05/02/2007 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB215 | |
| HB113 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 113 | TELECONFERENCED | |
| + | HB 215 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
May 2, 2007
1:29 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator John Cowdery
Senator Fred Dyson
Senator Joe Thomas, Vice Chair
Senator Kim Elton
MEMBERS ABSENT
All members present
OTHER LEGISLATORS PRESENT
Representative Anna Fairclough
Representative Bill Thomas
COMMITTEE CALENDAR
CS FOR HOUSE BILL NO. 215(HES)
"An Act relating to the establishment of a task force to review
the Council on Domestic Violence and Sexual Assault."
MOVED CSHB 215(HES) OUT OF COMMITTEE
CS FOR HOUSE BILL NO. 113(HES)
"An Act relating to the prescription and use of pharmaceutical
agents, including controlled substances, by optometrists."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 215
SHORT TITLE: TASK FORCE RE: COUNCIL ON DOM. VIOL.
SPONSOR(s): REPRESENTATIVE(s) FAIRCLOUGH
03/21/07 (H) READ THE FIRST TIME - REFERRALS
03/21/07 (H) HES, FIN
04/10/07 (H) HES AT 4:00 PM CAPITOL 106
04/10/07 (H) Moved CSHB 215(HES) Out of Committee
04/10/07 (H) MINUTE(HES)
04/11/07 (H) HES RPT CS(HES) 6DP
04/11/07 (H) DP: CISSNA, FAIRCLOUGH, GARDNER,
SEATON, ROSES, WILSON
04/18/07 (H) FIN AT 1:30 PM HOUSE FINANCE 519
04/18/07 (H) <Bill Hearing Postponed to 4/20/07>
04/20/07 (H) FIN AT 1:30 PM HOUSE FINANCE 519
04/20/07 (H) Moved CSHB 215(HES) Out of Committee
04/20/07 (H) MINUTE(FIN)
04/23/07 (H) FIN RPT CS(HES) 5DP 1NR
04/23/07 (H) DP: GARA, CRAWFORD, THOMAS, HAWKER,
MEYER
04/23/07 (H) NR: KELLY
04/25/07 (H) TRANSMITTED TO (S)
04/25/07 (H) VERSION: CSHB 215(HES)
04/27/07 (S) READ THE FIRST TIME - REFERRALS
04/27/07 (S) HES, FIN
BILL: HB 113
SHORT TITLE: OPTOMETRISTS' USE OF PHARMACEUTICALS
SPONSOR(s): REPRESENTATIVE(s) SAMUELS
01/30/07 (H) READ THE FIRST TIME - REFERRALS
01/30/07 (H) HES, L&C
03/20/07 (H) HES AT 3:00 PM CAPITOL 106
03/20/07 (H) Heard & Held
03/20/07 (H) MINUTE(HES)
03/31/07 (H) HES AT 12:30 AM CAPITOL 106
03/31/07 (H) Moved CSHB 113(HES) Out of Committee
03/31/07 (H) MINUTE(HES)
04/02/07 (H) HES RPT CS(HES) 4DP 1NR 2AM
04/02/07 (H) DP: CISSNA, SEATON, NEUMAN, FAIRCLOUGH
04/02/07 (H) NR: GARDNER
04/02/07 (H) AM: ROSES, WILSON
04/11/07 (H) L&C AT 3:00 PM CAPITOL 17
04/11/07 (H) Moved CSHB 113(HES) Out of Committee
04/11/07 (H) MINUTE(L&C)
04/13/07 (H) L&C RPT CS(HES) 1DP 6NR
04/13/07 (H) DP: LEDOUX
04/13/07 (H) NR: GARDNER, BUCH, RAMRAS, NEUMAN,
GATTO, OLSON
04/19/07 (H) BEFORE THE HOUSE
04/20/07 (H) TRANSMITTED TO (S)
04/20/07 (H) VERSION: CSHB 113(HES)
04/23/07 (S) READ THE FIRST TIME - REFERRALS
04/23/07 (S) HES, L&C, FIN
05/02/07 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
Representative Fairclough
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of HB 215
Chris Aschenbrenner, Interim Program Administrator
Council on Domestic Violence and Sexual Assault
POSITION STATEMENT: Available for questions on HB 215
Representative Samuels
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of HB 113
Dr. Mike Bennett, President
Alaska Optometric Association
POSITION STATEMENT: In support of HB 113
Bob Losher, representing himself
POSITION STATEMENT: In opposition to HB 113
Carl Rosen, representing himself
POSITION STATEMENT: In opposition to HB 113
Cindy Bradford
American Family of Ophthalmology
POSITION STATEMENT: In opposition to HB 113
Jill Matheson, chair
Alaska Board of Examiners in Optometry
POSITION STATEMENT: In support of HB 113
Eric Colter, representing himself
POSITION STATEMENT: In opposition to HB 113
Peter Cavanaugh, representing himself
POSITION STATEMENT: In opposition to HB 113
ACTION NARRATIVE
CHAIR BETTYE DAVIS called the Senate Health, Education and
Social Services Standing Committee meeting to order at 1:29:40
PM. Present at the call to order were Senators Dyson, Cowdery
and Chair Davis. Senators Elton and Thomas arrived soon
thereafter.
CSHB 215(HES)-TASK FORCE RE: COUNCIL ON DOM. VIOL.
CHAIR BETTYE DAVIS announced CSHB 215(HES) to be up for
consideration.
REPRESENTATIVE FAIRCLOUGH, sponsor of HB 215, said that the bill
will create a task force to review the Council on Domestic
Violence and Sexual Assault, which has been indicated to need
improvement. The task force will help retool the functioning and
mission of the council, specifically in the area of prevention.
20 out of the last 27 years, Alaska has had the highest per
capita number of rapes in the nation.
1:32:53 PM
SENATOR COWDERY asked when the task force will present its
report.
REPRESENTATIVE FAIRCLOUGH replied that the date was moved to
February should the bill pass from both bodies, and the task
force would be meeting during the interim.
1:33:24 PM
SENATOR DYSON said that little boys are assaulted at very high
rates in Alaska as well, and shouldn't be ignored. Apparently
prison rape rates are low in Alaska, but that's the only bright
spot in the issue.
REPRESENTATIVE FAIRCLOUGH commented on how rapes often go
unreported.
1:34:34 PM
CHAIR DAVIS said that she supports the bill, and asked if the
money funding the council will come from the Department of
Public Safety (DPS).
REPRESENTATIVE FAIRCLOUGH replied that it will, and said that
there were members of that department available for questions.
The council will pay for its members to travel, but the DPS will
pay for others' travel.
1:36:05 PM
CHRIS ASCHENBRENNER, Interim Program Administrator for the
Council on Domestic Violence and Sexual Assault, said she's in
favor of the bill and that people who work with victims of
domestic violence welcome any measures to aid their cause. She
added clarification of how travel expense for the task force
will be paid for.
1:37:56 PM
SENATOR COWDERY moved to report CSHB 115(HES) from committee
with individual recommendations and attached fiscal note(s).
There being no objection, the motion carried.
CSHB 113(HES)-OPTOMETRISTS' USE OF PHARMACEUTICALS
1:39:42 PM
CHAIR BETTYE DAVIS announced CSHB 113(HES) to be up for
consideration.
REPRESENTATIVE SAMUELS, sponsor of HB 113, said that the bill
will allow optometrists to prescribe oral medications to
patients; their prescriptive powers are currently limited to
topical medications. Because of the remoteness of many parts of
Alaska, better access to health care needs to be provided. The
bill is trying to open access to care in an area with wide
geographical dispersion and high costs. The rest of the country
has implemented such bills safely, and Alaska should be able to
do so as well.
1:42:03 PM
DR. MIKE BENNETT, president of the Alaska Optometric
Association, said that the association supports the bill, while
understanding that here may need to be an amendment regarding
injectable drugs. The bill will increase access to high-quality
health care for Alaskans.
He added that the chair of the Optometry Board of Alaska was
present and could answer questions.
1:43:45 PM
SENATOR COWDERY asked for an explanation of additional required
training.
DR. BENNETT replied that everything covered in the bill is
included in current optometric education and has been for the
last 25 years; in the state the privilege hasn't been available
in the past so a requirement for refresher courses wouldn't be
out of line.
SENATOR COWDERY asked if the bill would require any special
training beyond what optometrists usually receive.
DR. BENNETT said that the bill does provide for additional
training regarding injectable drugs and oral medications.
CHAIR DAVIS remarked that the committee substitute would be
addressed after public testimony.
1:45:28 PM
SENATOR THOMAS asked if the suggested changes in the bill have
been discussed with those in opposition of the bill.
DR. BENNETT replied that they haven't worked directly in
conjunction.
SENATOR THOMAS said that there is reference to injection
training courses in the bill, asked if it was in the committee
substitute, and asked for comment; he opined that a seven-hour
course may not be sufficient.
1:47:12 PM
DR. BENNETT replied that the injectables referred to in the bill
wouldn't necessary entail a whole new way of application. He
clarified that there is specific prohibition against injection
into the eyeball.
1:48:19 PM
BOB LOSHER, representing himself, related his work and health
history, and said that he opposes the committee substitute. Eye
health is important to bodily health and people need to be
qualified to work with eyes. The expansion promoted in the bill
isn't in the best interest of public health and safety. Training
of optometrists isn't as intensive as that of ophthalmologists,
who take other health matters into account; people should be
careful to have comprehensively trained health providers, and
eye medications can be very powerful. He concluded that the
argument seems to be between two professional organizations, and
very few lay-people are coming forward to speak out; the
legislature needs to view the matter as one of public interest
and ensure that quality medical services are available in
Alaska.
1:55:23 PM
REPRESENTATIVE THOMAS, co-sponsor of the HB 113, said that it's
a necessary tool for rural communities; it's expensive for
people to fly to bigger cities to see ophthalmologists when an
optometrist is already there and could prescribe needed
medication. There are only 20 ophthalmologists in Alaska and
they don't serve many of the state's smaller communities. The
bill is very important and much-needed.
1:57:54 PM
CHAIR DAVIS commented that she doesn't see the bill as being a
fight between two professional factions; people from both sides
work well together.
1:58:50 PM
CARL ROSEN, representing himself, said that there's a reason
it's difficult to get admission to medical school; the bar for
medical training is high so that people can get the best
possible care. He described his work history, and said that
there are 40 ophthalmologists in the state, many of whom travel
to rural communities. There has been no public outcry from
people who may have suffered because of the lack of
ophthalmologists. Telemedicine is helpful for treating people
living in rural areas, and the technology will only get better.
He explained that the bill expands the scope of treatment
dramatically; the bill would give Alaska the most liberal laws
in the country, which would give optometrists more powers than
ophthalmologists. A seven-hour course is not sufficient for
learning how to inject drugs. People should get high quality
health treatment no matter where they are; if an optometrist
needs to give out a medication, there should be more policing by
trainers and boards. Letting the optometric board decide on
policy is not acceptable; a committee should be set up.
2:07:33 PM
CHAIR DAVIS said that there has already been opportunity for
comment and suggestions on the bills, and she hoped Mr. Rosen
would be willing to work on it.
2:08:09 PM
CINDY BRADFORD, representing the American Family of
Ophthalmology, said that she is in opposition to HB 113.
Allowing the application of drugs to other parts of the body
besides the eye is dangerous; she voiced her uncertainties about
the language of the bill as regards injections. Medication given
in the eye has an effect on the entire body and could have
negative ramifications. She gave examples of inherent medication
risks, and said that optometrists do not have sufficient
training or experience for the powers granted by the bill;
patients deserve quality medical care. Rural or urban patients
requiring more intensive treatment than topical drugs should be
treated by a doctor. Diagnosis and treatment of eye diseases
could be delayed by initial improper treatment by an
optometrist.
2:13:53 PM
JILL MATHESON, chair of the Alaska Board of Examiners in
Optometry, clarified that the board does know its job, which is
to protect the public; it holds public meeting just like any
other board and operates under the same rules as the state
medical board. Optometrist are not trying to become
ophthalmologists, and the bill prohibits them from treating
cardiac or other issues; the medications they would be using are
only for treating eye issues.
She said that to get an optometry license in the state, there's
a licensing process after eight years of higher education; the
additional education written in the bill would be specifically
for oral medications. The seven-hour class isn't hands-on
training; such training is already covered in standard
optometric training.
She explained the classes that would be required by the
legislation, which have been used by other states with the same
laws.
2:17:04 PM
ERIC COLTER, representing himself, said that he opposes the bill
but is open to changing the scope. There hasn't been an outcry
about lack of eye care; it's important to know that optometrists
can already prescribe a variety of medications, and there's no
lack of care in Alaska that warrants such expanded powers. The
bill represents a paradigm shift, and presents dangers to the
public. To vote for the bill is to go against the reasoning of
the state medical board, and might lead to inappropriate care.
The bill is too loosely structured; it would allow injections
that are not related to optometry. It doesn't reflect an effort
at community improvement but rather reveals special interest
policy.
2:23:23 PM
CHAIR DAVIS commented that it's not too late for suggestions to
be made on the bill, and asked if Mr. Colter had read the bill.
MR. COLTER replied that he had read what was available online.
CHAIR DAVIS said that she could provide him with the bill.
MR. COLTER replied that he has read it online, and repeated his
opposition to the bill; it's possible that some compromise could
be reached.
CHAIR DAVIS said that it's the responsibility of the state
boards to keep up with the progress of the bill, and nobody had
come forward up to that point.
MR. COLTER replied that he doesn't represent the board.
2:25:50 PM
PETER CAVANAUGH, representing himself, related his work history
in ophthalmology, and said that he rarely has occasion to use
the medicines covered in the bill and in fact let his license to
do so lapse because he used them so rarely. If he can practice
without doing so, optometrists should be able to do so as well.
2:29:01 PM
CHAIR DAVIS commented that optometrists have extensive training,
and said she hoped Mr. Cavanaugh would help work to improve the
bill.
MR. CAVANAUGH said that optometrists don't want to be regulated
by a medical board, but by laypeople.
CHAIR DAVIS replied that the medical board was uninterested in
having optometrists under their jurisdiction.
MR. CAVANAUGH replied that that was not true. He repeated his
opinion that optometrists do not wish to be regulated by the
medical profession.
CHAIR DAVIS held HB 113 for further work and, seeing no further
business to come before the committee, adjourned the meeting at
2:31:35 PM.
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