03/13/2006 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB379 | |
| SB299 | |
| SB281 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 299 | TELECONFERENCED | |
| + | HB 379 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | SB 281 | ||
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 13, 2006
1:33 p.m.
MEMBERS PRESENT
Senator Fred Dyson, Chair
Senator Gary Wilken, Vice Chair
Senator Lyda Green
Senator Kim Elton
Senator Donny Olson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR HOUSE BILL NO. 379(JUD)
"An Act relating to scheduling as a Schedule IA controlled
substance gamma-hydroxybutyric acid and certain similar
substances."
MOVED CSHB 379(JUD) OUT OF COMMITTEE
SENATE BILL NO. 299
"An Act relating to preventing unfair discrimination against a
health care provider who is willing to meet a health insurer's
terms and conditions for participation in the insurer's plan,
policy, or contact for health care services; amending the
definition of 'provider' as it relates to authorized collective
negotiations by physicians affecting the rights of providers
under health benefit plans; and providing for an effective
date."
HEARD AND HELD
SENATE BILL NO. 281
"An Act relating to interdistrict operation of public schools;
relating to enrollment of students by school districts and
regional educational attendance areas; and relating to charter
schools and correspondence programs."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 379
SHORT TITLE: CONTROLLED SUBSTANCES, INCL. ANALOGS
SPONSOR(s): REPRESENTATIVE(s) MEYER
01/18/06 (H) READ THE FIRST TIME - REFERRALS
01/18/06 (H) JUD, FIN
01/27/06 (H) JUD AT 1:00 PM CAPITOL 120
01/27/06 (H) Heard & Held
01/27/06 (H) MINUTE(JUD)
02/06/06 (H) JUD AT 1:00 PM CAPITOL 120
02/06/06 (H) Moved CSHB 379(JUD) Out of Committee
02/06/06 (H) MINUTE(JUD)
02/08/06 (H) JUD RPT CS(JUD) NT 3DP 1NR
02/08/06 (H) DP: WILSON, KOTT, MCGUIRE;
02/08/06 (H) NR: COGHILL
02/14/06 (H) FIN AT 1:30 PM HOUSE FINANCE 519
02/14/06 (H) Moved CSHB 379(JUD) Out of Committee
02/14/06 (H) MINUTE(FIN)
02/15/06 (H) FIN RPT CS(JUD) NT 9DP 1NR
02/15/06 (H) DP: STOLTZE, KERTTULA, JOULE, HAWKER,
WEYHRAUCH, MOSES, HOLM, FOSTER, MEYER;
02/15/06 (H) NR: KELLY
02/24/06 (H) TRANSMITTED TO (S)
02/24/06 (H) VERSION: CSHB 379(JUD)
02/27/06 (S) READ THE FIRST TIME - REFERRALS
02/27/06 (S) HES, JUD
03/13/06 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 299
SHORT TITLE: NONDISCRIMINATION HEALTH CARE PROVIDERS
SPONSOR(s): SENATOR(s) SEEKINS
02/14/06 (S) READ THE FIRST TIME - REFERRALS
02/14/06 (S) HES, L&C
02/22/06 (S) HES AT 1:30 PM BUTROVICH 205
02/22/06 (S) Heard & Held
02/22/06 (S) MINUTE(HES)
03/13/06 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 281
SHORT TITLE: SCHOOL DIST. ENROLLMENT SHARING/CORRESPON
SPONSOR(s): SENATOR(s) DYSON
02/13/06 (S) READ THE FIRST TIME - REFERRALS
02/13/06 (S) HES, FIN
03/01/06 (S) HES AT 1:30 PM BUTROVICH 205
03/01/06 (S) Heard & Held
03/01/06 (S) MINUTE(HES)
03/03/06 (S) HES AT 2:00 PM BUTROVICH 205
03/03/06 (S) Scheduled But Not Heard
03/13/06 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
Representative Kevin Meyer
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of HB 379.
Mike Pawlowski, Legislative Aide
Staff to Representative Meyer
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Provided information on HB 379.
Chris Beheim, Lab Supervisor
Alaska State Crime Lab
5500 E Tudor Rd.
Anchorage, AK 99507-1221
POSITION STATEMENT: Provided information on HB 379.
Senator Ralph Seekins
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of SB 299.
Mike Hogan, Executive Director
Alaska Physicians and Surgeons
4120 Laurel Street, Suite 206
Anchorage, AK 99501
POSITION STATEMENT: Provided information on SB 299.
Brian Hove, Legislative Aide
Staff to Senator Seekins
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Presented information on SB 299 for the
sponsor.
Greg Loudon, Vice President
Willis of Alaska
Anchorage, AK
POSITION STATEMENT: Testified in opposition to SB 299.
Rose Kalamarides, Administrator
Alaska Teamster-Employer Trust
Anchorage, AK
POSITION STATEMENT: Testified in opposition to SB 299.
ACTION NARRATIVE
CHAIR FRED DYSON called the Senate Health, Education and Social
Services Standing Committee meeting to order at 1:33:15 PM.
Present were Senators Gary Wilken, Lyda Green, Kim Elton, Donny
Olson and Chair Fred Dyson.
CSHB 379(JUD)-CONTROLLED SUBSTANCES, INCL. ANALOGS
CHAIR DYSON announced CSHB 379(JUD) to be up for discussion.
1:35:18 PM
REPRESENTATIVE KEVIN MEYER, sponsor of CSHB 379(JUD), said that
gamma-hydroxybutyric acid (GHB) is oderless, tasteless,
colorless, and easy to slip into a drink; consequently it is
gaining popularity as a date rape drug. He related an incident
that occurred in the state last year in which a 16-year-old girl
died, and an 18-year-old girl was put into a coma after
overdosing on GHB.
He said that none of the analogues of GHB are listed under state
statute because it is currently listed as a category IV
controlled substance. He said that HB 379 would correct this
oversight by elevating GHB to class one status, which has been
its status with the federal government since the year 2000. He
added that the bill would for allow the continued use of GHB in
industry.
1:37:20 PM
CHAIR DYSON said he assumed that most of the violations
associated with the drug would be prosecuted in state court if
this bill becomes law.
REPRESENTATIVE MEYER replied yes.
1:37:43 PM
MICHAEL PAWLOWSKI, staff to Representative Meyer, said that the
aforementioned overdose case was tried in a federal court
because the substance was not covered under state law.
1:38:11 PM
SENATOR OLSON asked why GHB should be made a Schedule I drug
when it does not share the addictive properties of other drugs
in that category.
REPRESENTATIVE MEYER replied that the federal government
recognizes GHB as a highly addictive drug.
1:39:33 PM
MR. PAWLOWSKI remarked that Alaska statute is behind federal
statute with regard to the classification of GHB because it has
only recently become a popular date rape drug.
SENATOR OLSON asked him to describe the effects GHB.
MR. PAWLOWSKI responded that is it slows the heart, respiratory
system, and it can cause amnesia. He said that a very small
quantity of the drug creates effects similar to that of severe
alcohol intoxication.
1:41:47 PM
SENATOR OLSON asked why this drug should be categorized as a
Schedule I drug when it is less addictive than other drugs in
that category.
MR. PAWLOWSKI replied that the federal government classified GHB
as a Schedule I drug because it is dangerous and addictive, it
causes serious withdrawal symptoms, and has significant
potential for widespread abuse.
1:42:06 PM
SENATOR OLSON asked how the drug causes fatalities.
MR. PAWLOWSKI replied the drug kills by causing respiratory
system failure and cardiac arrest.
CHAIR DYSON referenced the following from material presented
with the bill:
When ingested these analogues produce effects such as
relaxation, mild euphoria, and drowsiness. Such
effects are similar to the results of alcohol
intoxication. They also increase libido,
suggestibility, passivity, and amnesia - traits that
make users vulnerable to sexual assault and other
criminal acts. On awakening from a coma, users may
exhibit extreme combativeness, a condition that is
also observed in those addicted to GHB.
1:43:02 PM
CHRIS BEHEIM, Crime Lab Supervisor, Alaska State Crime Lab, said
that state law does not cover two of the analogues of GHB. He
affirmed that the federal government categorized GHB as a
Schedule I drug because of its high potential for widespread
abuse and because of its addictive properties.
SENATOR OLSON asked why metabolites of the drug clear so quickly
from the liver and the kidney.
MR. BEHEIM replied that question should be directed to a
toxicologist.
SENATOR OLSON asked whether metabolites of the drug are detected
through spectrometry tests.
MR. BEHEIM replied yes. He stressed that routine tests, such as
the ones conducted in a hospital, would not detect the drug or
its analogues.
1:45:49 PM
SENATOR ELTON asked how authorities establish whether the drug
has been used.
MR. BEHEIM replied that the state lab could detect the drug in a
liquid sample. He added that is how it was identified in the
aforementioned overdose case.
CHAIR DYSON remarked that the lab might one day have to equip
itself to detect the drug in blood and urine samples.
SENATOR OLSON asked whether there is a legal medical application
of GHB.
MR. BEHEIM replied that the drug has a legitimate medical
application that is protected under the state's controlled
substances statutes.
1:49:03 PM
SENATOR OLSON asked whether the medical community has expressed
its opinion on the passage of this bill.
MR. BEHEIM replied that the medical community has not expressed
an opinion on the bill.
1:49:31 PM
SENATOR OLSON moved to report CSHB 379(JUD) out of committee.
Without objection, CSHB 379(JUD) was reported from the Senate
Health, Education and Social Services Standing Committee.
SB 299-NONDISCRIMINATION HEALTH CARE PROVIDERS
CHAIR DYSON announced SB 299 to be up for discussion.
1:51:29 PM
CHAIR DYSON asked whether there was any objection to adopting
Version F as the working document. Without objection, it was so
ordered.
SENATOR SEEKINS, sponsor of SB 299, stated that this bill would
prevent insurance companies from discriminating against health
care providers who meet the terms and conditions of
participation in their insurance plans, policies, or contracts
for health care services.
1:53:18 PM
MIKE HOGAN, Executive Director, Alaska Physicians and Surgeons,
said that he was available to answer questions on SB 299.
CHAIR DYSON asked him to summarize his previous testimony.
MR. HOGAN responded that the passage of this bill ensures that
doctors who meet the credential and licensure requirements for a
given health plan could not be denied admission to that plan.
He added that this bill would allow Alaska residents to see
doctors who are not members of their health care plans.
CHAIR DYSON asked what it means for a physician to be admitted
into a plan.
1:54:20 PM
MR. HOGAN responded that typically, health plan managers
construct a panel of providers to establish well-rounded plans;
however, certain groups are often excluded from these panels for
various reasons. This bill would allow health care
professionals to join any plan that they are qualified to join.
1:55:02 PM
SENATOR SEEKINS remarked that many provider types and services
listed in the original A version of the bill were removed in the
F version.
1:55:56 PM
SENATOR ELTON asked how the bill's list of providers was
established. He asked specifically why hospital based services
were removed from the F version.
1:57:09 PM
BRIAN HOVE, staff to Senator Seekins, replied that some of the
provider types listed in the original version were removed at
the request of the drafter because they were not compatible with
definitions in existing statute. He said, for example, that
statute defines "health care provider" as a state licensee that
is certified or otherwise authorized.
CHAIR DYSON called an at-ease from 1:58:23 PM to 1:58:45 PM.
1:59:25 PM
SENATOR ELTON asked why hospital services were excluded from the
bill while rural health services remained in it.
SENATOR SEEKINS replied he excluded them at the request of
hospital managers who asserted that the bill should apply to
persons and not inanimate objects.
SENATOR ELTON remarked that the same argument could be applied
to clinics, which are covered under the bill.
SENATOR SEEKINS replied that while that is correct, rural
clinics are generally not billed by members of their staff. He
added that when he made the list he tried to accommodate the
requests of health care providers who requested to be included
or excluded from it.
2:01:34 PM
CHAIR DYSON said the bill would be held in committee at the
request of the sponsor. He added that the state's current
public health director supports the establishment of a
comprehensive public information database that lists the state's
health care providers and their track records. He said he could
imagine a circumstance in which a patient might want to visit a
hospital with a better record of performance when given a choice
to do so.
SENATOR ELTON remarked that he appreciated the comments of the
chair and sponsor and requested they contact his office for
further discussion of the matter. He said he would like to know
why long-term care facilities and rural health clinics are
included in the bill while hospitals were excluded. He asked
why respiratory therapists were removed while audiologists were
not.
SENATOR SEEKINS replied that respiratory therapists were
excluded from the list because they do not fit the statutory
definition of "health care providers."
2:04:34 PM
SENATOR GREEN asked why certain doctors are granted membership
in health care plans while other qualified doctors were
excluded.
MR. HOGAN replied that many physicians join major health care
plans because they cover so many potential patients. He added
that the bill would confer an advantage to physicians because
patients covered under major providers would not be penalized
for seeing them.
2:07:40 PM
SENATOR GREEN asked him whether physicians currently covered
under insurance plans pay less than 100 percent of the regular
cost of insurance.
MR. HOGAN replied that in Alaska they typically pay 90 to 95
percent of the regular cost.
SENATOR GREEN asserted that insurance companies offer a discount
to certain physicians to attract a greater volume of customers.
MR. HOGAN replied that is correct in the case of Blue Cross. He
commented that Alaska is woefully short of physicians and that
insurance plans further limit the access of many patients to
their preferred practitioners.
2:09:41 PM
SENATOR GREEN remarked that the passage of this bill would
diminish the revenue of insurance providers because they would
have to offer their discounts to every qualified physician that
requests membership.
MR. HOGAN acknowledged the concern and remarked that the bill
was drafted in the interest of making doctors more accessible to
patients and improving the continuity of care for patients when
they change their health care plans. He referenced a letter
from the Kentucky Environmental and Public Protection Cabinet
that indicated it had a similar law on the books for a while and
couldn't find any long-term impacts on the amount employers paid
for premiums.
2:12:15 PM
SENATOR WILKEN stated his concern over letters from AETNA and
Beach Street Corporation that speak markedly to the fact that
this legislation will increase the cost of insurance across the
state. He added that the Federal Trade Commission (FTC) stated
in a July 2004 report that they are against any willing provider
legislation. He asked Mr. Hove to consider how the Department
of Justice and FTC would respond to this legislation per the
remarks in the aforementioned letters.
MR. HOGAN replied that he did not have the report or the letters
before him and could not offer an opinion at the present time.
SENATOR WILKEN suggested that he review the report and the
letter and consider how this legislation may run contrary to
what the FTC, AETNA, and Beach Street Corporation are
suggesting.
2:14:28 PM
SENATOR OLSON stated for the record that he is a licensed
medical physician and is not on any preferred medical provider
list.
CHAIR DYSON stated for the record that his retired wife's former
profession is listed in the bill.
2:15:23 PM
TOM BRICE, Alaska District Council of Laborers, Laborer's Local
942, Local 341, and Public Employees Local 71, opposed SB 299.
He said that the organizations he represents believe that the
legislation will hinder their ability to procure the best health
care arrangements for their employees. He said these
organizations are currently able to negotiate favorable
arrangements with health care providers by offering them the
patronage of their members. He said that if this bill passes,
the organizations will lose the power to negotiate and the cost
of their health care will increase.
2:18:16 PM
SENATOR GREEN asked what would be the eventual outcome if all of
the practitioners qualified to become preferred providers
actually became preferred providers.
MR. BRICE replied that there would ultimately be no preferred
provider status because no organization could offer customer
volume in exchange for lower rates.
2:21:33 PM
GREG LOUDEN, Vice President, Willis of Alaska, said that Senator
Green expressed many his organization's concerns about the bill.
He said that the bill would limit the value of many current
contracts. He added that in fiscal year 2004, [Indiscernible
2:22:51 to 2:22:54] estimated that changing from a directed
preferred provider organization (PPO) to an open PPO was going
to save $1.5 million per year for the state. In the last year
the estimate was not a dollar figure but four percent of the
gross cost, which comes out to almost the exact same amount,
$1.5 million per year.
2:23:50 PM
ROSE KALAMARIDES, Administrator, Alaska Teamster-Health Plan,
said that this bill was introduced under the preface that
individuals buy their own health care. However, of the $5
billion spent on health care in Alaska last year, only five
percent was paid on individual policies.
She said that Alaska has the highest cost of health care in the
nation and added that spending on health care in the state is
expected to increase at the rate of approximately 9 percent a
year.
MS. KALAMARIDES said this legislation would impact employers
directly and negatively because they would not longer be able to
offer customer volume in exchange for discounts. Consequently,
their already large health care costs would increase and they
would undoubtedly transfer some of the new costs to their
employees.
She said this type of legislation has been popular in states
with managed health care. However, there is virtually no managed
care in Alaska and therefore the scare tactics offered by the
proponents of this legislation are a smoke screen. She said
this legislation is intended for the benefit of doctors and
nothing more.
MS. KALAMARIDES said that according to recent I-Search study,
medical and surgical procedures in Alaska cost 18 percent more
than elsewhere in the United States. Doctors in Alaska are paid
well and do not have to contend with HMOs. She said that
regulating this industry through anti-compete legislation may
have made sense when we were living in an economy with heavily
regulated industries, but today it only serves the interest of
doctors. She urged the committee not to pass SB 299.
2:28:31 PM
CHAIR DYSON held SB 299 in committee.
SB 281-SCHOOL DIST. ENROLLMENT SHARING/CORRESPON
2:28:50 PM
CHAIR DYSON announced SB 281 to be up for discussion.
2:29:33 PM
CHAIR DYSON moved to adopt the proposed committee substitute,
Version I as the working document. He objected for discussion
purposes of discussion. He said:
The I-version says that an enrolling school district
will receive the same amount of state revenue as the
school district of residence would have received had
the student enrolled in his home district, but only if
the enrolling district has a contract with the
district of residence. It specifies that the district
of residence is to provide the educational facility
and the routine mentoring and supervision - it is
called daycare here - of the student, and student
behavior responsibilities and if not, the student will
be funded at the same [level] as a correspondence
student at 80 percent of the funding with no allowance
for district cost factors.
2:31:11 PM
CHAIR DYSON removed his objection and asked whether there was
any objection to adopting Version I. Without objection, Version
I was adopted and the chair announced that SB 281 would be held
over.
CHAIR DYSON adjourned the Senate Health, Education and Social
Services Standing Committee meeting at 2:31:36 PM,
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