Legislature(2005 - 2006)HOUSE FINANCE 519
02/21/2006 03:00 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB236 | |
| HB150 | |
| HB334 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| SB 236 | |||
| = | HB 150 | ||
| = | HB 334 | ||
HOUSE BILL NO. 150
An Act requiring licensure of occupations relating to
radiology technology, radiation therapy, and nuclear
medicine technology; and providing for an effective
date.
3:52:07 PM
ED HALL, (TESTIFIED VIA TELECONFERENCE), PHYSICIAN ASSISTANT
IN FAMILY PRACTICE (PA-C), REPRESENTING THE ALASKA ACADEMY
OF PHYSICIAN ASSISTANTS, ANCHORAGE, testified against HB
150. He stated there has been a lack of justification to
impose licensing through the bill and that there are no real
facts to support the need for the bill.
Historically, Physician Assistants (PA) have been portrayed
as the only group against the bill. Following a round-table
discussion, some concerns were addressed and some wording
was changed. The final bill was not supported; that was two
years ago. The bill died in the House HESS Committee. Last
year, the bill was reintroduced in the House Labor and
Commerce Committee and then preceded to the House Judiciary
Committee. That Committee asked for more objective data and
was not moved forward.
Mr. Hall reiterated that the PA's have not found any harm
resulting from radiation x-ray; he questioned why the bill
had not been heard a second time in the House HESS Committee
as it relates to health concerns.
3:55:15 PM
Mr. Hall acknowledged that the cumulative affect of
radiation could cause long-term harm. However, x-rays from
dentistry were excluded. The Academy of Physicians
Assistants supports training and has discovered evidence of
training programs in place. He advised that the Alaska
Native Medical Center in Anchorage receives that training.
Mr. Hall referenced a handout demonstrating irresponsible
advertising. (Copy on File). He discussed two antidotes:
· His brother has been working at the Providence
Emergency Room for 32-years and has yet heard or
experienced any case of a person suffering from x-ray
or radiation exposure;
· He noted that his nurse attended a training program and
shared her notes, indicating that x-ray exposure is
minimal and that it is always important to provide
quality films for reading.
Mr. Hall pointed out that the bill goes "above and beyond"
addressing basic x-ray. He added clinicians working in both
urban and rural areas do support some sort of training.
4:00:02 PM
Mr. Hall discussed the costs associated with the bill and
that the costs of medical care are high and continue to
rise. Mr. Hall stressed that most PA's would not be able to
afford the training costs as individuals. Those clinics are
the ones that serve the outlining areas of the State. Many
PA's will opt not to have x-ray services because of costs
associated with that training. He believed that people
would, therefore receive sub-standard care.
4:01:45 PM
Mr. Hall acknowledged that PA's do not totally object to the
bill. They do support basic x-ray being removed. Other
procedures such as MRI's and CT scans involve more than the
basic x-ray skills. If that change is not made, PA's
advocate a 40-hour program such as the one in place at the
Alaska Native Medical Center instead of the 240 recommended
hour training for an on-line education course. Mr. Hall
stated that would be an adequate time to train in basic
radiology and radiation safety.
4:03:32 PM
Mr. Hall noted that the "physician assistant" concept was
created to ease medical care costs.
He pointed out that originally the bill supported a 20-hour
Continuing Medical Education (CME) component. He reiterated
for a basic x-ray course the time was excessive and means
that employers would have to compensate the employee's time-
spent training.
4:04:55 PM
Mr. Hall concluded that the costs are going to be high and
passage of the bill would create a health concern making
access to x-ray unavailable.
4:05:19 PM
LAURIE HERMAN, REGIONAL DIRECTOR, GOVERNMENTAL AFFAIRS,
PROVIDENCE HOSPITAL, ALASKA STATE HOSPITAL AND NURSING
ASSOCIATION (ASHNA), ANCHORAGE, testified in support of the
bill. Both Providence and ASHNA are in support of the bill
and have been involved in working on compromise legislation.
The goal is that of strengthening the quality of imaging
services provided in Alaska and achieving it without
creating a workforce crisis through legislative passage.
4:06:57 PM
Representative Kerttula asked about Mr. Hall's testimony
regarding the 40-training hours versus the 240-hour training
program. Ms. Herman needed to look at the curriculum to see
what would be removed.
4:07:54 PM
Representative Kerttula asked if the training was about
quality versus hours. Mr. Herman thought so.
4:08:09 PM
Vice Chair Stoltze mentioned conversations with Palmer
doctors practicing rural medicine and that they worried
about a diminished access to health care. He asked if the
PA's were providing diagnostic services. Ms. Herman
understood they were and has been debated over the past
three years.
4:08:51 PM
Vice Chair Stoltze reiterated concerns with the diagnostic
sections of the bill.
4:09:16 PM
Vice Chair Stoltze MOVED to ADOPT work draft #24-LS0470\B,
Mischel, 2/20/06, as the version of the bill before the
Committee. There being NO OBJECTION, it was adopted.
HEATH LEDYARD, STAFF, REPRESENTATIVE TOM ANDERSON, commented
on the changes made to work draft \B:
4:10:30 PM
Page 2, Lines 20-26: The sponsor included
language exempting medical personnel in the
military and United States (US) Public Health
Service, a standard statutory exemption. The
language was taken directly from the same
exemption for physicians found in AS 08.64.370.
Alaska Legal Services recommended it would be
appropriate to include the language because
State statute cannot supersede federal law.
Further, the sponsor noted that the federal
government has licensing and training
requirements that exceed those included in the
bill. The change was included in response to
concerns expressed by the Alaska Native Health
Board.
4:13:16 PM
Page 5, Line 31 & Page 6, Lines 1-12: A new
section was included, detailing standards for
the examination for a limited radiological
imager. The section stipulates that the
Department must provide the exam at regular
intervals to provide maximum access for
applicants; the exam will be based on the
American Registry of Radiology Technologists
(ARRT) examination in consultation with the
State Medical Board, the Alaska Society of
Radiology Technologists, the office of
Radiology Health in the Department of Health
and Social Services, and a resident member of
the American College of Radiology with a
minimum passing score of 75%. The change
resulted from discussions with the Alaska State
Medical Association.
4:13:23 PM
Page 6, Lines 27-29: New (b) replaces (b) and
(c) of the previous version-24-LS0470\N. That
section places one standard for the issuance of
a temporary permit. The new language states
that a temporary permit is valid for two years
from the date of issuance. The change resulted
from comments made by the Alaska Primary Care
Association (APCA).
4:14:21 PM
Co-Chair Chenault asked the affect the changes would have on
the fiscal note. Mr. Ledyard did not know. The change
would create a two-year delay effective date and once the
license was obtained, it would be permanent. He deferred to
Mr. Urion from the Department of Commerce, Community &
Economic Development.
4:15:05 PM
Representative Kerttula inquired about the 240-hour
requirement. Mr. Ledyard thought that the Department would
measure that concern. He added that had been included in
the "N" version as well and mentioned there was concern
regarding that. The "B" version on Page 5, Line 16 contains
the program approval for the radiological imager. That
language was included to alleviate those concerns. He
referenced Line 25. The intent of that language provides
that any training under a licensed practiconer and sponsored
by a medical facility, constitutes training. The 240-hour
reference is from the on-line training program only. It is
one option but not a requirement.
4:16:43 PM
Vice Chair Stoltze asked the health risk difference between
a dental hygienist and the person affected through the
legislation. Mr. Ledyard stated that his understanding was
based on testimony from one of the supporting physicians and
that on average, dental x-rays are roughly 1/10 or less the
amount of the exposure of medical x-rays.
4:17:27 PM
Vice Chair Stoltze wondered why there were so many lobbyists
with conflicting views on the legislation. He voiced
concern how it would affect the under-represented population
of Alaska.
4:18:35 PM
Vice Chair Stoltze MOVED to ADOPT new conceptual Amendment
#1. Co-Chair Meyer OBJECTED.
Vice Chair Stoltze addressed the changes:
Page 6, Lines 17-19, deleting all material.
Page 6, Line 17, inserting:
(A) Is enrolled in a program for the area approved
under AS 08.89.160 and pays the appropriate fee; or
(B) Demonstrates to the satisfaction of the department
that the applicant has been performing limited scope
radiology diagnostic imaging under AS 08.89.150(b) for
two years preceding July 1, 2008 and pays the
appropriate fee; or
SUZANNE CUNNINGHAM, STAFF, REPRESENTATIVE KEVIN MEYER,
explained that during the review of the "B" version, there
was concern with the temporary permit. In the revision of
that statute, it was noticed that a certain class of people
were being "caught in the middle" demonstrating to the
Department, two years of limited scope radiology diagnostic
imaging. The intent with the amendment was to guarantee
that those people would still be able to obtain a limited
permit under statute.
4:20:42 PM
Representative Weyhrauch asked why the imaging could not be
addressed under "A or B". Ms. Cunningham replied under
Section A, the limited permit would be for a person enrolled
in a program, paying the appropriate fee. The full permit
is for a person who has taken the examination and is waiting
for the results. There was concern that if the bill passed,
it has a two year delayed effective date; hence, a person
with two previous years experience, who could be eligible to
receive a full permit after taking the exam, would not be
able to have a temporary permit to work.
Representative Weyhrauch pointed out that the language says,
"passed the exam". Ms. Cunningham noted that they would be
waiting for the exam results under #2, Subsection (A).
Representative Weyhrauch pointed out Section 150(B).
4:22:03 PM
Mr. Ledyard added that in version "B" before the Committee
and with regard to the temporary permit, item (1) applies
only to those seeking a temporary permit for limited
radiological imaging. He noted that 150(B) refers to
qualifications for limited radiology imagers. In drafting
the committee substitute, the intent was not to create
disparity between those persons who had two years previous
experience and those who did not and was intended to create
a two-year temporary partial permit. Drafting that, an
error was noticed, which left some people in "limbo" that
could have experience. The amendment makes a change to
allow those people the opportunity to obtain a temporary
permit while waiting for their results.
4:24:18 PM
Co-Chair Meyer WITHDREW his OBJECTION to the amendment.
There being NO further OBJECTION, new Amendment #1 was
adopted.
4:25:08 PM
Co-Chair Meyer asked if there were new fiscal notes. Mr.
Ledyard stated he did not at this time and that the Division
has not yet had an opportunity to prepare the new note.
Co-Chair Chenault asked if there was on-line testimony to
speak to the fiscal note.
RICK URION, DIRECTOR OCCUPATIONAL LICENSING, DEPARTMENT OF
COMMUNITY AND ECONOMIC DEVELOPMENT, said he could not
address the new note at this time.
AT EASE: 4:26:05 PM
RECONVENE: 4:27:58 PM
4:28:05 PM
Co-Chair Meyer maintained concern with not having the
revised fiscal note in Committee. He advised that if the
bill does pass Committee, it would not be transmitted to the
Clerk's office until the appropriate fiscal note was
available. He asked the impact the proposed changes would
have on the note.
Mr. Urion stated that the law requires the Department to
charge the licensees to manage that program. Whatever the
fiscal note is would not include general fund monies. Mr.
Urion directed his testimony to the collection of fines, as
supported by fees not fines.
Co-Chair Meyer requested that issue be discussed at a later
date.
4:29:52 PM
Representative Weyhrauch questioned how many complaints the
Division receives every year from radiology technicians.
Mr. Urion responded that the Division had never received a
complaint.
4:30:31 PM
Representative Foster MOVED to REPORT CS HB 150 (FIN) out of
Committee with individual recommendations and with the
accompanying fiscal notes. Vice Chair Stoltze OBJECTED.
A roll call vote was taken on the motion.
IN FAVOR: Holm, Joule, Kerttula, Weyhrauch, Foster,
Hawker, Meyer, Chenault
OPPOSED: Moses, Stoltze
Representative Kelly was not present for the vote.
The MOTION PASSED (8-2).
CS HB 150 (FIN) was reported out of Committee with a "no
recommendation" and with a new fiscal note by the Department
of Commerce, Community & Economic Development.
4:33:02 PM
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