HB 73-EXTEND STATE MEDICAL BOARD Number 1546 CHAIR ANDERSON announced a hearing on HOUSE BILL NO. 73, "An Act extending the termination date of the State Medical Board." REPRESENTATIVE DAHLSTROM, sponsor of HB 73, testified that the bill extends the termination date of the State Medical Board for four years. She described the membership of the eight-member board, which is appointed by the governor. She also said: The board serves the public interest by establishing the minimum education and work-experience requirements that individuals must meet to become licensed physicians, osteopaths, podiatrists, paramedics, and physician assistants. The board further serves the public interest by investigating complaints against licensed professionals and taking disciplinary action when appropriate and necessary. The board has consistently proven to be efficient; therefore I recommend that the State Medical Board be extended to June 30, [2007], and I urge you to vote for its passage. Number 1641 REPRESENTATIVE ROKEBERG asked why the sponsor didn't follow the recommendation of the legislative audit report for an eight-year extension. KIMBERLY HANGER, Staff to Representative Nancy Dahlstrom, Alaska State Legislature, quoted AS 08.03.020, which sets the four-year extension for a board unless it is continued or reestablished for a longer period. REPRESENTATIVE ROKEBERG noted that the legislature can continue the board longer than the four-year period if it chooses, depending on the level of confidence the legislature has in the board's work. The board has been in the headlines frequently, holding disciplinary hearings, and perhaps, he surmised, that means it's doing a good job. It's a judgment call how long to extend the sunset provision. Often, the legislative audits expose problems in the statute or the regulations of a board. A shorter sunset period allows the legislature to review the results of previous changes to the law. Number 1811 PAT DAVIDSON, Legislative Auditor, Legislative Audit Division, Alaska State Legislature, explained that the audit report [No. 08-20017-02] recommended an eight-year extension to 2011 for several reasons. Auditors found that the board was actively working on statutory and regulatory development of items in the public interest. The board was functioning smoothly and there were no financial problems with its operations. It's unusual for her office to recommend such a lengthy extension of the board, she said, and the statutes indicate a preference for four-year extensions. She reminded legislators that they can ask her agency to review a board if they see problems. MS. DAVIDSON answered Representative Lynn's questions about the details of board members' terms and appointments. She said the eight members' terms are four-years and staggered; members are appointed by the governor and approved by the legislature. MS. DAVIDSON replied to Representative Rokeberg's query about the statute controlling the extension of the boards, AS 08.03.020. She said the statute gives legislators leeway to put whatever year they'd like on the termination date. Number 1965 MS. DAVIDSON, as requested by Representative Rokeberg, explained the one-year closeout period provided by state law if the legislature chooses not to extend the termination date of a board. She explained that the licensing function may remain and be administered by the Division of Occupational Licensing even if the board dissolves. When a board shuts down, the division loses the voice of the professionals it is regulating. It is more difficult to make changes in statute and regulations, which as a result tend to get stale. Because a board only meets several times a year, those activities would get shelved during a wind-down year. MS. DAVIDSON answered a question from Representative Guttenberg about the State Medical Board's taking an active role in shaping state laws and regulations. She said its members testify before the legislature on bills and develop regulations to support the statutes. REPRESENTATIVE GUTTENBERG noted the board's 413 investigative cases referenced in the audit and asked whether any resulting legal challenges handled by the Department of Law have affected the board's budget. MS. DAVIDSON replied that most times when the Department of Law does work associated with a licensing board, the department charges the board for those services. Number 2135 REPRESENTATIVE DAHLSTROM said that as the sponsor of the bill, she favors the four-year period because the medical industry is changing so rapidly, and this allows the legislature to review the board again in four years. MS. HANGER noted that the committee's bill packet includes a letter from the former director of the Division of Occupational Licensing, Catherine Reardon, agreeing with the audit's recommended eight-year extension. Number 2176 REPRESENTATIVE GATTO agreed with the sponsor's choice of a four- year extension. He commented that a board might increase its activities as it sees a termination date approaching. He has followed the news of the board's investigations reported in the newspaper. He has worked as a paramedic in Anchorage for 28 years and is familiar with some of the professionals being investigated. MS. DAVIDSON replied to Representative Guttenberg's question about whether a board's activity increases as it nears its termination date. She said it depends on the particular board. Some boards prefer to have their sunset extension handled separately from any changes to their governing statues. Other boards may be going through growing pains and may be more active before a sunset review. Number 2355 RICK URION, Director, Division of Occupational Licensing, Department of Community & Economic Development, said the division supports HB 73 and asked the committee to pass it on. He said the department has no problem with either a four-year or eight-year extension of the board. Setting the term of the board does not affect the four-year term of the members, and he's not aware of any boards that become more active at the approach of sunset. TAPE 03-7, SIDE B  Number 2370 MR. URION said the Medical Board is extremely active and has handled a number of disciplinary actions, which causes their administrative costs to rise. He discussed how diplomacy actions affect the licensing fees, and for professions with fewer members, that can have a severe impact. He said the State Medical Board is about $190,000 in the hole, and he predicted next year will be a quieter year with less investigative activity. The fee for physicians is $590 as of the beginning of the year, and the next renewal is in 2004. MR. URION replied to Representative Lynn's question about when an investigation becomes public. He said under current division policies, a complaint becomes public right away. But the division is working on adding an intermediate step in which a complaint would be screened for validity before beginning an investigation. Number 2139 REPRESENTATIVE GATTO asked how a patient can take action against an incompetent physician. He also questioned whether the medical profession is truly self-policing. MR. URION replied that the patient can file a complaint about the doctor with the Division of Occupational Licensing. He added that it's easier for physicians to assess the competency of their peers, now that they've been relieved of the liability under a change in state law [AS 08.64.362] several years ago. CHAIR ANDERSON invited Mr. Urion to brief the committee at a future meeting about complaint procedures and the budget impact of these procedures. Number 1935 REPRESENTATIVE DAHLSTROM, in response to a question from Representative Rokeberg, said she is not comfortable with increasing the four-year extension, but she is willing to talk to Senator Con Bunde, who is sponsoring a similar bill. Number 1856 REPRESENTATIVE LYNN moved to report HB 73 out of committee with individual recommendations and the accompanying fiscal note. There being no objection, HB 73 was reported from House Labor and Commerce Standing Committee.