Legislature(1999 - 2000)
05/14/1999 03:24 PM House L&C
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
CSSB 71(RLS) am - PHYSICIAN LICENSURE CHANGES
Number 0533
CHAIRMAN ROKEBERG announced the committee's next order of business
is CSSB 71(RLS) am, "An Act relating to licensure by the State
Medical Board." The chairman invited the sponsor's representative
forward.
Number 0559
SHARON CLARK, Legislative Assistant to Senator Mike Miller, Alaska
State Legislature, came forward to present SB 71 as aide to the
Senate Health, Education and Social Services Standing Committee
(Senate HESS), the bill sponsor. Ms. Clark informed the committee
SB 71 had been introduced by the Senate HESS Committee at the
request of the State Medical Board, which fully supports this bill.
This legislation resolves licensure problems for the board, updates
the Alaska Statutes in relation to other states, and corrects
unintended problems within the current law. Ms. Clark noted the
members of the State Medical Board appreciate the scheduling of SB
71 before the House Labor and Commerce Standing Committee. She
indicated Dr. Sarah Isto, Chair of the State Medical Board, and Dr.
Martha Cotten [State Medical Board member], both instrumental in
bringing this legislation to the Senate HESS Committee, are
present.
MS. CLARK explained the Senate version of SB 71 [CSSB 71(RLS) am]
had been heard that morning in the House HESS Committee. A
conceptual amendment was adopted to page 2, lines 12 and 13, of
CSSB 71(RLS) am, and was probably in the committee members' bill
packets. The conceptual amendment deleted the language, "; and (5)
be a citizen of the United States or be lawfully admitted for
permanent residence" [current statute, AS 08.64.200(a)(5)]. Ms.
Clark indicated the bill sponsor had no problem with the amendment,
and she stated, "The committee substitute was adopted and the
amendment was adopted, and it moved out of committee." Ms. Clark
noted Dr. Isto would speak on the legislation's specifics. Ms.
Clark urged the committee to support the legislation; it is a good
bill, it does what the State Medical Board wants. She informed the
committee that Catherine Reardon of the Division of Occupational
Licensing had also been behind the legislation. Ms. Clark
indicated all involved had worked very hard.
Number 0709
SARAH ISTO, MD, Chair, State Medical Board, Division of
Occupational Licensing, Department of Commerce and Economic
Development, came forward to testify in support of SB 71.
Indirectly referring to her previous testimony in support of SB 29
at this same committee meeting, Dr. Isto said SB 71 also addresses
the statutes which govern the State Medical Board. The legislation
takes care of several housekeeping issues for the board. Currently
the board cannot renew the 60-day temporary licenses for
replacement physicians, so-called locums licenses [from "locum
tenens"], unless a quorum of the board meets. Gathering a quorum
together every 60 days to renew one or two licenses is awkward
since the board meets quarterly. This change would allow the board
to designate the staff to do renewals under a protocol. The
legislation would allow the board to designate staff to handle
issues of physicians who are late in turning in their continuing
education credits. Currently, this is supposed to be handled at a
board meeting, which is, again, an awkward issue. The legislation
would also allow the board to consider an applicant's felony
history. If an applicant has a Class A or unclassified felony, the
board would be able to consider that when a person applies for
licensure.
DR. ISTO described that a person who had killed his/her partner by
beating the partner to death while the partner was sleeping had
applied for a license from prison. This felony was not in the
practice of medicine and Dr. Isto noted Alaska Statute currently
says "only if you commit that sort of crime during the practice of
medicine." The State Medical Board was not allowed to consider
that [felony] in the application. Dr. Isto commented she is
thankful to say this application had other deficiencies. Finally,
Dr. Isto informed the committee that SB 71 addresses postgraduate
medical education for United States and Canadian [medical school]
graduates. It would require new graduates - those who have
graduated in 1995 or thereafter - to have two years of postgraduate
training. This is because nearly all [medical] residencies are
three to five years. The Canadian family practice residency is two
years; the osteopathic residency is two years. Those are the only
exceptions. Dr. Isto commented it is standard to expect that a
medical school graduate will complete the residency before applying
for a license. This provides the State Medical Board some
guarantee of the person's quality. Physicians who graduated in
1985 and have been practicing in the state of Washington for 10
years are no problem for the State Medical Board; these people have
a practice history the board can rely on. Dr. Isto indicated this
would only apply to new graduates.
Number 0873
REPRESENTATIVE MURKOWSKI questioned if there is a requirement for
something like an FBI [Federal Bureau of Investigation] background
check prior to licensure of a new applicant.
DR. ISTO indicated there is the National Practitioner Data Bank
(NPDB) [Health Resources and Administration, U.S. Department of
Health and Human Services], a data bank that includes all
malpractice actions, board disciplinary actions, medical school
disciplinary actions, residency disciplinary actions, and negative
hospital actions. That is the background check. As it happens, if
an individual has committed some sort of crime, often the medical
board in another state, a hospital, or other entity, has taken
action and so some of that information comes into it. However,
there is not an FBI check. Dr. Isto indicated the board does have
fairly extensive information on applicants because it has an
applicant's entire four-year medical school history, three years of
postgraduate training, and any work history; therefore, the board
feels it has a fairly good understanding of a person's doings for
at least the past seven years.
REPRESENTATIVE MURKOWSKI noted previous discussion in the committee
of the case, she believes, involving a Dillingham pharmacist who
was eventually charged with giving young boys drugs in exchange for
sexual favors. Representative Murkowski believed the pharmacist
had had a [criminal] background in another state. She said she was
surprised to learn there is not the full FBI criminal background
check. As a lawyer, they are checked out through that. Therefore,
Representative Murkowski noted, unless it was a medical-related
issue, it is not going to follow the person.
DR. ISTO agreed that is correct; however, in the case of a doctor,
if a doctor had some kind of conviction relating to sexual
misconduct, a medical board would take action, and so that would
enter the practitioner data bank. Dr. Isto said she does not know
much about pharmacy, pharmacists, and how that kind of information
is kept. She is fairly confident that drug issues and sexual
misconduct would appear in the National Practitioner Data Bank.
Other sorts of things like financial crimes, et cetera, probably
would not.
Number 1054
CHAIRMAN ROKEBERG noted the presences of Representative John
Coghill, Jr. and Representative Eric Croft.
REPRESENTATIVE HALCRO noted Dr. Isto's mention that the State
Medical Board meets quarterly. He questioned what would happen in
a case involving misconduct.
DR. ISTO responded the board has emergency teleconference meetings
and the board is very happy to do that. Indicating the board is
made up of volunteers, she noted it is a little more difficult to
energize the board to meet to renew a doctor's 60-day permit at the
hospital's request when there are no problems with the person. Dr.
Isto indicated the board considers this a non-emergency issue and
would like to make this process work more smoothly for the board.
REPRESENTATIVE CISSNA indicated she assumes drunken driving would
probably catch a relevant entity's attention, but she asked about
other alcohol-related items.
DR. ISTO answered it is a state requirement for hospitals to report
within 24 hours to the State Medical Board if they are concerned
that a physician is coming to work drunk, misusing alcohol, is
present using alcohol in the hospital. She thinks hospitals are
quite careful and defensive about reporting. Dr. Isto indicated
the board does receive these reports in the required manner.
REPRESENTATIVE CISSNA asked about someone coming from another
state, where perhaps there had been some real problems which
reached the courts but not the hospital, [medical] board, et
cetera.
DR. ISTO noted each state has its own separate licensing laws, but
there are many similarities. She thinks there isn't any state that
does not concern itself with substance misuse. These are emergency
issues because of the risk to patients from care by an incompetent
provider. She thinks that most of those [cases] come to the
attention of a board.
REPRESENTATIVE CISSNA questioned if there is any way of checking
the records, et cetera, of people coming from other countries.
DR. ISTO responded she is hoping SB 29 will pass; SB 29 would
require foreign medical school graduates to have been under close
observation in a residency for three years. Dr. Isto indicated the
State Medical Board would need to depend on that three years of
close observation as protection if something arises. She further
indicated that if someone has a problem, things usually do appear
within three years, although not always.
Number 1273
REPRESENTATIVE MURKOWSKI referred to Section 5 of HCS CSSB 71(HES).
She expressed confusion with this ability of substituting. [HCS
CSSB 71(HES), Section 5 read:
* Sec. 5. AS 08.64.275(a) is amended to read:
(a) A member of the board or its executive secretary
may grant a temporary permit to a physician or osteopath
for the purpose of substituting for another physician or
osteopath licensed in this state. The permit is valid
for 60 consecutive days. If circumstances warrant, an
extension of the permit may be granted by the board or
its designee.]
DR. ISTO explained there is a temporary license, a locums license,
which requires a person to have a clear existing license in another
state. It is a somewhat faster licensing process but the license
is for a much shorter period. This license would be used, for
example, when a physician goes on vacation or becomes ill. Under
this temporary license there must be a clinic, hospital, or
someone, monitoring and vouching for the person's work.
REPRESENTATIVE MURKOWSKI questioned if there is a maximum time
period.
DR. ISTO answered it is 60 days, but it may be renewed twice upon
request of the hospital or the clinic - the supervising body - but
not at the practitioner's request. She indicated this request from
the supervising body had to be submitted to the State Medical Board
in writing.
Number 1356
CHAIRMAN ROKEBERG confirmed there were no further questions for Dr.
Isto or further witnesses on SB 71. Therefore, the chairman closed
the public hearing on the legislation.
Number 1377
REPRESENTATIVE HALCRO made a motion to move HCS CSSB 71(HES) out of
committee with individual recommendations and the attached zero
fiscal note. There being no objection, HCS CSSB 71(HES) moved out
of the House Labor and Commerce Standing Committee.
| Document Name | Date/Time | Subjects |
|---|