02/28/2011 03:28 PM House L&C
| Audio | Topic |
|---|---|
| Start | |
| HB122 | |
| HB155 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
February 28, 2011
3:28 p.m.
MEMBERS PRESENT
Representative Kurt Olson, Chair
Representative Craig Johnson, Vice Chair
Representative Mike Chenault
Representative Dan Saddler
Representative Steve Thompson
Representative Bob Miller
MEMBERS ABSENT
Representative Lindsey Holmes
COMMITTEE CALENDAR
HOUSE BILL NO. 122
"An Act relating to naturopaths and to the practice of
naturopathy; establishing an Alaska Naturopathic Medical Board;
authorizing medical assistance program coverage of naturopathic
services; amending the definition of 'practice of medicine'; and
providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 155
"An Act relating to public construction contracts."
- HEARD & HELD
HOUSE BILL NO. 125
"An Act moving the Alcoholic Beverage Control Board to the
Department of Commerce, Community, and Economic Development and
relating to duties of that department; and providing for an
effective date."
- HEARING CANCELED
HOUSE BILL NO. 87
"An Act relating to penalties for antitrust violations."
- SCHEDULED BUT NOT HEARD
HOUSE BILL NO. 164
"An Act relating to insurance; relating to health care
insurance, exemption of certain insurers, reporting, notice, and
record-keeping requirements for insurers, biographical
affidavits, qualifications of alien insurers assuming ceded
insurance, risk-based capital for insurers, insurance holding
companies, licensing, federal requirements for nonadmitted
insurers, surplus lines insurance, insurance fraud, life
insurance policies and annuity contracts, rate filings by health
care insurers, long-term care insurance, automobile service
corporations, guaranty fund deposits of a title insurer, joint
title plants, delinquency proceedings, fraternal benefit
societies, multiple employer welfare arrangements, hospital and
medical service corporations, and health maintenance
organizations; and providing for an effective date."
- SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 122
SHORT TITLE: NATUROPATHS
SPONSOR(s): REPRESENTATIVE(s) MUNOZ
01/26/11 (H) READ THE FIRST TIME - REFERRALS
01/26/11 (H) L&C, HSS, FIN
02/28/11 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 155
SHORT TITLE: PUBLIC CONSTRUCTION CONTRACTS
SPONSOR(s): LABOR & COMMERCE
02/11/11 (H) READ THE FIRST TIME - REFERRALS
02/11/11 (H) L&C
02/25/11 (H) L&C AT 3:15 PM BARNES 124
02/25/11 (H) Heard & Held
02/25/11 (H) MINUTE(L&C)
02/28/11 (H) L&C AT 3:15 PM BARNES 124
WITNESS REGISTER
KENDRA KLOSTER Staff
Representative Cathy Munoz
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 122 on behalf of the prime
sponsor, Representative Cathy Munoz.
EMILY KANE, Naturopathic Doctor
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 122.
JON SHERWOOD, Medicaid Special Projects
Office of the Commissioner
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Answered questions during the discussion of
HB 122.
DON HABEGER, Director
Division of Business & Professional Licensing
Department of Commerce, Community & Economic Development (DCCED)
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 122.
MARY MINER, Naturopathic Doctor (ND)
Fairbanks, Alaska
POSITION STATEMENT: Testified during the discussion of HB 122.
DR. KRISTEN COX, Naturopathic Doctor (ND)
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 122.
COREY BAXTER, District Representative
Operating Engineers Local 302
Juneau, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
JONATHAN SMITH, Member
Carpenters Local 227
Juneau, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
PAUL GROSSI, Lobbyist
Alaska State Pipe Trades UA Local 375
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 155.
ROCKY DIPPLE, Member
International Brotherhood of Electrical Workers (IBEW)
Anchorage, Alaska
POSITION STATEMENT: Testified during the discussion of HB 155.
DALE MILLER, Member
Teamsters Local 959
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
SERGIO ACUNA
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
BERNIE LOOMIS, Member
Alaska Regional Council of Carpenters
Anchorage, Alaska
POSITION STATEMENT: Testified during the discussion of HB 155.
VINCE BELTRAMI, President
Alaska AFL-CIO
Fairbanks, Alaska
POSITION STATEMENT: Testified during the discussion of HB 155.
KIRK JACKSON, Member
United Association Plumbers & Pipefitters Local 375
Fairbanks, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
JAY QUACKENBUSH, Assistant Business Manager
International Brotherhood of Electrical Workers (IBEW);
President; Fairbanks Building Trades
Fairbanks, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
DENNIS TRAILER, Member
International Brotherhood of Electrical Workers (IBEW)
Fairbanks, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
JOHN BROWN
Fairbanks, Alaska
POSITION STATEMENT: Testified in opposition to HB 155.
ACTION NARRATIVE
3:28:14 PM
CHAIR KURT OLSON called the House Labor and Commerce Standing
Committee meeting to order at 3:28 p.m. Representatives Olson,
Chenault, Thompson, Johnson, and Miller were present at the call
to order. Representative Saddler arrived as the meeting was in
progress.
HB 122-NATUROPATHS
3:28:26 PM
CHAIR OLSON announced that the first order of business would be
HOUSE BILL NO. 122, "An Act relating to naturopaths and to the
practice of naturopathy; establishing an Alaska Naturopathic
Medical Board; authorizing medical assistance program coverage
of naturopathic services; amending the definition of 'practice
of medicine'; and providing for an effective date."
3:29:08 PM
KENDRA KLOSTER, Staff, Representative Cathy Munoz, Alaska State
Legislature, on behalf of the prime sponsor, explained that HB
122 would establish a Naturopathic Medical Board consisting of
three naturopaths, one pharmacist, and one public member, who
may also be a licensed physician. This bill would authorize a
prescription endorsement for naturopaths (ND) who have five
years of experience as an ND, 60 hours of pharmacology
education, and who have met the criteria relating to the
administration of prescription drugs. This bill would also
provide NDs with a limited prescription authority for non-
controlled substances. These drugs would include drugs such as
blood pressure medication or antibiotics, but not controlled
substances which are addictive in nature. This bill would
update the definition for Naturopathic Doctor (ND) to align with
the current federal definition and would add NDs to the Medicaid
roster. This bill would allow NDs to treat patients under the
Denali Kid Care and for those NDs who want to be able to provide
service to Medicaid patients.
3:30:53 PM
MS. KLOSTER related that about 40 Naturopathic Doctors (NDs)
currently practice in Alaska. The prescription authority would
give the NDs the flexibility to provide necessary medical
treatment. In order for NDs to practice in Alaska they must
attend a graduate program with doctorate level training from a
U.S. Department of Education accredited school of Naturopathic
medicine, possess a four-year undergraduate degree in current
basic science, and complete the minimum prerequisites. The NDs
must pass 14 national licensing exams, which includes five basic
sciences and nine diagnostic therapeutic exams. Additionally,
NDs must obtain state licensure and be of good moral standing.
She stated that NDs have been licensed in Alaska since 1986.
3:31:45 PM
MS. KLOSTER related that NDs' primary focus is on preventative
care through traditional healing, which is holistic, and
comprehensive in nature. Dr. Emily Kane and Dr. Kristin Cox are
available for questions.
3:32:19 PM
REPRESENTATIVE MILLER asked anyone who could describe an ND's
current training and experience. He related his understanding
that HB 122 would create an ND board and provide for limited
prescription authority, but that the ND's duties would remain
the same.
MS. KLOSTER recapped the changes she previously mentioned, plus
she added that the definition would allow NDs to use the title
of Naturopathic Doctor and Naturopathic Physician. These terms
are ones used by the U.S. Department of Labor, she said. She
added that the NDs would also need to submit to continuing
education (CE) requirements, which the proposed board would
monitor. The NDs would also specifically be required to meet CE
in pharmaceuticals, as well.
3:34:06 PM
EMILY KANE, Naturopathic Doctor, stated that she is also the
President of the Alaska Association of Naturopathic Physicians.
She related that NDs are interested in bringing their scope of
practice into alignment with their training. The NDs have
comprehensive medical training. She explained that the
naturopathic law in Alaska has not been modified since 1986 so
it has fallen behind most other states that license NDs. Thus,
as a Naturopath (ND) she feels underutilized as a resource for
wellness, prevention, and disease management. She pointed out
that the NDs focus is on disease prevention and to promote
patient wellness. Additionally, NDs diagnose illnesses in their
practices. She recalled a press release issued by Commissioner
Streur, Department of Health and Social Services (DHSS), that
indicated by 2014, 32,000 more Alaska will be Medicaid eligible.
She asked who would provide the care since currently many
Medicaid patients wait months to see physicians. Some diseases
can be prevented through preventive care and nutritional
guidance, such as preventing obesity, alcoholism, and diabetes.
She offered her belief that NDs are well positioned to help
reduce the burden of these diseases. The bill addresses the
formation of a board. All other health care professionals in
Alaska have boards and it is time for NDs to also have a board,
she said.
3:36:33 PM
DR. KANE offered that while the Department of Commerce,
Community & Economic Development (DCCED) has been helpful the
NDs and will continue to manage NDs, the agency's staff is not
qualified to handle the NDs once they receive prescription
ability. She assured members that NDs simply want to practice
their profession per their training. Historically, objection to
the proposed changes in Alaska's statutes governing NDs have
come from the NDs professional allies, which is disappointing to
her since "in real life" she works closely with the medical
community. She provided an example, such as if she has a
patient with a complicated tonsil or abscess ailment that she
would refer the patient to Dr. Raster, the local Ear, Nose, and
Throat specialist. She has no interest in going beyond the
scope of her own skill set, she said. Often other health care
professionals will allege that NDS are untrained and pose a
danger to the public. However, there has never been a
malpractice suit against an ND during the 26 years NDs have
practiced in Alaska since NDs know their training and skills and
do not go beyond the scope of their ability. The NDs inherently
practice safe natural remedies and never use pharmaceuticals
first. One of the main reasons she wants access to
pharmaceuticals is that many of her patients are on drugs and
are unwell. She assists her patients by assisting them to get
well. This may include incorporating a regimen to reduce their
drugs and to review drug incompatibilities that have created
adverse drug interaction cross effects. Often, her patients use
natural drugs or herbs they have purchased from the natural food
store, which can create side effects. She stressed that NDs are
the only health care providers who are trained in drug nutrient,
drug herbal medicine interaction.
3:39:15 PM
DR. KANE related a scenario in which one of her patients
suffered from a urinary tract infection that needed immediate
attention so she referred her patient to the local Urgent Care.
However, this meant her patient had to incur the additional
medical costs just to obtain an antibiotic that Dr. Kane could
have provided if only she had the authority to write
prescriptions. She related that pharmacists are very familiar
with NDs. She suggested several options she could have taken,
including that she could have called a pharmacist in Oregon and
had the medication sent to Alaska. Another option would have
been to call one of her colleagues in the Lower 48, and a local
pharmacist could have filled the prescription, she said. In
fact, local pharmacists can fill prescriptions written by other
NDs who possess the same training she has, yet she cannot have
local pharmacists fill her prescriptions since she does not have
the authority to prescribe.
3:40:26 PM
DR. KANE reiterated her training is the same as her colleagues
in Washington, Oregon, and California. She related that she
attended a four-year undergraduate college, obtained a degree in
an unrelated subject, and then attended graduate school in
Naturopathic medicine. She related she spent six years in
school with a one year residency. She carries malpractice
insurance, has hospital privileges, and uses the full set of
diagnostic tools available to any health care professional, such
as lab work and radiology. She explained that how she differs
from medical doctors is that she spends more time with her
patients to educate them and help them modify their wellness
with good food choices and exercise. She said it may not sound
"all that jazzy" but it is hugely important. She suggested that
curing someone by modifying his/her food and exercise is a
better place to start than prescribing drugs. She stressed that
she needs access to drugs because she sometimes helps diabetics
and as these patients begin to lose weight, they need to have
their insulin reduced. She has had several patients who have
been able to completely stop using insulin. However, she cannot
help them "dial down" their medication since she cannot
prescribe.
3:42:32 PM
REPRESENTATIVE MILLER related his understanding that HB 122
would provide limited prescription ability.
DR. KANE agreed. She explained that drugs are listed by
schedule and some drugs have the potential for addiction, such
as narcotics used for pain medication. Schedule 1 drugs are
highly addictive drugs. The other drugs are legend drugs, which
include antibiotics, and antihypertensive drugs such as beta
blockers. Drugs used to treat urinary tract infections and
anti-viral medications fall under legend drugs and do not have a
great potential for harm or addiction, she said.
DR. KANE advised members when she has patients with intractable
pain that she refers them to a pain specialist or a neurologist.
Additionally, she indicated that the likeliness of these
patients becoming addicted is fairly high so the pain specialist
must develop a skill set to wean the patient off the scheduled
drugs. She stressed that all 40 of the NDs in Alaska would be
comfortable having restrictions and limits on prescription drugs
they could prescribe. The NDs would continue to refer patients
who need Schedule I drugs to medical doctors, she said.
3:46:00 PM
REPRESENTATIVE MILLER asked whether NDs currently have a
requirement for ongoing pharmacological training.
DR. KANE responded that currently NDs are not required to have
mandated CE. She asserted that the first thing she would do as
after establishing the ND board would be to require mandatory
CE. She related that every ND undergoes CE just to maintain
their standing with the national and state professional
organizations. However, the state does not have any requirement
to do so. She reiterated pharmacological training would be
necessary, especially since new drugs are developed that require
continual knowledge and education.
3:47:27 PM
REPRESENTATIVE JOHNSON asked whether the NDs' insurance costs
are the same as medical physicians and if NDs are concerned that
medical malpractice costs will increase if NDs assume the
liability of prescribing drugs.
DR. KANE responded that she pays $1,600 per year for malpractice
insurance since NDs are a good risk. Nationwide, very few
lawsuits happen even though NDs have been licensed since 1940s.
She reported that there have not been any malpractice lawsuits
in Alaska against NDs since their initial licensure in 1986.
NDs practice safe medicine. "That's our mandate. That's our
shtick, if you will. We do safe medicine. We do prevention,"
she said. Insurers are a good assessor of risk, she added. She
highlighted that she contacted her insurer, who is the largest
insurer nationwide, who related that her insurance rates will
not go up if HB 122 were to pass. The cost of the risk has been
amortized across all NDs. She pointed out only 5,000 NDs
practice nationwide so it is a small profession, but the demand
is growing. Most NDs practicing have access to legend drugs and
some also prescribe scheduled drugs, she said.
REPRESENTATIVE CHENAULT pointed out that 40 naturopaths practice
in Alaska and the proposed board is a five person board. He
said he did not see a fiscal note in members' packets. He asked
for clarification on the costs to administer the proposed board.
3:50:35 PM
The committee took an at-ease from 3:50 p.m. to 3:53 p.m.
3:53:07 PM
REPRESENTATIVE CHENAULT referred to the fiscal note and related
that one Department of Commerce, Community & Economic
Development (DCCED) would require receipt support services of
$48,000, which is nearly $50,000. He related his understanding
that the cost would be passed on to the NDs.
DR. KANE agreed that NDs' fees would increase.
REPRESENTATIVE CHENAULT offered that the fees would increase by
about $1,000.
DR. KANE agreed the fees would increase substantially.
REPRESENTATIVE CHENAULT referred to the Department of Health and
Social Services (DHSS) fiscal note identifies the cost as
$150,000 in services, $75,000 for federal funds, and $75,000
general fund (GF) matching funds for the Medicaid program. He
asked for clarification from the department on the fiscal note.
3:54:35 PM
JON SHERWOOD, Medicaid Special Projects, Office of the
Commissioner, Department of Health and Social Services (DHSS),
stated that the department submitted a fiscal note for a onetime
cost $150,000. The DHSS estimates half would be federal funds,
and half would be state general funds to make changes to the
data system to add another provider type in order to pay claims
for Medicaid services. The department does not expect an
ongoing cost, but it would incur costs to change the system to
add a new provider.
3:56:06 PM
REPRESENTATIVE CHENAULT asked whether NDs are not currently
accepted by Medicaid.
MR. SHERWOOD answered no, that currently NDs are not listed as
an optional service for Medicaid.
REPRESENTATIVE CHENAULT related his understanding that HB 122
would allow NDs to seek compensations for services they render
on behalf of Alaskans.
MR. SHERWOOD answered yes, that under the bill NDs would be able
to seek payment for Medicaid eligible individuals.
3:57:12 PM
CHAIR OLSON asked for another example of optional services for
Medicaid services.
MR. SHERWOOD answered that the basic services covered by
Medicaid include physician, hospital, and lab services, and
nursing facilities. Additionally, many other types of services
are optional, including services performed by advanced nurse
practitioners, direct-entry midwives, and mental health
providers. Medicaid does not cover family and marital
counselors or podiatrists, he said.
CHAIR OLSON recalled Alaska has a board for Certified Direct-
Entry Midwives.
3:58:28 PM
REPRESENTATIVE CHENAULT asked for an explanation of the $150,000
cost in order to change the system to allow NDs to participate
in Medicaid.
MR. SHERWOOD stated that the claims processing system is an old
Medicaid Management Information System (MMIS) legacy system from
the 80s. It is not a modern system with relational structure so
programming is required for reporting. Although he acknowledged
that he is not a computer expert, he related his understanding
that the basic logic in the system would requirement substantial
programming to make the system recognize the new provider type,
to report, process, adjudicate claims and report the claims into
the state's accounting system and into the right formats for the
federal partners. He said he hoped the new system would be in
place by the spring 2012 to make it easier and less costly to
make these changes. The changes would necessary to implement
the bill timely.
4:00:28 PM
REPRESENTATIVE CHENAULT asked whether the funding has been
allocated for the new system.
MR. SHERWOOD offered his belief that most of the money has been
appropriated. He said he was unaware of any outstanding request
for funding.
REPRESENTATIVE CHENAULT how long the process has taken.
MR. SHERWOOD recalled the current attempt was initiated in 2007,
but the department has worked since 1995 to replace the system.
He related that in once instance the bid was unsuccessful and in
another the department had to wait for Y2K changes to occur, as
well as changes to the federal electronic claims transmission.
Additionally, the department had an unsuccessful vendor in the
mid 90s.
4:01:46 PM
CHAIR OLSON has heard legacy brought up several times in the
budget subcommittee meetings. He asked whether that meant it
was no longer the "state of the art" system.
MR. SHERWOOD responded that would be an understatement.
REPRESENTATIVE MILLER referred to the narrative description in
the DCCED's fiscal note that indicates NDs would be allowed
prescriptive authority and could perform minor surgery. He
asked for the definition of minor surgery.
MR. SHERWOOD deferred to the DCCED.
4:03:06 PM
DON HABEGER, Director, Division of Business & Professional
Licensing, Department of Commerce, Community & Economic
Development (DCCED), stated that the reference to medical
procedures in the fiscal note were in error. He explained that
the fiscal note referred to an older version of a naturopathic
bill and should be stricken.
4:04:04 PM
MARY MINER, Naturopathic Doctor (ND), stated that she has been
interested in changes to the naturopathic statutes since 1994.
The crux of the issue for her relates to patient care. Patients
come to see her for routine naturopathic care, but the need
arises for patient referral, that would not be necessary if NDs
had prescription authority. She expressed concern that costs
are prohibitive, especially if patients do not have health
insurance and must pay costs out of pocket. In those instances,
the patient may not make the appointment and may not get
adequate care. This issue arises more frequently as people
become careful about health care dollars. She offered her belief
that this is not novel legislation, that many states have
enacted legislation, such as Oregon, Washington, and Arizona
with little consequence and no harm to the public.
4:06:56 PM
DR. KRISTEN COX, Naturopathic Doctor (ND), offered to speak to
the Medicaid portion of the bill. She related that adding NDs
to the Medicaid roster would save the state money. She said she
often receives calls from patients who want to bring their
children to see her, but Alaska's Denali Kid Care does not cover
her services. She stressed that NDs are willing, able, and
available to see patients. Most of the Medicaid patients are
children, who could benefit from naturopathic medicine since it
preventative medicine that focuses on diet, nutrition and
lifestyle counseling. She and other NDs could potentially save
hundreds of thousands of dollars by educating children. She
stated that by treating children the physician also has access
to the family and have an opportunity to educate their parents
and the benefits get spread. The ND spends significantly more
time, an hour or longer, with each patient gaining trust and
educating patients, which many patients need.
DR. COX asked to speak to prescriptive authority. Many of her
patients want to feel better and when they come to see her they
are often tired, overweight, depressed, with high cholesterol
and high blood pressure. Some patients are interested in
hormone balancing but she cannot prescribe natural hormone
replacement therapy even though she is well trained and could do
so. She screens patients for thyroid problems and encounters
many thyroid problems, which are easy to treat, yet she cannot
prescribe thyroid treatment. If all thyroid problems were
adequately treated it could save money over time. She related
that many NDs are attracted to rural areas and rural areas have
a shortage of doctors. However, an ND cannot practice in rural
Alaska without the ability to prescribe nor can they act as
primary care physicians without the ability to prescribe
antibiotics or other medications. She noted that she practiced
naturopathic medicine in Fairbanks for a year.
DR. COX related a scenario in which a man had been bitten by a
cat and had red streaks running up his arm from the bite. He
needed an antibiotic and she referred him to a medical doctor,
but refused to go. She explained that some patients have an
abnormal fear of traditional medical care. She also referred
him to the emergency room. She later found out he lied to his
veterinarian in order to obtain an antibiotic and took medicine
prescribed for a dog. She offered her belief that she should
have been able to prescribe an antibiotic for her patient, but
could not. She characterized this as an example of routine
situations NDs encounter in their practices as primary care
physicians, which they are licensed to do, but must do with "one
hand tied behind their backs."
4:12:16 PM
REPRESENTATIVE MILLER acknowledged the difficulty to quantify
future cost savings with respect to health care costs, but
related his understanding that the main goal of NDs is disease
prevention. He offered his belief, based on earlier testimony,
that as many as 14,000 new Medicaid patients are anticipated.
The system has already been constrained and putting 40 more
physicians into the system could help reduce the strain on the
system.
DR. COX advised members that it is difficult for patients to get
doctor appointments, particularly since many doctors in Juneau
are not accepting new patients. She asserted the need for more
practitioners, especially those who are skilled in nutrition,
prevention, and lifestyle counseling. She offered her belief
that the NDs are those practitioners. The NDs have been
licensed in the state and are an under-utilized resource.
4:14:11 PM
REPRESENTATIVE SADDLER asked why she pursued this branch of
medicine.
DR. COX answered that she was not interested in prescribing,
conventional medicine. She acknowledged that traditional
medicine has its place, particularly for emergency medical care.
The biggest problem she sees in the U.S. is chronic illness,
which responds to low-tech cheap therapies that have been
neglected. It doesn't cost a lot for people to eat well or to
treat people with herbs as compared to pharmaceuticals. She
said she is fascinated with plants and likes the natural world
and was drawn to that type of practice.
4:16:18 PM
REPRESENTATIVE SADDLER asked her to describe her background.
DR. COX explained her education. She related that she first
obtained a Bachelor of Science degree in pre-medicine. She
originally thought she wanted to become a physical therapist.
However, she learned about ND medicine while in Portland, which
has one of the oldest ND schools. She appreciated the
philosophy of the medicine which focuses on the natural cure,
the healing power of the body and its innate powers to heal.
The goal of the physician is to remove the obstacles to the
cure. She remarked at the simple and beautiful process. She
related that NDs tend to use the gentle therapies first. She
said that NDs also encourage patient responsibility and self
healing, which is a lot of work, much more so than taking a
pill. Patients become empowered and change their lives. She
pointed out there is a great demand for this type of medicine.
Clearly no one would argue that nutrition or exercise is
important. She offered her belief that diet and nutrition could
solve 90 percent of the health problems.
4:18:53 PM
REPRESENTATIVE SADDLER asked how she could reconcile having
prescription authority with her philosophy of naturopathic
holistic care.
DR. COX agreed to the conflict. She asserted that she would not
use prescriptions as the primary treatment, but would reserve
writing prescriptions for emergency situations. She related
that NDs know when people need help, such as when patients have
sky high blood pressure, it needs to be treated to come down.
She explained that naturopathic medicine takes time to work such
as to lose weight, but in the meantime the patient's blood
pressure must be treated or they risk having a stroke. It is
difficult to tell a patient who has chosen ND medicine that they
need to go to the emergency room to obtain medicine. For many,
it represents an added expense. She agreed that sometimes
prescriptions are necessary. Her biggest interest in
naturopathic medicine lies in hormone therapy. She has treated
many thyroid patients, who have ailments that can be prevented.
She offered an example of the type of problem she treats. She
related a scenario in which a 50 year carpenter, without medical
insurance, had severe knee pain and his orthopedic surgeon
recommended a double knee replacement. She screened him for a
thyroid problem, treated him with thyroid medicine and his pain
decreased by 90 percent. She said that treating the
inflammation helped reduce his pain. Low thyroid function can
cause carpel tunnel and pain due to the inflammation. She
related her understanding that she saved her patient thousands
of dollars in surgery with about $7 worth of thyroid medicine
and her patient is now back at work.
4:21:46 PM
CHAIR OLSON, after first determining no one else wished to
testify, kept public testimony open on HB 122.
[HB 122 was held over.]
4:22:11 PM
The committee took an at-ease from 4:22 p.m. to 4:23 p.m.
HB 155-PUBLIC CONSTRUCTION CONTRACTS
4:22:11 PM
CHAIR OLSON announced that the final order of business would be
HOUSE BILL NO. 155, "An Act relating to public construction
contracts."
4:24:05 PM
COREY BAXTER, District Representative, Operating Engineers Local
302, stated he is a fourth generation Alaskan. He related that
he takes great pride in supporting his state and family by
working in Alaska. He asked to testify against HB 155. He
said, "You don't have to look hard to constantly be reminded at
how much harder it is for people to make ends meet." At a time
when families are struggling to pay for basic living, to put
Alaskans first by buying and working locally, this bill would
take more money out of employees' pockets any time they perform
state construction projects under $75,000. He did not
understand the logic, especially given the state's surplus. He
stated that this bill sends a message that quality workmanship,
quality of life, and potential public safety does not have a
priority. He said, "This law should not be changed."
4:25:28 PM
JONATHAN SMITH, Member, Carpenters Local 227, stated that he is
a lifelong Alaskan. He spoke in opposition to this bill. He
offered his belief that this bill lowers wages for working
people, but particularly for Alaskans. He stated that when a
contractor bids on projects, Alaskans have a level playing
field. Under this bill, employees would work for half the
wages. He offered his belief that nonresidents would "lowball"
the wages without Alaska hire provisions. In Southeast Alaska,
workers rely on small projects to keep busy. He supported
higher wages for Alaskans, especially given the high cost of
fuel prices and heating oil. Initially, some money may be
saved, but in the long run, people will be unemployed.
REPRESENTATIVE MILLER said he seems to be opposing this bill
since outside contractors would have a leg up over local Alaskan
hire.
MR. SMITH offered his belief the prevailing wage is $55 for a
carpenter and under the bill the Alaskan worker would lose out.
4:28:22 PM
REPRESENTATIVE THOMPSON commented in rural areas some employers
cannot comply with reporting under the Little Davis-Bacon Act
(LDBA). That affects many rural contractors, who cannot bid on
projects. The contracts are awarded to larger contractors, who
must fly in, and it adds a whole lot of money on a small project
such as repairs to a school. He related that certain aspects of
the bill could help in rural areas with respect to rural areas.
MR. SMITH related that in his experience in Dillingham that the
LDBA leveled the playing field. He knew he would be paid the
same wage as those coming in from Anchorage. He offered his
belief that without the provision in law, that the employer
could pay any wage. He supported the LDBA wages.
4:29:54 PM
PAUL GROSSI, Lobbyist, Alaska State Pipe Trades UA Local 375,
stated that his organization is concerned with the bill for many
of the same reasons that other testifiers have raised. He
offered his belief that the $75,000 minimum threshold is too
high. He related it would put a lot of jobs outside of LDBA
work. Additionally, he expressed concern about the exemption
from the LDBA for school districts, and the new definition of
maintenance.
CHAIR OLSON explained the school district would have the same
cap, that he anticipated the language being cleared up. He
offered his belief that the national average is $108,000 for
LDBA. He explained that the minimum will not be above the
national average and school district will be included in the
final number. He related that schools would not be built
outside of the LDBA. He pointed out that the language would be
cleaned up. In further response to Mr. Grossi, he clarified the
definition for maintenance would also be reconsidered as part of
the work on the bill.
MR. GROSSI pointed out that LDBA comes with resident hire law.
He expressed concern that exempting any portion of title 36 may
also exempt the requirement for local hire. Currently, the LDBA
requires 90 percent resident hire. In response to
Representative Chenault, he clarified that Little Davis-Bacon
requires 90 percent local hire.
MR. GROSSI related that an argument could be made that this bill
won't affect local hire, but currently the department does not
have any way to track the jobs. In response to Chair Olson, he
advised the department tracks resident hire through the
certified payroll. Thus, whatever portion is exempted would not
filing certified payroll so by law or by de facto resident hire
would not be covered.
4:34:42 PM
MR. GROSSI said he is speaking for the pipe trades, but pointed
out that all construction workers and contractors could lose a
significant amount of work, not just because of a reduction in
pay but due to the resident hire provision. He offered his
belief that hiring local people, also helps the state and local
economy. He pointed out that when hiring outside Alaska, the
people will do their job and leave. They spend little money in
Alaska. If you hire a resident plumber, that person will spend
his/her money locally. He also said he realizes the provision
probably created an unintended consequence but it is a serious
one.
4:35:58 PM
REPRESENTATIVE JOHNSON asked if $75,000 is too high of a
threshold whether the current threshold of $2,000 is too low.
MR. GROSSI said he'd like to keep it at $2,000 but that choice
is the prerogative of the committee. He asserted that $75,000
is too high. He said he realizes that the threshold has been
set at $2,000 for some time but he did "not have a number for
you."
4:36:57 PM
ROCKY DIPPLE, Member, International Brotherhood of Electrical
Workers (IBEW), expressed concern about raising the threshold to
$75,000. He stated that rural Alaska is expensive. He said he
does not want to take wage cut at a time when all other costs
are increasing. He thought the bill would allow contractors to
"low ball" bids and "fly by night" not established shops would
bid on projects. He offered his belief that new companies would
come in, do the jobs cheaply, but ultimately the new shop would
end up going broke. He expressed concern about who would pick
up the costs. He said, "Creating a race for the bottom is never
a good idea because in the end if you 'pay peanuts all you catch
is squirrels.'"
4:39:01 PM
DALE MILLER, Member, Teamsters Local 959, stated this bill would
harm families, benefit employers, but will not guarantee lower
bids. The state is not experiencing financial difficulties yet
this will cause problems for working men and women. He did not
think lowering wages would spur economic growth. He suggested
if the process is a cumbersome filing process to try to change
the filing process and not raise the threshold limit. He
acknowledged the bill was a bill in progress. Still, he said he
does not believe maintenance definition is a good idea, as it
would make the LDBA even more confusing. The LDBA covers
construction projects, which is already defined. He also did
not think it was a good idea to exempt school districts.
Construction projects on these buildings are not less important
than those of other buildings. He urged member to not pass this
bill in its current form. He recalled that even the Alaska
Municipal League resolution did not recommend this high of a
threshold limit.
4:41:58 PM
SERGIO ACUNA stated that he is a laborer. He asked to testify
in opposition to the bill. He said it difficult to provide for
his family. He is a construction worker and he works seasonal
work. He suggested Alaska does not need anti-worker bill. He
thought the bill would protect the big and the powerful. He
said he speaks not only for himself but also for his fellow
workers who were not able to testify today. He said, "Please
leave the bill alone. Thank you."
4:43:10 PM
BERNIE LOOMIS, Member, Alaska Regional Council of Carpenters,
stated that the previous bill on NDs also plays into this bill.
There are pluses and minuses to the bill. He related that
everyone is affected when the standards are removed and people
cannot make a decent living in rural communities or major
communities. Everyone is impacted, especially seniors, when the
value of the working force is diminished. He said it seems that
people do not mind paying $80 or $90 to fix a car that
depreciates daily, yet some people want to pay the lowest wages
instead of paying workers a decent wage to work on projects with
a huge equity growth in gain and value. He predicted that could
ruin the economy. He suggested the value of hiring a
professional instead of an amateur could result in cost savings.
He asked members to consider taking away the negatives that
impact the working class.
4:44:53 PM
REPRESENTATIVE SADDLER asked whether he could identify the
pluses of HB 155.
MR. LOOMIS acknowledged that the $2,000 threshold has been in
place for some time and it probably needs to change a little
bit. One problem he has experienced is the antiquated system
the state uses on Little Davis-Bacon projects that make it
difficult for contractors. He said he deals with certified
payroll issues every day. He offered his belief that the state
is experiencing a huge influx of out of state workers and the
money they earn does not stay in Alaska. This drains the
Alaskan economy. "The more you open the door, the more you
allow it to negate the economy for the rest of us who live here
and have grown up here," he said.
4:46:33 PM
REPRESENTATIVE CHENAULT asked whether the underhanded dealing he
has noticed happens on both sides of the aisle.
MR. LOOMIS answered that he did not think it happens as much
with Alaskan residents. He stated that the lions of the
industry have proven themselves and have track records. Some
issues arise but not to the same degree. He offered his belief
that smaller companies would come in for a smaller piece of the
pie. He said they don't care, but would just "take their money
and run."
4:47:38 PM
VINCE BELTRAMI, President, Alaska AFL-CIO, asked to clarify a
few points. He referred to the sponsor statement, which lists
the average threshold nationwide at $108,000. He pointed out
after reviewing 32 other states that he thought the threshold
seemed to be $40,000 less than that figure. Some states skew
the average since their threshold is extremely high, in the
$400,000 - $500,000 range. He recalled earlier testimony that
raising the threshold by $50,000 would simply adjust the
threshold for inflation. He offered his belief that would
increase inflation by about two-thirds. He suggested that
proposed Section 8, of HB 155 should be removed. He stated that
the changing the terminology and definitions may have unintended
implications and are a bad idea. He also thought that modifying
the threshold invites "low ball" low-quality construction on the
state's public infrastructure, which could compromise safety,
particularly in public buildings such as schools.
MR. BELTRAMI recalled earlier testimony on the language that
would eliminate the local hire provision. Approximately 1,400
projects fell under $75,000 last year, not taking into
consideration the schools. He recalled Representative
Chenault's has a construction background. Adjusting the
threshold won't necessarily translate to reduced bid costs.
Instead, it would invite contractors to lower the bid, and
pocket more of the money and pay workers less. The federal
Davis-Bacon Act sets a standard of living. He pointed out the
state may potentially have a $12 billion surplus this year so he
did not understand the economic driver that makes it necessary
to lower the standard of living for construction workers. He
referred to the fiscal note of $400,000 per year which means it
will cost our state general fund monies. He reported that of
the 25 or 30 people at the Fairbanks Legislative Information
Office (LIO), a strong majority are in their 20s. These folks
want to work in construction industry and earn a decent wage.
Under this bill contractors could slice their pay by whatever
amount they deemed as appropriate. The bottom line is that the
state has a $12 billion surplus and a law has worked well since
statehood. He did not see "pushing this" bill. He said, "Good
paying jobs serve to improve a stagnant economy. It just seems
like an unnecessary bill that helps employers, small employers,
at the expense of the workers they'd be hiring." He spoke in
opposition to HB 155.
4:53:08 PM
KIRK JACKSON, Member, United Association Plumbers & Pipefitters
Local 375, also serves on the Supplemental Unemployment
Committee for the UA Plumbers and Pipefitters. He stated that
he is speaking on behalf of its member today. He stated that
raising the threshold to $75,000 is too high. He did not think
cutting hourly wages is the answer to save money on public
construction projects. Contractors can best serve their
communities by paying workers a decent wage so they can support
their families. The cost of living in Alaska, especially in
rural communities is high. Fuel costs are significantly higher
and cutting a "working man's wages" is not appropriate in
today's economy. He spoke in opposition to HB 155, as written.
4:54:17 PM
JAY QUACKENBUSH, Assistant Business Manager, International
Brotherhood of Electrical Workers (IBEW); President, Fairbanks
Building Trades, stressed his opposition to HB 155. He related
his understanding that change takes place in the process.
However, this is not the time to make a change to LDBA, which
protects the prevailing wage. He said, "It doesn't matter to me
or the people I represent, or the people who put their blood and
sweat into the jobs. It doesn't matter what your skill is, if
you are a construction worker you have a skill and there is a
prevailed wage for that skill." The wages may vary for sheet
metal worker, operating engineers, or bricklayers. However, the
skills are valuable and wages are based on the economy, the
skill, and the training. He expressed concern that the proposed
changes would bring in workers from the Lower 48. He pointed
out that the out of state workers have a lower cost of living,
but will come to Alaska and undercut the market and Alaskan
workers' ability to make a good living. He hoped this bill
would not go any farther in the process.
4:56:17 PM
DENNIS TRAILER, Member, International Brotherhood of Electrical
Workers (IBEW), stated he is a member of the IBEW and is
speaking on behalf of himself. This issue is not a union or
non-union issue. This is about Alaskans who would lose out.
The prevailing wage was set in place to prevent other states'
workers from coming in and undercutting Alaska's contractors.
He said, "This is going to be a Pandora's Box. If we open this
up, we're going to get contractors coming from the Lower 48.
They're going to bring low paid workers into our area. They're
going to undercut all of our contractors. It's going to give
economic harm to a lot of our workers, both union and non-
union." He spoke in opposition to HB 155. He hoped the
committee would see that this bill would damage Alaskans.
REPRESENTATIVE CHENAULT commended the gentlemen who just spoke.
He agreed this is not union or non-union issue. He said, "It's
a dollar issue."
4:58:23 PM
JOHN BROWN stated that he is retired. Many of the issues have
already been raised so he asked to provide a brief history. The
LDBA is based on the federal Davis-Bacon Act, which was
initiated in the 1920s and was passed in 1935. He related that
the Davis-Bacon Act was initiated because two Republican
Congressmen from Illinois were tired of Mississippi contractors
bidding on Illinois projects, bringing in Mississippi workers,
and taking their earnings out of the state of Illinois. He
agreed this issue is not a union or non-union issue. Instead,
the issue is about our economy and keeping our economy strong.
The only way that can happen is for contractors to obtain as
fair a chance as possible to keep the dollars spent in Alaska.
He spoke in opposition to HB 155. He urged members to "leave it
alone."
[HB 155 was held over.]
5:00:14 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
5:00 p.m.
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