral.
REPRESENTATIVE HALCRO said he understands, but he does not sit on
either of those two committees. He withdrew his objection.
[There being no further objection, HCS CSSB 177(L&C) moved from
the House Labor and Commerce Standing Committee.]
CHAIRMAN ROKEBERG called an at-ease at 3:34 p.m. He called the
meeting back to order at 3:37 p.m.
SB 34-BD OF BARBERS ETC/TATOOS; BODY PIERCING
CHAIRMAN ROKEBERG announced the next order of business would be
CS FOR SENATE BILL NO. 34(FIN), "An Act relating to tattooing,
body piercing, and ear piercing; relating to other occupations
regulated by the Board of Barbers and Hairdressers; relating to
fees charged by the Board of Barbers and Hairdressers; and
providing for an effective date."
Number 0453
SENATOR JOHNNY ELLIS came forward to testify as the sponsor of
CSSB 34(FIN). He said he would make some brief introductory
remarks and then cover the highlights of the new proposed
committee substitute (CS).
REPRESENTATIVE HALCRO made a motion to adopt the proposed CS for
SB 34, Version V [1-LS0279\V, Lauterbach, 4/12/00]. There being
no objection, SB 34, Version V, was adopted.
SENATOR ELLIS explained:
A constituent of mine came to me. She's a mother of
two then-15-year-old girls, and she was horrified to
learn that her daughters had received body piercings in
what were described to me as very unprofessional and
unsanitary conditions. Some serious infections ensued.
It was a crisis within this family and, needless to
say, the parents were outraged.
I was disturbed and frustrated to find that there was
really no recourse. We're one of the last states in
the Union to have any health and safety standards or
licensure procedure in place for this growing industry
of body art; body piercing and tattooing. We have, in
the work here, taken into account the health and safety
issues, the transmission of HIV [Human Immunodeficiency
Virus], hepatitis, syphilis, other infections that
should be of concern to us all.
We've taken our guidance in regulating the body arts
from the National Environmental Health Association's
Body Art Model Code and Guidelines. So, we've taken
the best from other states and from this national
organization to avoid some of the mistakes that have
been made elsewhere. We're adopting the standard
procedure for licensure and regulation here.
We handle that in our state for the professions and
vocations through the Division of Occupational
Licensing to license practitioners and shop owners to
ensure that they have the knowledge and good practice
of sanitation, aseptic techniques, sterilization and
aftercare procedures to prevent transmission of disease
or other injury to the consumer.
We're also using the standard practice of having the
Division of Environmental Health regulate the proper
sterilization of equipment and inspection of the
licensed facilities. And, again, Alaska is one of the
last states to address this important public health
issue. In fact, there are some good operators in our
state and there are some bad operators, and we're
interested in making sure that the public health is
protected.
Number 0654
Now, for a quick summary of the changes. ... I'm
skipping around a bit, but there are some requests from
the Division of Occupational Licensing that are of a
technical nature and housekeeping nature that can be
explained by the division director.
There are also changes here in the committee substitute
[Version V] that were requested by the industry. I'll
mention one specific example. There's a woman in
Fairbanks who heard about this bill. She practices
what we're calling permanent coloring. Some people
have referred to that as cosmetic tattooing. It's a
growing thing in our country. There's one person we
know of in Alaska that practices this, and without this
committee substitute, she would be operating outside of
the law. So, permanent coloring referenced here in the
CS relates to the experience in Oregon, their statutes
that have been received very well for the license of
permanent coloring as part of body arts.
There also were some other industry requests from the
legitimate operators in terms of training and
apprenticeships. That's a complicated issue; how long
people should apprentice for body piercing and
tattooing and we're leaving that up to the board to
decide the correct number of hours for those different
situations. The industry also wants to be able to hold
conventions, or get-togethers, where they talk to each
other about the best practices in terms of sanitation
and other considerations, and we wanted to make sure
that they, the folks who get together for the
conventions, are licensed and that the premises are
sanitary for these get togethers of folks in the
industry.
There was also an industry request to modify the
definition of tattoo, and we've taken the standard
definition there, as well. So, with that, Mr.
Chairman, I do have a staff member with me who's an
expert in these details and, again, Catherine Reardon
is here from the Division of Occupational Licensing,
and I know there's a representative from DEC
[Department of Environmental Conservation].
Number 0789
REPRESENTATIVE MURKOWSKI asked what the difference is between
tattooing and permanent coloring. She wondered, "They're both
through injection or through a needle, aren't they?"
SENATOR ELLIS responded that they are. The cosmetic tattooing is
being referred to as permanent coloring, but it is the same
procedure as tattooing. Permanent coloring entails permanent eye
lining, eyebrows, blush, etcetera.
REPRESENTATIVE HALCRO wondered:
Senator Ellis, going through the Senate committee
meeting minutes, there was a question about creating an
"under 18, you had to get permission." Was there any
further discussion on that?
SENATOR ELLIS indicated there were some folks concerned, and a
number of suggestions were incorporated into the final Senate
version of the bill. One of those concerns dealt with parental
permission to do body piercing and tattooing. The national
industry standard was adopted, which states that no one under the
age of 18 can be tattooed because it is a permanent procedure.
He explained:
It's a permanent situation, and the standard industry
practice says no one under 18 is tattooed by legitimate
operators in our state today. The illegitimate
operators do tattoo people under 18, and that's what
led to the outraged parents.
SENATOR ELLIS said body piercing is a serious procedure, as well,
but it is not permanent. People under the age of 18 can be body-
pierced with the permission of their parents. People between the
ages of 15 and 18 can, in the presence of a parent or legal
guardian, receive a body piercing. Under the age of 15, body
piercing is not allowed. Currently, the largest tattoo artist in
Anchorage, Larry's Tattoo, tattoos over 10,000 people a year.
The owner of Larry's Tattoo has his employees licensed in Hawaii
because he is committed to high industry standards and public
safety.
Number 0988
REPRESENTATIVE MURKOWSKI asked, "When I was younger, we would go
over to somebody's house and take a raw potato and a needle and
pierce your girlfriend's ear. What does that do to those slumber
parties?"
SENATOR ELLIS said that is an excellent question. People are
being allowed to continue to do the ear piercings. Piercing of
the lobe and outer cartilage of the ear continues to be legal.
He added:
The choice that we've made here in this legislation is
that there are a limited number of people who do body
piercing in Alaska, but there's literally thousands of
retail stores and jewelry stores that do the ear
piercing when you buy jewelry at their retail outlet
across the state. ... Those piercings are usually done
with the guns.
We are giving DEC the authority, on a complaint-driven
basis, to inspect those premises to make sure that the
piercing guns are sanitized to a certain level of
public health standards. But if people want to their
own tattooing [piercing] on their ears, that remains
legal. It's sometimes called "hacking and scratching"
when people do this to themselves and it's not for
profit. That will continue to be a legal practice in
Alaska.
But with the guns, we're not saying that the folks who
operate the guns in the retail have to go through the
apprenticeship process and be licensed. The gun has to
be sanitized, and DEC can inspect them to see that
they're clean, if there are any complaints that arise.
REPRESENTATIVE MURKOWSKI wondered if there is any penalty if the
guns are not clean.
SENATOR ELLIS responded that DEC will develop regulations under
this legislation in order to cover those health standards.
CHAIRMAN ROKEBERG said:
A number of us were attending an Anchorage caucus a
month or so ago in Anchorage. There was a witness that
brought this subject up to the Anchorage caucus because
he was a sufferer of hepatitis C. He indicated that he
had contracted the disease from tattooing. It really
hit ... home because I have a brother-in-law that's
basically dying of hepatitis C and the treatment is not
working. ... Do you have any comments on that?
SENATOR ELLIS replied that it is a very serious concern, which is
why the Alaska Hepatitis C coalition is in support of this bill
[letter included in bill packet]. Hepatitis is one of the
biggest concerns. There are no reported cases of HIV
transmission in Alaska. He commented, "The good operators are
very quick to point that out. So, I want to protect their
reputation." He indicated this bill will go a long way to rein
in bad operators.
Number 1218
JANICE ADAIR, Director, Division of Environmental Health,
Department of Environmental Conservation, testified via
teleconference from Anchorage. She said she was available to
respond to questions.
CHAIRMAN ROKEBERG asked what the fiscal impact of the bill is on
the Division of Environmental Health.
MS. ADAIR replied that there would be some additional burden.
She said:
The fiscal impacts will be paid by ... the tattoo
artists and the body piercers. So, our fiscal note
will reflect interagency receipts. I neglected to
include, in the last fiscal note I did, some minor
costs for ear piercers. The cost there is going to be
associated with public notice and just getting
information out to what we expect to be hundreds of
facilities that pierce ears, and the regulations will
not be complicated. ...
Representative Murkowski, I had my ears pierced exactly
that same way, with a potato and a needle. It won't be
complicated regulations, but we do need to really make
an effort to make sure those people who are regulated
understand what the proposal will be.
REPRESENTATIVE SANDERS wondered what the connection is between
this bill and the environment.
MS. ADAIR explained that DEC deals with issues related to
environmental health as well as the resource environment. The
department deals with bacteria and the kinds of things in the
environment that can affect public health.
Number 1343
DAVID LLOYD, Alaska Hepatitis C Coalition, testified via
teleconference from Anchorage. He stated:
I'm here today on behalf of the Alaska Hepatitis C
Coalition. We are a grassroots organization [composed]
of people infected with the hepatitis C virus, family
members and the professionals who care for us.
Hepatitis C is a disease that is at epidemic
proportions in the U.S. There is no cure and no
vaccine. It is conservatively estimated that one in 55
people [has] it. That translates to 11,000 Alaskans.
We are not against tattoos but support a public health
standard that would decrease the liklihood that years
from now there'll be an outcry to demand why we knew of
this disease yet did nothing to prevent its spread.
The National Centers for Disease Control have
established the correlation between tattoos and body
piercing with hepatitis cases, and we are being
presented with the means to bring Alaska alongside the
other states that have enacted sets of controls to
protect their citizens in the manner proposed by SB 34.
For instance, North Carolina's legislation stipulates a
method of infection control in which all human blood
and bodily fluids are treated as if they were known to
be contaminated with HIV and other infections that can
be transmitted by blood.
Because the disease may often have no symptoms for the
first decade or two, many of the people infected have
no idea they carry the virus. It is currently the
leading indication for liver transplantation in the
United States, and each year 8,000 to 11,000 people die
from HCV [hepatitis C virus] related disease.
Unfortunately, it is estimated that the number of
deaths will triple over the next two decades as large
reservoirs of infected people become sicker.
As treatment outcomes improve, however, experts predict
that we have window of opportunity to turn those grim
statistics around. Some of the doctors I've spoken
with about this tell me the durability and the ease of
transmission of this virus make HIV look like a weak
sister by comparison. Its means of transmission cross
into every demographic segment of the population. Some
of these includes sports and body building through the
use of injectable steroids, internasal cocaine use,
tattoos, body piercing and transfusions - until 1989,
the nation's blood supply wasn't even tested for it -
as well as IV [intravenous] drug use. So, obviously,
this bill will not halt the spread of hepatitis C in
Alaska, but it is a start.
And as a person who was infected with the virus at an
Anchorage tattoo [parlor] in 1979 - which I assumed to
be safe because of the license on the wall - I would
like to applaud Representative Croft and Senator Ellis
for their concern with the health and safety of
Alaskans.
Number 1523
GAIL MCCANN, Owner/Operator, Electrolysis Clinic, testified via
teleconference from Fairbanks. She has been in business for the
past 18 years. Since 1991, she has been practicing another form
of tattooing called permanent cosmetics. It is essentially
tattooing the skin. However, it has a totally different outcome
and goal. She said:
What I do with permanent cosmetics, there are what we
call glamour applications, which have to do with
enhancing the eyebrows, eye liner, lip liner, full lip
color, blush. Then there's another aspect of this that
deals with reconstruction of facial features for, say
burn survivors and people that are afflicted with
facial abnormalities and disfigurements.
So, I didn't know about this bill until just recently
and sometimes feel a little unprepared for what's going
on here, so please bear with me. I do want you to
know, however, that as a professional, I had to go out
of state to come back with the pertinent and accepted
credentials that the industry has to recognize, except
we are not offering them to people like me in Alaska.
So, we do have to seek outside education and testing
to show that we are competent in our field. (Indisc.)
plan was to go to Oregon and sit for the state boards
so that, again, I could show that I am a qualified and
competent professional in the application of my skills
and knowledge for permanent cosmetics.
I am glad to see that SB 34 is out there on the floor.
It does need to be massaged and brought up to standard
so that not only is it a bill that would protect the
public, but will also guarantee that we are giving them
competent applications of color to their skin, in
whatever realm we're doing it.
So, I am in total support of SB 34. I would like to
see that only qualified professionals practice any of
these devices, the figurative tattooing, which is what
you would know as traditional tattooing, or cosmetic
tattooing, which is what I primarily do, which
technically includes, as I said, the glamour
applications, repigmentation and camouflaging.
Another one of the applications for what I do is to
work with women who have had mastectomies who are not
only having had a radical mastectomy but, in
reconstruction, they no longer have a nipple. So, they
would come to see someone like myself, and I would,
through implantation of pigment, help to normalize the
appearance of this individual.
So, there are many applications that maybe you haven't
thought about or just weren't aware of. And I hope
that I've enlightened you to the point that it is
something that, there definitely is an image situation
here that needs to be dealt with. Through
enlightenment and education and information, we can let
people know what they should be looking for in
qualified professionals, and what they should looking
for, in order to not go to individuals that don't fall
in that realm. I hope to be involved all the way to
the end with this bill, and certainly would like to
leave myself open for any questions that you might
have.
CHAIRMAN ROKEBERG asked if Ms. McCann is aware of anyone else in
Alaska who performs permanent coloring.
Number 1710
MS. MCCANN answered that there are other people. It is a
profession that is growing. She said it seems to her that
electrologists, like herself, are naturally transitioning into
this area and adding it to their repertoire of services. There
are other people in Alaska that are practicing what she calls
permanent cosmetic tattooing or cosmetic tattooing. She would
like to see this term changed in the bill. She explained:
There's a difference between the outcome in traditional
or figurative tattooing versus what I do, which is, by
our industry standards, called permanent cosmetics or
cosmetic tattooing, not cosmetic coloring. I'd like to
just see that wording changed from "cosmetic coloring"
to either "permanent cosmetics" or "cosmetic
tattooing."
SENATOR ELLIS clarified:
I appreciate the input, and I know my staff has been
working with this practitioner to come up with some
good language. We chose to take what Oregon had
adopted in their statutes, the permanent coloring,
because there are a number of things here that it could
be: permanent cosmetics, permanent makeup, interdermal
pigmentation, or micropigmentation. We thought that
"permanent coloring" was the more expansive, inclusive
term that covered those things that this practitioner
may do or that some of the other practitioners may do.
We wanted it to be a flexible, all-encompassing
definition and not one so specific that it wouldn't
incorporate other folks as body arts move on through
time here.
CHAIRMAN ROKEBERG asked whether there was consideration of using
"permanent cosmetic coloring."
SENATOR ELLIS said that is not the specific thing he considered.
CHAIRMAN ROKEBERG asked Ms. McCann if using the term "permanent
cosmetic coloring" would make her happier.
MS. MCCANN responded:
We could be a little more definitive, I think. ... From
the state of Kansas they have a very succinct and, I
think, clear definition of what figurative tattooing is
versus cosmetic tattooing. Cosmetic tattooing is to
include eyeliner, eyebrows, lipliners, full lip color,
repigmentation or camouflage. So, that encompasses it,
I think, very well, rather than just "tattooing
coloring," as it is in SB 34, simply because my
industry has been in existence for probably close to 15
to 20 years, and our industry standards were describing
... having it recognizable, ... to go with either
"permanent cosmetics" or "cosmetic tattooing." Even in
the phone books there are categories under the
definitions that I just mentioned. I think, for
clarity's sake and for continuity throughout my
profession, that would be more understandable and
acceptable.
CHAIRMAN ROKEBERG said, "I noticed, Senator, you have a license
for permanent coloring and a license for tattooing, but you've
got a joint definition. Is it one license?"
SENATOR ELLIS answered that it is one license. There are two
separate licenses for body piercing and tattooing.
CHAIRMAN ROKEBERG asked Ms. McCann if she does figurative
tattooing.
MS. MCCANN replied yes. She said there is a difference and
explained:
If you wanted to transfer over and start to do what
they call cosmetic tattooing, if you have not gotten
the proper information about the anatomy of the eye, et
cetera, it could be a problem. So, cosmetic tattooing
takes your traditional tattooing techniques into a
different realm, because there's just a little more
information and education that you would need to know
to be able to do cosmetic tattooing - although the
application of the skills and knowledge is pretty much
the same, when it comes to the practical aspect of the
profession, both of them.
In other words, we're not using guns, ... we're using
machines. I'm using the same tattooing or implanter
that somebody who's doing figurative tattooing is
using. ... There are a couple of avenues that can be
explored here when it comes to the equipment that we
use. Basically, we're all doing the same thing by
inserting pigment into the dermal layer of the tissue
in the attempt to leave some permanent color there.
CHAIRMAN ROKEBERG wondered if Ms. McCann's testimony is that a
person has to have more skill to be a permanent cosmetic or a
cosmetic tattooing artist. He also wondered if the word "artist"
is correct.
MS. MCCANN stated that a person who practices permanent cosmetics
is usually called a technician or practitioner. She said there
is certainly artistry involved. She commented:
As far as our skills, we require the same skills;
however, you require a little more education and
knowledge when you're going into the eye areas, because
you haven't learned about the anatomy in your regular
figurative or traditional tattooing. In that respect,
it just requires a little more knowledge, which can be
easily attainable.
SENATOR ELLIS wondered what the suggestion is for the term of art
to be used.
CHAIRMAN ROKEBERG answered that Ms. McCann's suggestion is to use
"permanent cosmetics" or "cosmetic tattooing". He indicated that
he earlier asked rhetorically about "permanent cosmetic
coloring". There are three terms to choose from. He said he was
a little confused by the definition of "tattooing and permanent
coloring" on page 12, lines 26 through 29. He did not think a
distinction had been made between the two definitions.
Number 2052
SENATOR ELLIS explained that there is no difference in the bill
between the licensing requirements because they are similar
activities with the same health ramifications. He said:
There would be an argument here if we brought everybody
in about who has more training in certain skills and
the apprenticeship requirement and on and on. That's
not really an argument that's very productive.
SENATOR ELLIS specified that his suggestion would be to consider
adding "figurative and cosmetic" before "tattooing" on page 14,
line 25, of the proposed CS. He wondered if he could have a
moment to discuss this with his staff.
CHAIRMAN ROKEBERG suggested having Catherine Reardon come forward
and testify first.
Number 2111
CATHERINE REARDON, Director, Division of Occupational Licensing,
Department of Community and Economic Development, came forward to
answer questions on SB 34, Version V. She indicated the sponsor
of the bill has been working with her to make all the necessary,
conforming changes.
CHAIRMAN ROKEBERG asked what the barbers and hairdressers think
about this.
MS. REARDON explained that the Board of Barbers and Hairdressers,
which would be overseeing this program, voted last year to
support the concept. The bill puts one member of the tattooing
and body piercing professions on the board. This will assist the
board in making good quality regulations.
CHAIRMAN ROKEBERG referred to page 2, subsection 2, which states:
the department shall establish fee levels under (a) of
this section so that the total amount of fees collected
by the Board of Barbers and Hairdressers approximately
equals the total regulatory costs of the department,
the board, and the Department of Environmental
Conservation for all occupations regulated by the
board.
CHAIRMAN ROKEBERG said it seems that a whole new area of
regulatory responsibility of DEC has been added, but that the
board ends up paying for it.
Number 2180
MS. REARDON said she does not think of it as such a large thing.
She expects a $5,400 fiscal note from DEC, which would ask the
Division of Occupational Licensing to "interagency receipt" that
money over, every year. The purpose of that money would be to
fund DEC's basic adoption of regulations governing these
professions.
CHAIRMAN ROKEBERG asked, "How many of these people do you think
there are in this state?"
MS. REARDON surmised that there are 10 to 25 establishments. She
stated:
It's mostly the regulation adoption process - you know,
public noticing, advertising, all that kind of thing -
I think that DEC's most concerned about. And there is
precedent for this. For example, we "interagency
receipt" construction contractor funds to the
Department of Labor for their enforcement activities
regarding those professions and electrical mechanical
administrators.
So, personally, I think it works well for DEC to have
the responsibilities to adopt the regulations and this
is a way of allowing it to happen and still have the
costs go where they ought to go which is to the
professions involved. This part of DEC is the part
that does restaurant inspections, other kinds of health
inspections.
CHAIRMAN ROKEBERG said that is what he is worried about. He
commented:
We see these bills all the time here in this committee,
and we've got another whole entire department here
where we're taking funds to be collected from the
licensees and shipping them over to another department
into their health inspector area or whatever. I'm not
sure I'm warming up to this idea here.
MS. REARDON clarified that she would be concerned if she felt
that there were going to be a "blank check and ... there'd be no
limit on what I might have to take out of my budget and be
sending to my neighboring department."
CHAIRMAN ROKEBERG interjected, "It's not coming out of your
budget. It's coming out the fees of these people."
MS. REARDON explained that she meant out of her expenditure
authority. She said:
When I send fees to another agency, it does count
against what I'm spending. So, I feel comfortable
because what's in the fiscal note is that they can
receive $5,400. They can't suddenly bill me for
$20,000. ... I'm sure that if there were any concern
about how the money was being used -- I get audited on
my fee-setting with some frequency. And so, people
could look and see that, yes, indeed, the costs that I
was getting billed and transferring the money for were
related to adoption of the regulations for body
piercing, tattooing and, probably, ear piercing.
Number 2316
CHAIRMAN ROKEBERG pointed out that the present committee has to
look at licensure costs. He asked again how many people were
used to calculate the licensure fee.
MS. REARDON responded that she is expecting 10 to 25 people. She
referred to page 2, Section 2, and indicated this is almost
identical language to that in the architects, engineers and Land
Surveyors statute right now. This language says that revenue
from the entire board area must cover regulatory costs of the
entire board area rather than its being occupation-by-occupation.
CHAIRMAN ROKEBERG asked, "Why do the body piercers that are
regulated have to pay for the regulation of the unregulated body
piercers?"
MS. REARDON said Ms. Adair could respond to that question. She
said she understood the $5,400 was primarily for the adoption of
the regulations.
SENATOR ELLIS interjected:
The retail locations that have the guns, that's a
complaint-drive system. DEC, ... they'll do an annual
inspection of the body piercing and tattoo shops, but
they won't go out to every retail operation and inspect
those annually, just if a parent complains about [that]
they didn't a disinfectant of the gun before or after
the procedure, they could complain to DEC. And DEC
would have the authority to check it out and make sure
they're cleaning their equipment. So, that was the
balance we tried to make between the licensed shops and
the places using the guns to pierce ears.
CHAIRMAN ROKEBERG referred to the fiscal note from DEC for
$3,100.
MS. REARDON said she believes there will probably be a new fiscal
note for $5,400 if Version V passes out of the committee.
CHAIRMAN ROKEBERG stated that he has a concern about having the
licensees pay for "stuff that's not in their area". He wondered
if he is mistaken.
SENATOR ELLIS said that argument can be made, but added:
I would make the argument that the public health
concerns here are great - and I know we share those -
that the relative amount of money is tiny and that the
good operators, the legitimate folks in the industry
that have come to us asking for -- it's not very often
that you get industries coming forward and [saying],
"We want to be licensed and regulated because there's
some bad operators out there." I think the good
operators feel like they are tarnished by the bad guys
that are infecting people, and it gives a taint and a
negative impression to the public of tattooing and body
piercing.
CHAIRMAN ROKEBERG commented that the first fiscal note is for
$2,000 and states that there will be annual inspections of the
tattooing establishments.
[Senator Ellis's response was not on tape because of the tape
change.]
TAPE 00-47, SIDE B
Number 0005
MS. REARDON stated, "If you're particularly concerned about the
ear piercing portion ...."
CHAIRMAN ROKEBERG interjected and said he is trying to look after
licensees. He does not think they should be paying for any more
than what they are already responsible for in their area. He
said, "They shouldn't be paying for the DEC to inspect jewelry
shops that are not under their licensure." He wondered if he is
on the right track.
MS. ADAIR said she had a question for Ms. Reardon regarding
whether or not the fees for adopting the ear piercing regulations
should be shown as interagency receipts or general funds. She
said:
For the same questions that you're asking right now, we
do not intend to inspect ear piercing places. We may
get complaints about them, and we will follow up on
those complaints as we can. It is a low-risk activity.
There is no known epidemiological risks that have been
identified with ear piercing, even though there can be
some blood that occurs when ears are pierced. It's
just a variable-risk operation.
It's not the same as body piercing. It's not the same
as tattooing. This bill does require that we do annual
inspections of body piercers and tattoo shops, and our
fiscal note reflects the costs to do those annual
inspections. I have gone through the Yellow Pages here
in Anchorage and have found about five permanent
cosmetic places listed in the Yellow Pages. So, our
fiscal note will change as a result of that. We will
have to add ... some kind of money for developing
regulations for ear piercing.
Number 0091
SENATOR ELLIS indicated the easy way to address the chairman's
concerns and the $2,000 of extra cost for adopting the
regulations would be to eliminate the requirement that DEC have
regulations for the exclusive ear piercing shops that use the
guns. They would still be on a complaint-driven basis, and DEC
could go in and inspect those facilities for sanitary conditions,
but would not be required to adopt these regulations. He stated:
The way I got into this was the tattoo artists believed
that the guns are not routinely sanitized to their
standards, which is to use an autoclave, which doesn't
exist in most retail stores or jewelry shops, and that
those should be banned. I thought that was a drastic
step that would upset a lot of people and wasn't really
necessary based on the health risk, and that we thought
DEC adopting regulations was the way to go. But we can
address your concern by taking out that requirement of
DEC.
REPRESENTATIVE BRICE asked where that is referenced in the bill.
MS. REARDON pointed out that it appears on page 13, line 22, of
Version V.
SENATOR ELLIS said "ear piercing" would be eliminated on page 13,
line 22. He stated, "This would reduce things by a few thousand
dollars and address the concern of the chairman."
MS. REARDON commented that a conforming amendment should be made
on page 2, line 21, by removing "ear piercing".
Number 0162
CHAIRMAN ROKEBERG asked Ms. Adair if DEC is presently inspecting
barber shops and hairdressers.
MS. ADAIR replied that DEC does have a statutory responsibility
for having regulations for those type of shops. Only complaints
are responded to, and a plan is signed off on, for the initial
occupational license.
SENATOR ELLIS stated:
That's a pretty easy way that I don't think would be a
problem to address your concern. I do know that we at
some point want to go back to Ms. McCann's concern, and
I have a proposal for that, as well.
CHAIRMAN ROKEBERG asked Ms. Reardon what the biennially license
fee would be.
MS. REARDON responded:
It'll be the same biennial license fee for all of these
barbers, hairdressers, all of this. And there'll be
3,000 people we're talking in that area. So, I don't
expect it to make a very substantial difference in the
fee.
CHAIRMAN ROKEBERG asked what the "ramp-up" costs of the
regulations are for the Division of Occupational Licensing.
MS. REARDON wondered if he meant the amount of the fiscal note.
CHAIRMAN ROKEBERG replied yes.
MS. REARDON responded that the division doesn't usually include
the cost of writing regulations in its fiscal notes.
CHAIRMAN ROKEBERG asked, "So, you're just going to basically
charged these people what the barbers and hairdressers are paying
now?"
MS. REARDON answered affirmatively. In further response to
Chairman Rokeberg, she said it is $125 for a two-year license.
There are 3,800 licensees, which is one reason the costs are low.
The amount of $3,000 is being requested to cover the costs of
printing, postage, communications and advertising. The
regulation writing would be "buried in there." The first-year
cost being asked for is $15,100. She said, "It increases as DEC
changes, then mine will be adjusted. So, now, I'd probably be
asking for $18,500."
Number 0281
REPRESENTATIVE MURKOWSKI referred to Section 4, on page 3, line
17. She noted that this section gives the board the authority to
develop oral and written instructions. She wondered what the
benefit is of having oral instruction.
SENATOR ELLIS said he believes this language was taken from other
states. It is pretty standard language in other states and
allows the board to develop the best ways to provide information.
He added, "It's flexible language for it to be an oral or written
instructions. I suppose we could tighten it down, if you so
choose."
REPRESENTATIVE MURKOWSKI responded:
Every time I see the word "oral" instruction or giving
somebody the leeway to not put it down in writing,
there's room for miscommunication, misinterpretation,
on down the road because you didn't have the
requirement that it be put in writing.
MS. REARDON said she believes these instructions are the notices
and instructions that the practitioners need to be posting and
giving to their clients.
Number 0389
MR. LLOYD noted that quite often a person will go 20 years before
the disease manifests any symptoms. There is a longevity factor
of the virus also. He explained:
Outside of the human body, most viruses die almost
immediately, whereas this virus can live for up to five
days. It has a dormant state in dried blood. The
point is, is that the inside of the tattooist guns or
the ear piercing equipment could possibly be infected.
There is some spore testing equipment that's available
through the medical community, and I was wondering if,
perhaps, the health department would be the appropriate
community to address that concern.
CHAIRMAN ROKEBERG said he agrees with Mr. Lloyd's comments. He
stated, "You should leave the regulatory DEC on the ear piercing,
but don't charge the licensees for it. Can you do that? Would
that create another separate GF [general fund] fiscal note?"
SENATOR ELLIS replied yes. He indicated he has been under pretty
clear instructions from majority members to make these things pay
for themselves.
REPRESENTATIVE CISSNA asked if the licensees benefit greatly by
having that oversight because it provides a lot of confidence
from the community.
CHAIRMAN ROKEBERG said no, it is just the opposite. He is
concerned about public health.
Number 0507
REPRESENTATIVE CISSNA wondered, "If you're concerned with the
public health, what is the cost on this again?"
CHAIRMAN ROKEBERG clarified that he is talking about having
licensees paying for DEC to inspect unlicensed premises or
jewelry shops that pierce ears. He does not think it is fair to
ask them to pay for a duty that should be the state's duty. He
pointed out that Senator Ellis is correct that it causes a
dilemma.
Number 0535
SENATOR ELLIS indicated that they got to the point of having the
ear piercing shops in the bill and not going through the premises
and not being licensed, but being under DEC's regulation. It
does cost a little bit of money. He does not mind its being
general fund money since it is only a few thousand dollars, and
he hopes that a few thousand dollars would not kill the whole
bill.
CHAIRMAN ROKEBERG said they could redraft it like that. He
recommended that Senator Ellis bring it up in the House Finance
Committee if he comes up against resistance.
SENATOR ELLIS responded that he would be happy to do that. He
indicated he wanted to revisit Ms. McCann's concern. He referred
to page 14, line 25, and asked whether adding the word "cosmetic"
between the words "permanent coloring" - so that it would read
"permanent cosmetic coloring" - would satisfy her concern.
MS. MCCANN responded that they could just remove the word
"coloring", so that it would read "permanent cosmetics" or it
could just read "cosmetic tattooing." She said for them, it has
to with the industry standard.
SENATOR ELLIS responded:
We're up against a drafter who insists on ... a gerund:
"tattooing and permanent cosmetic coloring". We can't
say "tattooing and permanent cosmetics" in this
sentence, unless we want to have that. So, Ms. McCann
is putting forward her opinion. I'm trying to
accommodate the drafter and Ms. McCann in the way this
should be stated. Otherwise, it'll be the subject of a
Revisor's bill next year, and I think we should avoid
that if possible.
CHAIRMAN ROKEBERG clarified for Ms. McCann that the legislature
has a drafting manual on how to use the English language to put
laws together. They have to put an "ing" on the end of it.
MS. MCCANN stated that it would satisfy her to see the bill get
passed, so for the sake of time and expediency she is willing to
make that concession.
SENATOR ELLIS reiterated that the suggestion before the committee
is to change the wording to "tattooing and permanent cosmetic
coloring" throughout the bill. He said he appreciates Ms.
McCann's input, but it is hard to balance all of the issues.
REPRESENTATIVE BRICE made a motion to adopt the conceptual
Amendment 1, to place "permanent cosmetic coloring" throughout
the bill where "permanent coloring" currently exists. There
being no objection, conceptual Amendment 1 was adopted.
SENATOR ELLIS indicated there should be a conceptual amendment
with regard to the fees.
CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 2:
"the fees for that are not paid for by the licensees' general
fund obligation for the DEC inspection of the non-licensed ear
piercing establishments."
REPRESENTATIVE BRICE asked about authority for inspection fees
for DEC.
CHAIRMAN ROKEBERG pointed out that they already have it.
JANET SEITZ, Staff to Representative Norman Rokeberg, Alaska
State Legislature, restated conceptual Amendment 2: "inspections
of the non-licensed ear piercing establishments will be paid by
the general fund."
CHAIRMAN ROKEBERG asked if there were any objections. There
being none, conceptual Amendment 2 was adopted.
CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 3,
to delete "oral and" from line 17, page 3. There being no
objection, conceptual Amendment 3 was adopted.
Number 0801
MS. REARDON indicated that as part of Amendment 3, a conforming
amendment would be needed on page 11, line 9.
CHAIRMAN ROKEBERG made a motion to amend Amendment 3 to also
change the wording on page 11, line 9. There being no objection,
conceptual Amendment 3 [already adopted] was amended.
REPRESENTATIVE BRICE made a motion to move SB 34, Version V [1-
LS0279\V, Lauterbach, 4/12/00], as amended, out of committee with
individual recommendations and accompanying fiscal notes. There
being no objection, HCS CSSB 34(L&C) moved from the House Labor
and Commerce Standing Committee.
HB 121-DENTAL CARE INSURANCE
Number 0880
CHAIRMAN ROKEBERG announced that the next item of business would
be HOUSE BILL NO. 121, "An Act relating to patients' rights under
a health care insurance plan or contract providing coverage for
dental care, and prohibiting certain practices by health care
insurers relating to dental care."
REPRESENTATIVE HALCRO made a motion to adopt the proposed CS for
HB 121, Version K [1-LS0454\K, Ford, 4/12/00] as the working
document before the committee.
REPRESENTATIVE BRICE objected and asked that it be clarified for
the record whether Version K was the same as Version M.
PATRICIA SWENSON, Staff to Representative Con Bunde, Alaska State
Legislature, testified on behalf of Representative Bunde, the
bill's sponsor. She confirmed that Version K and Version M are
exactly alike.
REPRESENTATIVE BRICE withdrew his objection.
CHAIRMAN ROKEBERG declared that Version K was before the
committee.
Number 0919
MS. SWENSON read:
HB 121 sets out the rights of dental health care
consumers. This bill specifically allows consumers to
choose any dentist they wish to see including a
specialist, prohibits insurers from reimbursing a
covered person at a different rate because of the
person's choice of dentist, gives covered people the
right to receive full information regarding their care
options without fearing adverse actions from insurance
companies, and allows patients to take civil action
against health care insurers to enforce their rights,
and requires any dental treatment plan review or
utilization review to be conducted by a dentist.
MS. SWENSON said that is what the bill did last year, and that
there has been some language change this year. She asked if
there was previous committee action that needed to be rescinded.
CHAIRMAN ROKEBERG said the committee had adopted a [proposed] CS,
and asked her to proceed with reviewing the changes.
Number 1010
MS. SWENSON said this bill seems to satisfy the objections of the
labor unions and "everybody else involved last year." The
changes were brought to Representative Bunde. She had been told
that everybody has agreed to the changes and signed them.
MS. SWENSON explained that the first change was on page 2, lines
8 through 13. This allows people to choose a dentist outside the
plan and the dentist can be reimbursed at the same rate as a
provider in the preferred provider organization (PPO), but
depending on the plan, the person may have to pay a higher
deductible because the dentist is not in the PPO.
MS. SWENSON said the next change is on page 2, lines 24 through
26. It says a dentist who treats a covered person may not waive
uncovered dental expenses for which the person has liability
because a covered person chooses a dentist outside the network or
preferred provider organization. The other changes, she said,
are in the definitions section.
CHAIRMAN ROKEBERG observed that this is similar to another bill.
MS. SWENSON concurred.
CHAIRMAN ROKEBERG explained that this is basically a point-of-
service provision that allows for a slight adjustment in the
copayment.
Number 1170
REPRESENTATIVE HALCRO moved to rescind the committee's failure to
move HB 121 out of committee. There being no objection, it was
so ordered.
REPRESENTATIVE HALCRO again moved to adopt HB 121, Version K, as
the working document before the committee. There being no
objection, it was so ordered.
REPRESENTATIVE HALCRO made a motion to move the CS for HB 121 out
of committee with individual recommendations and the accompanying
(updated) fiscal notes. There being no objection, CSHB 121(L&C)
moved out of the House Labor and Commerce Standing Committee.
SB 297-BOARD OF CHIROPRACTIC EXAMINERS
Number 1229
CHAIRMAN ROKEBERG announced that the next item of business would
be CS FOR SENATE BILL NO. 297(L&C) am, "An Act relating to the
licensing of chiropractors and to disciplinary actions against
chiropractors." [The bill was sponsored by the Senate Health,
Education and Social Services Committee, chaired by Senator Mike
Miller.]
Number 1252
SHARON CLARK, Staff to Senator Mike Miller, Alaska State
Legislature, specified that the committee was working from CSSB
297 (L&C) am. She explained that this bill, requested by the
Board of Chiropractic Examiners, amends the licensing statute for
Alaska chiropractors. She read from the sponsor statement:
Section 1 allows for a temporary permit to practice
chiropractic in Alaska. The temporary license
initially is for 60 days and may be extended by the
Board of Chiropractic Examiners. It is subject to the
same terms and conditions of a regular license. This
section also provides for a licensee who does not
practice in the state to hold an inactive license. The
section finally provides for a retired licensee. A
person holding a retired license may not practice
chiropractic in the state. A person holding a retired
license may apply for an active license subject to
terms and conditions set by the board.
Section 2 provides for new reasons why the Board of
Chiropractic Examiners may refuse to issue a license in
the state. These include conviction of a felony or
other crimes that would affect the person's ability to
practice competently and safely. Conviction of crime
involving the unlawful procurement, sale, prescription,
or dispensing of drugs, and attempting to practice
after becoming unfit due to an infectious or contagious
disease.
Your consideration of this bill is appreciated.
Number 1336
MS. CLARK explained that CSSB 297(FIN) am had been passed
unanimously by the Senate. One amendment was adopted before the
bill was passed. A concern had come up in committee about the
word "physiotherapy." Senator Ellis had offered an amendment:
On page 2, line 22, after the word "board," delete "physiotherapy
examination" and insert "physiological therapeutic examination;
and on page 2, line 23, after the word "examiners," insert
"required by the board." That amendment was adopted, and the
amended bill was passed by the Senate.
MS. CLARK mentioned that someone had asked what "locum tenens"
means. According to Black's Law Dictionary, it means "holding
the place of deputy; a substitute, a lieutenant or a
representative." Webster's Dictionary defines it as "one holding
a place; a person, a physician or a member of the clergy who
substitutes for another."
CHAIRMAN ROKEBERG asked the intent behind having a retired
license status.
MS. CLARK said she would prefer to have Catherine Reardon from
the Division of Occupational Licensing speak to that.
Number 1500
DR. LOREN MORGAN, President, Alaska Chiropractic Society,
testified by teleconference from Anchorage. He said he supports
the bill, which provides continuity for the profession, locum
tenens, and grounds for suspension. There has been no provision
for temporary licensing or for retired licenses until now.
CHAIRMAN ROKEBERG asked if there has been a need for temporary
chiropractors.
DR. MORGAN explained that a solo practitioner has difficulty
taking care of his patients' needs while he or she is out of
time. Right now, the only alternative is not to provide any
care.
CHAIRMAN ROKEBERG asked, "So you can't take a vacation?"
DR. MORGAN agreed, "Yes, you're kind of stuck."
CHAIRMAN ROKEBERG asked about the retired license.
Number 1583
DR. MORGAN said a retired licensee would be for a person who has
been licensed in the state and who leaves the state but may want
to come back. This lowers the fees while he/she is not here in
active practice, but maintains all of his/her continuing
education and other credits while he/she is away.
Number 1612
REPRESENTATIVE MURKOWSKI asked about the inactive license.
Number 1630
DR. MORGAN said they are almost the same. A retired licensee
would be for someone who is not going to practice but wants to
remain involved in chiropractic activities. It would be a like a
retired person maintaining some type of affiliation with his or
her professional associates.
REPRESENTATIVE MURKOWSKI said she was looking at the language of
the bill, which says that if a person practices at all, even
infrequently, he/she has to have to have an active license. She
asked: If I am only going to practice four times a year, would I
have an active license or a retired license?
DR. MORGAN said she would have an active license.
REPRESENTATIVE MURKOWSKI said she still did not understand why it
is necessary to have an active, an inactive and a retired status.
Number 1710
CATHERINE REARDON, Director, Division of Occupational Licensing,
Department of Community and Economic Development, explained that
the retired license status is basically for someone who does not
intend to return to the profession, but who would like to
continue to get to "call themselves a chiropractor" for emotional
reasons. It acknowledges the professional credential one had
during one's working life. It doesn't do anything other than
that. The person cannot work. The reason for an inactive
license is that one has have to keep up his/her continuing
education because he/she may want to return to active practice.
[The division] wants to ensure that when the person does [return
to active practice], he/she is ready to practice competently.
Number 1805
REPRESENTATIVE MURKOWSKI asked, "We get money from them for a
retired license fee and they don't get to do anything?"
MS. REARDON said that is correct. Some people want to pay to be
a former chiropractor, more or less.
REPRESENTATIVE BRICE, referring to discussion of another bill,
said he thinks it is important, given that [the legislature] can
use the fees coming in for retired licensing to pay for the
inspections of unlicensed body piercers. [Laughter]
Number 1844
MS. REARDON said she thinks the big motivation for the inactive
status is because it is also a lesser price than for an active
license, although it is not the one-time fee for retired status.
The feeling of the board is that people who move elsewhere and do
think they might return to Alaska are more likely to keep paying
even though it is a lesser [license]. This will help the overall
financing.
REPRESENTATIVE MURKOWSKI asked what the retired license fee would
be.
MS. REARDON said she doesn't know; the fee would be set by
regulation. She has no stake in having them be very high. The
fee is not repeated and would not bring in a great deal of
revenue. She indicated she would look for public comment on that
point.
REPRESENTATIVE MURKOWSKI wondered if this is done in other areas.
MS. REARDON replied yes. She explained that physicians also have
retired status.
REPRESENTATIVE MURKOWSKI asked, "Do you give them some kind of a
licensure or an endorsement?"
MS. REARDON responded that they are given a retired license.
REPRESENTATIVE MURKOWSKI stated that she is trying to equate this
to the practice of law: When "you are ready to retire, you stop
paying your bar dues - and that's a good thing - and you still
get to call yourself a retired lawyer."
MS. REARDON answered that for some reason, some people like to
continue to pay and be on the roster.
Number 1977
CHAIRMAN ROKEBERG commented:
I've actually thought about this in the real estate
statute - in expanding that section, repealing a
sabbatical leave-type of a provision. Because of the
licensure - continuing education - there's a lot of
problems around that. Plus, usually a professional,
not only do they pay the great State of Alaska that
licensing fee biennially, they usually belong to a
number of other professional associations and societies
and so forth. And that may be one reason they want to
have a retired status, so they can keep up their
license, to keep up their national affiliation.
REPRESENTATIVE MURKOWSKI referred to Section 2, page 4, lines 16
through 17, relating to the refusal to issue a license due to an
infectious or contagious disease. She said she guessed that this
makes sense, but she was trying to think of infectious diseases
that one would want to "stay away from or that you would deny
somebody a license based on the disease." She wondered what the
thought was behind adding that to the bill.
Number 2131
DR. MORGAN explained this was included to reduce any risk to the
public. It is a public safety issue.
REPRESENTATIVE BRICE and REPRESENTATIVE MURKOWSKI expressed
curiosity regarding how it is defined.
REPRESENTATIVE BRICE commented:
Somebody in the early stages of HIV [Human
Immunodeficiency Virus] infection obviously might not
be ... contagious or a problem or anything else. Are
they unfit at that point in time, or [at] what point in
time do they become unfit?
CHAIRMAN ROKEBERG replied:
The board can impose disciplinary sanctions or refuse
to issue a license, but it doesn't indicate revocation.
There may be quirk in their licensing law. On the
other hand, that's a question I'd direct to Ms.
Reardon. I'm not sure this is legal under the
Americans with Disabilities Act [ADA], depending on
what the infectious disease was.
REPRESENTATIVE BRICE said for a physical disability, that is
already in statute.
MS. REARDON added that it seems to be a subset of physical
disabilities already included in statute. She said it is her
assumption is that the board would have to find that the person
was unfit to perform chiropractic work, not just that the person
had an infectious disease of some type. This is why it would not
violate the ADA. If it did not impact one's ability to practice
as a chiropractor, she thinks it probably would be against the
law. She does not know of any problems encountered that would
have to led to the inclusion of this language in the bill.
Number 2333
REPRESENTATIVE MURKOWSKI said she thinks the language is a "red
flag."
REPRESENTATIVE BRICE asked Ms. Clark, "Where did that come from?
Did that just come from the chiropractors?"
MS. CLARK said that is correct.
MS. REARDON clarified that the language came from the board. It
is her personal belief that elimination of the language would not
create a problem. If there is some physical issue that makes
someone unfit, "we're going to be able to do something about it
under the current statute." She suspects the language came from
the board's desire to be very consumer-protection-oriented. She
does not know of any specifics.
CHAIRMAN ROKEBERG referred to page 4, line 15, which adds
"person's" and removes "licensee's". He pointed out that
"licensee" is referenced throughout the entire bill.
MS. REARDON explained, "It now applies to refusing a license, and
so the person that they want to refuse a license to won't be a
licensee yet."
TAPE 00-48, SIDE A
Number 0016
MITCH GRAVO, Lobbyist, Alaska Chiropractic Society, came forward
to testify on CSSB 297(L&C) am. He said he hadn't talked to the
board members who put this together. However, he thinks it is
probably modeled after the other health care provider legislation
in the state. If the committee changes it, he would suggest
keeping either "infectious" or "contagious" because he does not
think anyone would want a health care provider who had a
contagious disease treating him or her. He believes there is a
difference between being infected and having a disease that is
contagious. A person can be infected without being able to
transfer the infection. But he doesn't believe that anyone would
want to be treated by a health care provider who had a contagious
disease. That would be a public safety issue.
REPRESENTATIVE BRICE said the question is whether infectious or
contagious diseases are a subset of a physical disability.
Number 0114
DR. MORGAN explained that "infectious and contagious" regarding
with the licensee or the individual is if those things affect the
doctor's ability to practice safely, not that he/she has the
disability. It is a hands-on profession.
MR. GRAVO pointed out that a change would require concurrence by
the Senate, an additional step.
REPRESENTATIVE BRICE said he does not know whether it is a big
deal or not, but he is comfortable leaving it like it is.
REPRESENTATIVE MURKOWSKI said she does not like it. She agreed
with Ms. Reardon that it is contained within "physical
disability." She thinks it is more problematic leaving it in.
MS. REARDON stated:
I did look up ... dentistry and medical licensing. ...
They just refer to physical or mental disability. So,
probably we're able to make responsible decisions
without having this language here.
REPRESENTATIVE MURKOWSKI made a motion to amend the bill by
deleting "or an infectious or contagious disease" on page 4,
lines 16 and 17.
Number 0502
CHAIRMAN ROKEBERG asked Ms. Clark what the sponsor's
representative would say about deleting that from the bill.
MS. CLARK said, "He would probably be in support of whatever the
sponsor wanted." She said that interestingly enough, this didn't
come up in any of the discussions.
CHAIRMAN ROKEBERG said, quite frankly, he thinks it runs the risk
of running afoul of the ADA.
Number 0553
MR. GRAVO said he did not think he could argue against [the
amendment]. It just might complicate the bill's passage this
session.
Number 0574
MS. REARDON pointed out that there is a good public health and
safety reason for the whole bill. She stated:
It's not just the inactive, retired, locum tenens
status. The really important thing about having this
bill pass into law is that without it, it retains a
giant loophole in chiropractic licensing, which is that
there is a list of things you can discipline a license
holder for, but there is nowhere where it says you can
deny a license. That's the really important part of
this whole bill, is where it says you can also deny a
license. ...
This is a bill that matters. And this has been a
problem for the board, where they had people with
fairly significant criminal backgrounds. And when they
went to see why they could deny a license to that
person, they found out they couldn't.
Number 0626
REPRESENTATIVE HALCRO asked whether, if the bill were left
unamended, the board couldn't create more specific rules
regarding "Section C, physical or mental disability," to more
closely reflect the physical or mental disability goal that the
committee is trying to reach.
Number 0661
MS. REARDON said:
If what you are asking is, "Could the board write
regulations that said that 'physical or infectious
diseases' wording only applies to diseases that impact
your ability to practice safely" or something like
that, I would think that they probably could.
I also think that even in the absence of that type of
regulation, if we tried to actually discipline, to file
an accusation against someone, or to deny a license and
they appealed, that if it conflicted with the ADA, that
the Department of Law would immediately yank us back
and say, "No, you can't charge someone with something
that doesn't relate to their ability to practice."
CHAIRMAN ROKEBERG asked if any more regulations would have to be
written because of this bill.
Number 0712
MS. REARDON said there is the opportunity to write regulations.
If they [the department] cared to write some regulations about
how one could get back one's retired license, into active status,
then the bill says they can write regulations on that. But there
isn't any mandate.
CHAIRMAN ROKEBERG reminded members that there was a motion before
the committee.
Number 0739
REPRESENTATIVE BRICE said he was going to oppose the motion for
the simple reason that he would like a clearer definition of what
this [legislation] has to do. He suggested that the bill could
still be amended on the floor.
CHAIRMAN ROKEBERG asked Representative Murkowski if she wished to
maintain her motion or wanted to call Legislative Legal Services
and asked for a legal opinion.
REPRESENTATIVE BRICE urged the committee to withdraw the
amendment. He said:
It's not going to be on the floor tomorrow or even the
next [day], at which point in time we can get this
completely cleared up as to exactly how important that
section is - whether there are actually areas where
there have been infected chiropractors that are
spreading disease and contagion and causing a problem,
or whether or not this is just something people wanted
to see (indisc.).
CHAIRMAN ROKEBERG stated:
My concern on the subject is that it may run afoul of
some legal problems with the ADA. On the other hand, I
believe it should be (indisc.) if there is unfitness on
the part of the practitioner because of a disease. ...
That's my concern. I would prefer to leave it in,
also.
MS. REARDON asked if a letter of intent would make people feel
comfortable.
CHAIRMAN ROKEBERG replied no. He said that he is concerned about
the legal aspect of this issue.
REPRESENTATIVE MURKOWSKI withdrew her motion.
Number 0918
REPRESENTATIVE BRICE made a motion to move CSSB 297(L&C) am out
of committee with individual recommendations. There be no
objection, CSSB 297(L&C) am moved out of the House Labor and
Commerce Standing Committee.
ADJOURNMENT
Number 0953
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
5:23 p.m.
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