Legislature(1993 - 1994)
02/24/1994 02:20 PM L&C
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
SENATE LABOR AND COMMERCE COMMITTEE February 24, 1994 2:20 p.m. MEMBERS PRESENT Senator Tim Kelly, Chairman Senator Steve Rieger, Vice-Chairman Senator Bert Sharp Senator Georgianna Lincoln Senator Judy Salo MEMBERS ABSENT NONE COMMITTEE CALENDAR SENATE BILL NO. 266 "An Act extending the termination date of the Board of Certified Direct-Entry Midwives; relating to the scope of practice of certified direct-entry midwives; and providing for an effective date." SENATE BILL NO. 213 "An Act extending the Alaska Public Utilities Commission and the regulatory cost charge." PREVIOUS SENATE COMMITTEE ACTION SB 266 - NO PREVIOUS ACTION. SB 213 - See Labor & Commerce minutes dated 9/28/93 and 2/8/94. WITNESS REGISTER Annette Krietzer, Aide Senator Loren Leman State Capitol Juneau, AK 99801-1182 POSITION STATEMENT: Introduced SB 266. Wendy Thon Alaska Nurses Association 237 E. 3rd Avenue, #3 Anchorage, Alaska 99501-2523 POSITION STATEMENT: Opposed SB 266. Pam Weaver, Member Board of Certified Direct-Entry Midwife OFFNET - 907-373-3420 Wasilla, Alaska 99687 POSITION STATEMENT: Supports SB 266. Kaye Kanne, Chairperson Board of Certified Direct-Entry Midwife P.O. Box 200 Talkeetna, Alaska 99676 POSITION STATEMENT: Supports SB 266. Don Schroer, Chairman Alaska Public Utilities Commission 1016 W. 6th, Suite 400 Anchorage, Alaska 99501-1963 POSITION STATEMENT: Testified on SB 213. David Hutchens, Director Alaska Rural Electric Cooperative Association 703 West Tudor Road, Suite 200 Anchorage, Alaska 99507 POSITION STATEMENT: Testified on SB 213. Randy Welker, CPA Legislative Auditor Legislative Budget & Audit Committee P.O. Box 113300 Juneau, Alaska 99811-3300 POSITION STATEMENT: Testified on SB 213. ACTION NARRATIVE TAPE 94-11, SIDE A Number 001 CHAIRMAN TIM KELLY called the Labor and Commerce Committee meeting g to order at 2:20 p.m. SENATOR KELLY introduced SB 266 (DIRECT-ENTRY MIDWIVES/BOARD & PRACTICES) sponsored by SENATOR LOREN LEMAN, and invited ANNETTE KRIETZER, Aide to SENATOR LEMAN. to testify. MS. KRIETZER gave a brief review of the six sections in a Sectional Analysis, and she began by explaining SB 266 would extend the termination date of the Board of Certified Direct-Entry Midwives, define the scope of practice of certified direct-entry midwives, and provide for an effective date. MS. KRIETZER directed the attention of the committee to a report prepared by RANDY WELKER, CPA, for the Legislative Budget and Audit Committee. She quoted SENATOR LEMAN as being encouraged by the professionalism of the allied health professionals such as physical therapists, nurse practioners, physician Assistants, and others who have called SENATOR LEMAN'S office, fearful they were being kept out of the health care reform debate by physicians. MS. KRIETZER reviewed the letters in the bill packet, some in opposition and others in support of the bill, including a letter from GOVERNOR WALTER HICKEL. MS. KRIETZER explained she has drawn on her experience as a health policy maker in the Aleutians East Borough, and as the health director from her former community in the Aleutians, which involved hiring mid-level practioners for their clinic and emergency medical services, for her experise. She described how overlapping client populations can produce friction among health providers. Number 060 MS. KRIETZER focused on possible reservations about SB 266, which she determined had to do with putting into regulation the list of women, for whom a midwife may not knowingly assist in delivery. She directed attention to the statutes and reviewed the list in the bill packet dealing with the serious conditions that would preclude the assistance of a midwife. MS. KRIETZER defined the difference in practice by physicians assistants, EMTs, and nurses, all who practice under the liability protection of a physician, but she said advanced nurse practioners and midwives do not. She discussed the problems for the midwives in being solely liable for their work. SENATOR KELLY thanked MS. KRIETZER, and called on WENDY THON, on teleconference from Anchorage. Number 103 MS. THON identified herself as being on the Legislative Committee for the Alaska Nurses Association, and testified to some opposition to SB 266. She explained the nurses association does support the extension of the Direct-Entry Midwife Board until 1998. However, they had reservations concerning the scope of practice issues in Section 2, paragraph (6). MS. THON explained all professional groups are defined in statute, but the definition of direct-entry midwives does not indicate they see a certain subset or narrow group of population such as low risk pregnant women. She further explained the definition was lacking in statute without the specific language in AS 08.65.140 (a-f) as repealed in Section 4 of the bill. SENATOR KELLY turned the teleconference network to Wasilla to hear from PAM WEAVER, a member of the Board of Certified Direct-Entry Midwife. MS. WEAVER spoke to the comments from MS. THON and thought there could be an agreeable solution. She wanted the legislation to move forward. In Juneau, SENATOR KELLY invited KAYE KANNE, Chair of the Board of Certified Direct-Entry Midwife from Talkeetna, to testify. MS. KANNE testified in support of SB 266, the extension of the board, and moving the laundry list from the statute to regulation, where she thought it belongs - technically. Number 151 MS. KANNE explained the board has written thirty seven pages of regulations and licensed 20 midwives. She referred to the high risk list conditions in statute, which she said needs to be in regulation where the board can update it from year to year. She explained the list, which changes, was put in statute in 1985 when there was no board established. She further explained, although it was updated in 1992, the board was not yet in place and regulations hadn't been written yet. She thought updating was an important reason to put the list in regulation. MS. KANNE said the Legislature approved the creation of the Board of Certified Direct-Entry Midwife to regulate the practice of midwifery in Alaska, but midwives do not want to take on the liability of delivering high risk babies and have no intention of changing the list or deleting anything from it. She thought there might be additions in the future. SENATOR KELLY asked if that's the case, why does the board want to take it out of statute, and MS. KANNE answered that they might want to add to the list. She used an entry dealing with 42 weeks post dates, to explain the changes that have made in the medical guidelines. SENATOR KELLY suggested she was giving conflicting testimony on changing the list. MS. KANNE clarified they had no intention of making the list more lenient, and high risk deliveries would not be allowed. SENATOR KELLY asked for clarification on what was requested in Section 4, and MS. KANNE explained it was the statute on page 6 (d) of the booklet. Number 200 MS. KANNE explained, in researching other professional definitions, no other professional group had a laundry list of things they cannot do. SENATOR KELLY countered by saying there was a list for optometrists as opposed to ophthalmologists which don't. SENATOR RIEGER thought there was good policy in pushing as much practice as possible to primary care providers, but was concerned about the implications of the legislation in relation to proposed statutes. He wanted to see a list of what was being proposed before repealing current law. MS. KANNE explained why the list needed to be placed in regulation, but thought the regulations would be returned to the legislature for confirmation. MS. KRIETZER clarified the regulation process was a public process and allows for public comment, where concerns are raised. Number 245 SENATOR KELLY reminded MS. KRIETZER the bureaucracy enacts regulations all the time that people don't want, and he explained how the board could change the regulations. MS. KANNE said they have a certified nurse-midwife and an OB-GYN on the Board of Certified Direct-Entry Midwives as well as two direct- entry midwives and a public member. She explained it has been an agreeable membership, and everyone wanted to see the safe practice of midwives. She referred to the regulations the board has written and said they were strict. SENATOR KELLY said he didn't see the necessity for change and asked MS. KRIETZER for her answer. MS. KRIETZER explained the changes would make it more accessible for a board through the public process to keep up with changes in medical standards, and she explained possible changes in standard of care. SENATOR LINCOLN admitted to being confused on the changes, and she quizzed MS. KANNE on the reasons for the changes. She asked if there was anything on the list that should not be in statute, and MS. KANNE repeated her contention about updating the list. She referred to the 1992 changes, when the board met with the nurses association, and she reviewed the additions to the list at that time. Number 297 SENATOR LINCOLN asked if it was difficult to get the changes, and MS. KANNE reviewed the 1992 changes that set up the board. SENATOR LINCOLN asked if there was anything on the list now that needed to be changed, and MS. KANNE said there wasn't, but she knew the guidelines change each year. SENATOR LINCOLN assured MS. KANNE the legislature has always complied to the wishes of the midwives, and she didn't think it was difficult to get a statute changed. MS. KANNE said the midwife association cannot afford a lobbyist, and since she lives in Talkeetna, it is difficult and expensive to come to Juneau. SENATOR LINCOLN said she has 93 communities who are in her same shoes, but she thought the prevailing mechanism was the one for the legislature to use. She didn't think there should be a need to hire a lobbyist each time a change in statute is required, and she suggested the committee hold the bill. SENATOR KELLY admitted to the same reservations, but had no opposition to extending the board, and there was agreement among the members of the committee. SENATOR KELLY said he would hold the bill and work with SENATOR LEMAN'S staff for a future meeting for some other arrangement. SENATOR SHARP said he would want some idea as to what is proposed. SENATOR KELLY returned SB 213 (ALASKA PUBLIC UTILITIES COMMISSION EXTENSION AND REGULATORY COST CHARGE) sponsored by the Senate Labor and Commerce Committee, and announced the committee would be looking at some potential amendments. SENATOR KELLY proposed to adopt a working draft from the amendments being proposed and return with a committee substitute another time. SENATOR KELLY invited DON SCHROER, Chairman of the Alaska Public Utilities Commission to make some proposed amendments, and he said he would like to make some comments. Number 349 MR. SCHROER said he would review the Proposed Amendments for SB 213 as presented by the committee. He began by noting the words, liberally construed, which ARECA has asked to have removed from the statutes, but he reminded the committee the language has been discussed by the supreme court in HEA v. City of Kenai, which he reviewed. MR. SCHROER asked if there has ever been any abuses by the commission of the public, persons, or a utility in the use of "liberally construed." He told the committee the commission could work with any statutes the legislators introduce, but he believed it would affect the ability of the commission, and he gave a couple of examples, the first being the problems in the cellular linkup with Barrow. SENATOR KELLY suggested the committee take each of the proposed amendments and discuss them in order. Amendment #1 - Replace the powers of the commission shall be liberally construed to accomplish its stated purpose in AS 42.05.141(a)(1) with the powers of the commission shall be those specifically conferred by the legislature or necessarily implied from those specific grants of authority. SENATOR KELLY asked who wanted to speak in favor of Amendment #1, and DAVID HUTCHENS, Director of the Alaska Rural Electric Cooperative Association,(ARECA) testified in support of amending the statute, because he has seen a number of instances where the commission in the past has broadened its power beyond any legislative history. He gave examples involving campaign contributions, lobbying expenses, environmental externality, and the Healy Clean Coal project. SENATOR KELLY said he didn't want to spend too much time on each of the amendments, because today's decisions won't be final until the committee looks at the proposed committee substitute at another meeting. SENATOR SHARP proposed Amendment #1 saying to leave the words in the bill would allow them to do as they wished, and he suggested it was a loaded gun. Number 401 MR. SCHROER explained legislation would be required whenever the court finds a gap, and he believed the APUC was established because the legislature did not want to deal with these decisions each time. Amendment #1 was not adopted on a 2 - 2 vote. SENATOR KELLY read the second amendment, which was proposed by the auditor and ARECA and opposed by APUC and ATA. Amendment #2 - Adjust the allocation of the Regulatory Cost Charge (RCC) (AS 42.05.253): MR. SCHROER opposed the amendment to keep the system simple and the costs down. RANDY WELKER, the Legislative Auditor, defended the amendment by explaining there were some basic time keeping systems that could be implemented at APUC, which would help in the rate setting process but also provide valuable management information on the work load and staff management. SENATOR KELLY proposed Amendment #2 to the committee. There being no discussion, the amendment was adopted. Next, SENATOR KELLY proposed Amendments #3 and #4, which were both adopted. Amendment #3 - Delete automatic repeal of RCC. (Proposed by Auditor. Supported by APUC.) Amendment #4 - To prevent RCC over-collection, amend AS 42.05.253 and 42.06.285 to ensure that over-collection does not lapse into the general fund, but rather would apply to the subsequent year thus reducing that year's RCC rate. (Proposed by APUC. Supported by ARECA.) SENATOR KELLY proposed Amendment #5 to the committee. Amendment #5 - Amend AS 42.05.711 to make it easier for utility consumers to opt in or opt out of economic regulation. (Proposed by Auditor.) MR. WELKER, the legislative auditor, explained the limits that were set awhile back haven't been changed, and it was felt the limits should be changed to make it easier for consumers to take part in the election process. He recommended that petition and election requirement should be modeled after AS 42.05.712. There was no opposition to Amendment #5, and the following amendment was adopted with no opposition, also. Amendment #6 - Stagger the terms of the APUC member's terms. Commissioners are appointed for a six year term. (Proposed by the Auditor. Supported by APUC and ARECA.) SENATOR KELLY proposed Amendment #7 to the committee. Amendment #7 - Amend the procurement code, AS 42.015.141, to provide an exemption for the APUC when procuring expert witnesses for cases. (Proposed by APUC and supported by ATA.) Number 453 SENATOR SHARP spoke in opposition to Amendment #7, commenting that when this has been done in the past, it has come back to bite us. SENATOR KELLY questioned MR. SCHROER as to the restrictions placed upon him in the procurement code to get expert witnesses. MR. SCHROER explained it was mainly time consumed by the procedure in getting the witness, time that was needed by the staff to collect the information needed for the case before the decision deadline. SENATOR SHARP said he had never seen a rate case expedited to the point of not allowing time to hire a consultant, since the hearing date was usually extended. SENATOR LINCOLN questioned the actual obligation of the provision, and she asked if it had been considered by the auditor. MR. WELKER said it was not an issue raised in the audit process, and he was not aware of how long it was a concern of the commission, but he conceded the audit was a bit dated. SENATOR LINCOLN expressed some concerns, and she asked for more examination by the auditors before the bill is passed from committee. She asked if the amendment could be held for another time. MR. SCHROER said there was no problem, since it is the way the commission has been operating, but he explained it would make it easier to operate. He said that SENATOR SHARP was correct in asking for extensions, but it delays the process. SENATOR LINCOLN pressed for an answer to how many times has there been a delaying factor in procuring expert witnesses, and MR. SCHROER gave an example of one with the Anchorage Telephone Utilities. SENATOR KELLY announced Amendment #7 died for lack of support. SENATOR KELLY introduced Amendment #8 to the committee and read the proposal by ATA: "The Alaska Telephone Association asserted that given the tremendous changes in technology within the telephone industry, the APUC doesn't have the ability to train their staff on a timely basis for such specialized knowledge, while waiting on a list of people to be hired within the State." Number 502 MR. SCHROER said the subject has not been discussed by the commission, and he described going through the requirements of hiring people on the register. He explained it was difficult to get personnel for technical positions, but the commission has not formally taken a position on the amendment. He thought someone from Anchorage might want to testify on the amendment. SENATOR KELLY checked the Anchorage teleconference, but found only observers. He brought the debate back to committee. MR. SCHROER said it was difficult and explained the commission had gone through three registers before finding someone qualified to handle the work, and he admitted it was difficult under the present code, but he stressed they had no official position on the code. SENATOR KELLY proposed Amendment #8 to committee as an idea worth exploring. Amendment #8 - Provide a waiver for the APUC from the state's hiring practices. (Proposed by ATA.) SENATOR LINCOLN opposed Amendment #8, saying she found it scary not to have some kind of a hiring practice. She expressed concerns that persons in Alaska, or local hire, would not get the first opportunity and would open the door to possible abuse. MR. SCHROER suggested there could be reasonable changes in the hiring practices. SENATOR KELLY admitted to being swayed by SENATOR LINCOLN'S comments and asked MR. FINK to get some restrictive language on Amendment #8. It was agreed the waiver might be for technical positions. The amendment was held for further action. Number 552 MR. WELKER asked for clarification on all of Amendment #3, since he had offered a solution and ARECA had proposed another one. There was some discussion on the proposals, and MR. WELKER said he would like to see the cost based on a reasonable approximation of the work that generates the costs using some kind of a time keeping system. SENATOR KELLY asked MR. FINK to come up with language to answer MR. WELKER'S suggestion. SENATOR SHARP suggested a formula be devised to fit part A of Amendment #2, and he thought part B explained how the dollars were collected from the utilities. SENATOR KELLY led the committee in adopting the following two proposals: (A) The APUC should periodically adjust the RCC factors to reflect workload on an industry by industry basis utilizing a timekeeping system, and (B) adjust the gross electric revenues by deleting the cost of power for electric utilities before the RCC is calculated." SENATOR KELLY announced there was a working draft for SB 213, which would be brought up at a future meeting. SENATOR KELLY reminded the committee of the Joint House/Senate Labor and Commerce meeting in the House committee room on Thursday, 3/3/94, on HSCR 3 - Disapproving Executive Order No. 89. There being no further business to come before the committee, the meeting was adjourned at 3:15 by SENATOR KELLY.