Legislature(1999 - 2000)
04/12/1999 01:32 PM Senate HES
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE
April 12, 1999
1:32 p.m.
MEMBERS PRESENT
Senator Mike Miller, Chairman
Senator Pete Kelly, Vice-Chairman
Senator Gary Wilken
Senator Drue Pearce
Senator Kim Elton
MEMBERS ABSENT
All members were present
COMMITTEE CALENDAR
SENATE BILL NO. 71
"An Act relating to licensure by the State Medical Board."
-MOVED CSSB 71(HES) OUT OF COMMITTEE
Briefing by the Alaska Food Coalition
SENATE BILL NO. 21
"An Act making an appropriation for construction and renovation of
the University of Alaska, Anchorage Consortium Library Facility;
and providing for an effective date."
-MOVED SB 21 OUT OF COMMITTEE
PREVIOUS SENATE COMMITTEE ACTION
SB 71 - See HESS minutes dated 4/7/99
SB 21 - No previous action to report
WITNESS REGISTER
Dr. Sarah Isto, Chair
State Medical Board
1718 Willow Drive
Juneau, AK 99801
POSITION STATEMENT: Supported SB 71
Ms. Catherine Reardon, Director
Division of Occupational Licensing
Department of Commerce & Economic Development
PO Box 110806
Juneau, AK 99811
POSITION STATEMENT: Supported SB 71
Senator Johnny Ellis
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Presented SB 21
Chancellor Gorsuch
University of Alaska Anchorage
3211 Providence Drive
Anchorage, AK 99508-4675
POSITION STATEMENT: Supported SB 21
Mr. Steve Rawlins, Dean
UAA Library
University of Alaska Anchorage
3211 Providence Drive
Anchorage, AK 99508-4675
POSITION STATEMENT: Supported SB 21
Mr. Joshua Hunter, President
Union of Students
University of Alaska Anchorage
3211 Providence Drive
Anchorage, AK 99508-8362
POSITION STATEMENT: Supported SB 21
ACTION NARRATIVE
TAPE 99-18, SIDE A
Number 001
SB 71-PHYSICIAN LICENSURE CHANGES
CHAIRMAN MILLER called the Senate Health, Education and Social
Services (HESS) Committee to order at 1:32 p.m. and brought up SB
71. After SB 71, the committee would hear a briefing by the Alaska
Food Coalition, followed by SB 21.
Number 010
DR. SARAH ISTO, Chairman of the Medical Board, spoke on behalf of
the board in support of SB 71, and expressed its appreciation of
Senator Miller and the committee for introducing this bill which is
important for the board's functioning and for Alaskans who are
patients. As background she noted there are about 2,000 licensed
physicians in the state, of whom about 400 are osteopaths and the
remainder, medical doctors. The board also licenses paramedics and
physician assistants, but this bill doesn't include those
practitioners who are in an up-to-date statute. SB 71 deals with
older provisions in the statute relating to medical doctors.
There is no reciprocity for medical licenses in the U.S. which
means each state sets its own standards, requiring people to apply
in each state they practice. DR. ISTO said Alaska statutes should
meet at least the same kind of standards that other states require
in order to get competent practitioners in our state.
DR. ISTO proceeded to explain the statute changes in SB 71
summarized in her letter to Senator Miller on April 7. She said
she grouped items together by subject matter in paragraphs rather
than by numerically following the statute. The italicized language
in her letter explains the board's reasoning and concerns that led
to these requested changes.
Paragraph (1) relates to the current situation in Alaska when
someone with a felony conviction applies for a medical license.
The board can consider the conviction only if it occurred in the
course of their practice of medicine or their duties as a
physician. The board received an application for a medical license
from penitentiary from someone who committed a brutal murder, and
the statute did not allow consideration of that part of the
applicant's history because it did not involve a patient and was it
not committed in the office or the hospital. DR. ISTO stated,
"Fortunately, there were other problems with that application and
we did not grant that person a license, because we would have been
very nervous, not being able to evaluate that part of the license."
This change adds language on a felony or misdemeanor substantially
related to the licensee's fitness to practice. A felony conviction
for tax evasion might not be considered by the board, but a brutal
murder should be.
Paragraph (2) adds "or its designee," and is a housekeeping measure
relating to licensed physicians who, when renewing their license,
are required to have 34 hours of continuing medical education. The
board sets up a plan, and physicians must wait until the board
meets again and even suspend their practice. This language change
would avoid having that delay built into a routine matter.
Paragraph (3) refers to Section 5 in the bill, another housekeeping
item relating to temporary or "locum physicians" replacing doctors
on vacation. The temporary physicians cannot renew that permit
without the board taking action at the moment the permit expires.
The board feels the renewals could be handled by the board's staff.
Paragraph (4) refers to Section 4 in the bill regarding physicians
in training. The only training program in Alaska is the three-year
Alaska Family Practice residency in Anchorage. Current statute
allows a permit to practice under the supervision of a training
program for only one year. By the time they complete their one
year, they must take an exam and get the results before they can
get an active license. If SB 71 passes, those who are foreign
medical graduates would be required to complete their entire
training before obtaining an independent license. This would
enable the board to renew those permits.
Paragraph (5) refers to Section 5. Currently the statute considers
only a suspension or revocation in another state in a new
applicant's file. But states also deny or have licenses
surrendered while an applicant is under investigation for
violations of law, or restrict or condition licenses, or place
people on probation. The board wants to be able to consider those
actions. This change would expand the language to include the
kinds of actions that other boards use.
Paragraph (6) refers to Section 1. Alaska is the only state that
requires citizenship of an applicant or permanent residence. There
are physicians legally here under visas allowing them to practice
temporarily, but they are not citizens or permanent residents. A
visiting specialist who is excellent couldn't be granted a license
by the board. Foreign trained physicians will have already had
three years of training according to this bill.
Paragraph (7) refers to Section 3. Forty-three states require
three years of post-graduate training for physicians who graduated
from foreign medical schools. Alaska does not have a way to
evaluate foreign education or, as in the case of Burma, even to get
the records. To confirm competency, most states require foreign
graduates to be trained in the U.S. in an accredited residency
program where they will be supervised for three years. The board
would like to do the same thing.
Paragraph (8) refers to Sections 2 and 6 and relates to applicants
who are U.S. and Canada trained and not considered to be from a
foreign medical school. Currently Alaska requires one year of
post-graduate training. There are few two-year programs, with most
programs lasting three to five years. The board wants to recognize
that situation and require those graduating after 1995 to have at
least 2 years, in order to evaluate competency. On the other hand,
if someone graduated in 1978, they have had a long work experience
and the board can evaluate that they are competent.
DR. ISTO concluded that in Alaska it's extremely important for
practitioners to have good skills and judgment, especially in rural
Alaska where there aren't a lot of specialists and equipment.
Thirty people were licensed at the last board meeting, and only
one would not have met these proposed criteria.
Number 205
SENATOR PEARCE asked if the Medical Board is notified when a
malpractice suit is filed or only if there's an actual judgment
against a doctor.
DR. ISTO replied a judgment or a settlement is required to be
reported to the board. The attorneys are aware of that requirement
and the board has sent out newsletters reminding the licensees of
it. The malpractice companies are careful to ensure that reporting
is done. She believed the board receives most of the reports.
SENATOR PEARCE asked if the board requires doctors to have
malpractice insurance. DR. ISTO answered "No, the board doesn't
get into the insurance business. Someone can be uninsured, but
they are still required to report."
SENATOR PEARCE asked if there could be a number of reports before
the board would evaluate a physician. DR. ISTO replied the board
looks at certain types of malpractice issues involving alcohol or
negligence. A pattern would concern the board, but there is no
computerized system and each report is scanned on arrival. A
patient can file a malpractice action and complain to the board.
All complaints to the board are evaluated, and the board knows if
there have been a number of complaints against a doctor.
Number 258
SENATOR ELTON said he appreciated Dr. Isto's concise sectional
analysis of the bill.
SENATOR PEARCE asked if there is a companion bill in the House.
DR. ISTO replied there is not, but the House expressed earlier
interest in the issue. SB 71 has a zero fiscal note.
SENATOR PEARCE asked if most hospitals require their doctors to
carry malpractice insurance. DR. ISTO responded she believed that
is true.
CHAIRMAN MILLER interjected he believed Ms. Isto is correct,
recalling that was an issue in tort reform a couple years ago. He
asked for a motion to adopt the Committee Substitute.
SENATOR WILKEN moved to adopt CSSB 71 (HES) Version D Lauterbach
4/7/99 in lieu of the original bill. Without objection, it was so
ordered.
Number 288
MS. CATHERINE REARDON, Director of the Division of Occupational
Licensing, Department of Commerce & Economic Development spoke in
support of the bill. She stated her division provides staff
support to the state Medical Board. The department appreciates the
time the committee has put into introducing and crafting the bill.
Following up on the previous discussion, MS. REARDON clarified the
board doesn't have statutory authority to require malpractice
insurance, and it would require legislative action if the committee
wanted to do that.
CHAIRMAN MILLER asked the wish of the committee.
SENATOR WILKEN moved to report CSSB 71 (HES) out with individual
recommendations and attached zero fiscal note. Without objection,
it was so ordered.
Number 315
MS. SAMANTHA CASTLE KIRSTEIN, Executive Director of Fairbanks
Community Food Bank (FCFB), thanked the Fairbanks members of the
committee as individual donors to the FCFB. She introduced Mr.
Wendell Otness, Executive Director of Fairbanks Rescue Mission, and
Mr. George Hieronymous, Jr., Executive Director of Bean's Cafe in
Anchorage.
She said they represent the Alaska Food Coalition, a group of
independent grass-roots individuals from city and village networks.
There is no statewide advocacy group or state or federal funding
for the issue of hunger
The coalition asks the committee to abandon HB 161/SB 126 which
would reduce payments to individuals under certain benefit programs
until the following conditions are met: the effects of the welfare
reform process are understood; legislators remove the vague
language from the bill; the Department of Law finds the bill
constitutional(it currently recommends it is not); and there is
good faith and fair dealing with the providers.
As people are moved from state welfare rolls, MS. KIRSTEIN said,
the safety net of local agencies and the community must gear up.
The coalition is worried about nonprofit response, and some
communities haven't yet taken the step of caring for their own.
She said the real question now is what is happening to the people
being removed from the welfare rolls: are they strong healthy
self-sufficient contributing members of their communities? Do they
need further assistance?
Number 402
MR. WENDELL OTNESS stated Fairbanks has been very supportive of the
Food Bank and Rescue Mission, and several other organizations. The
federal numbers indicate the Welfare to Work program is working.
The mission helps people get GEDs, and single mothers who can't
survive on the minimum wage with day care costs use the services at
the mission. People exist through a combination of welfare, work,
and service organizations. MR. OTNESS described "the working poor"
as a married couple who both have jobs but live at the mission
because they can't afford housing.
No one really knows where the welfare people have gone. He'd like
to see the numbers before stating the program is a success, and it
may take a few years, as Ms. Kirstein said. He told the committee
the Rescue Mission would like to see a five-year program before
cuts are made or successes are proclaimed.
Number 442
MR. GEORGE HIERONYMOUS, Executive Director of Bean's Cafe, stated
that Bean's feeds and provides a day shelter for homeless men and
women. Last July Bean's took over a small program called Kids
Kitchen begun a couple years ago by Eldon Jones. It now includes
4 sites and 220 children a day getting a hot after-school meal. He
estimated feeding 600-700 children a day by next year at this time,
in about a 4-neighborhood area of Anchorage. The Children in
Transition Title I program for homeless children estimates 3,000
kids are eligible for their program. MR. HIERONYMOUS stated he
doesn't know if he can feed 3,000 kids every day.
With the Welfare to Work rule, he asked what happens to the people
when you tell them they've lost their benefits. "Am I seeing them
at Bean's or their children at Kid's Kitchen because they don't
have food at home?" The parents just aren't there to feed the
kids. In making decisions on the budget and on DHSS bills, he
encouraged the committee to keep in mind the long-range outcome.
The great majority of the children they feed are under 11 years
old. Kids Kitchen serves at Fairview Community Center, Mt. View
Elementary, Mt. View Boys and Girls Club, and NE Community Center
in Muldoon. MR. HIERONYMOUS said they're looking to expand that
program to four or five more sites, adding several hundred more
kids.
CHAIRMAN MILLER asked the speakers to provide written copies of
their testimony to the committee.
Number 481
SENATOR WILKEN asked Ms. Kirstein how long she's been with the Food
Bank. She replied 10 years, and added that it provides 2-5 tons of
food each day, and collects 1.5 million pounds of food a year.
Prompted by Senator Wilken, she related the story of the $1.5
million building on South Cushman that Dennis Weiss donated to the
Food Bank. On February 8 the Food Bank moved into the turnkey
building that's mortgage free. Other groups donated manpower and
materials. This donated building has allowed the Food Bank to focus
on the program. Fifty percent of the people served are children,
and MS. KIRSTEIN said " that's just not acceptable."
SENATOR WILKEN noted that legislative citations prepared for the
building donors will be presented in June. He asked Mr. Otness if
the female dormitory at the Rescue Mission is new.
MR. OTNESS replied it was built in 1985. Until four years ago,
there was low occupancy because of its reputation of being unsafe.
The zero tolerance in alcohol has changed it from a flophouse.
There's room for 28 women with children, and four are currently in
the recovery program for women.
SENATOR WILKEN asked how his program differs from WICCA. MR.
OTNESS said WICCA handles mostly abused wife and emergency
situations. For security reasons, the Rescue Mission doesn't do
emergencies, but it coordinates with WICCA.
CHAIRMAN MILLER thanked the speakers. There are several successful
programs the Fairbanks business community has been involved in,
such as Scan Away at Christmas, and CHAIR MILLER felt it should
become the statewide direction. The bookkeeping is minimal and
it's a way for businesses and the general public to help.
SENATOR WILKEN asked if Scan Away was a statewide program. MR.
OTNESS said it originated in Syracuse, New York. It brought in
$25,000 this year, split between the mission and food bank in
Fairbanks.
MS. KIRSTEIN explained it is the trademark Rescue Mission program
and Carr's is sponsoring it in Anchorage as "Swipe Away." A local
program at Carr's will benefit the SE Alaska Food Bank.
CHAIRMAN MILLER remarked that it's a program that could expand
beyond grocery stores to businesses with a lot of clientele.
SB 21-APPROP: UAA CONSORTIUM LIBRARY FACILITY
CHAIRMAN MILLER brought up SB 21, and stated that Senator Ellis
would present the bill.
Number 564
SENATOR JOHNNY ELLIS, sponsor of SB 21 expressed appreciation of
the committee for hearing the bill. Last year the legislature
passed an amendment by Senator Kelly during deliberations on the
capital budget that allowed the University of Alaska Anchorage to
take deferred maintenance monies of about $10 million to begin work
on this project. This bill proposes to appropriate from the
General Fund the balance of monies needed to complete the project.
Expansion of the library is essential for continued national
accreditation. Support of the project is widespread among
students, faculty and staff, and the general public. The UAA
Library operates the most active inter-library loan program in
Alaska. The project will provide new opportunities to train the
future workforce in the state.
SENATOR ELLIS said his true purpose is to get this on the agenda of
the Finance Committee as a project in the capital construction
budget and leave the exact appropriation amount and source of
funding to their wisdom and experience.
CHANCELLOR GORSUCH, on-line from Anchorage, spoke in support of SB
21. He said the UAA Library is 25 years old, and the student body
has doubled in that time.
TAPE 99-18, SIDE B
Number 588
CHANCELLOR GORSUCH discussed the issues of the expansion of the
library and the materials contained in it. ARILS is a collection
of 8 previously independent natural resource libraries of both
federal and state agencies located in a consolidated facility on C
Street. UAA plans to make ARILS an integral part of its expanded
library. He said UAA hopes to find other partners to join in the
library expansion. He pointed out the resolutions passed by the
Municipality, Anchorage Chamber of Commerce that indicate this is
a high priority project.
Number 556
SENATOR WILKEN asked if society is moving away from libraries. Law
offices are now being built without libraries, and instead use the
space for computers and offices for more attorneys. He asked, "Do
we really need a $30 million library?" Would the money be better
spent for a smaller building with greater distributive capacity for
access by people with computer terminals?
COMMISSIONER GORSUCH replied it's a good question. Steve Rawlins,
Dean of the Library, is very familiar with the emergence of the
electronic library, and would follow up on his comments. The chief
director of the Library of Congress informed the commissioner that
it was unlikely within the next 30 to 40 years that more than 30%
of the Library of Congress's hard copy holdings would be fully
digitized and available in electronic form. In the chief
director's estimate, the written book will not die, and we will
continue to have many of our historical materials in hard copy,
while seeing a continued explosion of information in electronic
form. COMMISSIONER GORSUCH said he has been cautioned about
digitizing library holdings because with every major computer
upgrade, data and information get lost in the conversion process.
For archival reasons, there's a strong recommendation for
continuing to have hard copy as a backup.
COMMISSIONER GORSUCH explained to Senator Wilken that a major
portion of the library includes study areas for students. The
current reference library facilities are undersized. The $40
million fiscal note would simply bring the library expansion up to
the maximum capacity standards at the time the library opens, and
would not accommodate needs for the next 20 to 30 years. He said
he is banking that some of the electronic holdings will diminish
the demands on the library.
Number 496
MR. STEVE RAWLINS, Dean of UAA Library, stated he likes to think of
the library of the 21st century as a place that holds "collections
and connections." Last year 65,000 books were published and very
few appeared on the Internet. In planning a library for the 21st
century you have to accommodate the people, the instruction
occurring in the building, the existing and growing print
collections, and the network connections.
COMMISSIONER GORSUCH asked Mr. Rawlins to discuss the collaboration
with the Municipality, the Rasmussen Library and the state library,
and how people outside the Anchorage area will be beneficiaries of
this project.
MR. RAWLINS explained that electronic connections are being
established as well as partnerships with other libraries. UAA teams
up with other university libraries to save money by jointly
licensing electronic library products. It will develop a joint
system with the Anchorage Municipal Library where people can access
the holdings from the UAA Consortium Library and all the extended
campuses of UAA on one database. It will also develop more
electronic access and digital formats through the Internet and
Worldwide Web.
Number 451
MR. JOSH HUNTER, UAA Student President, spoke from the students'
perspective. He said that since the first semester he attended
UAA, the students have complained bitterly about the current state
of the library. Depending upon the program, there is a lag time in
current research and available documents. Research documents for
medical and biology students have been cut off, and there have been
cuts in journal acquisition over the past four years. When
students go on with their education or go to work in their fields,
they are several years behind in knowing what's currently going on.
Faculty can only spend so much of their own money copying and
distributing important journal articles. MR. HUNTER said many
students have flown to libraries in Washington and Oregon and paid
to become members in order to obtain current research information.
He urged the committee to look further ahead and build for
tomorrow, not for today.
CHAIRMAN MILLER asked the wish of the committee.
SENATOR PEARCE moved SB 21 from committee with individual
recommendations. Without objection, it was so ordered. The
committee adjourned at 2:40 p.m.
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