Legislature(2023 - 2024)BUTROVICH 205
03/05/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearing(s): | |
| Alaska Mental Health Trust Authority Board of Trustees | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | SB 241 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 5, 2024
3:31 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator James Kaufman, Vice Chair
Senator Löki Tobin
Senator Forrest Dunbar
Senator Cathy Giessel
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CONFIRMATION HEARING(S):
State Medical Board
David Barnes - Palmer
David Wilson - Palmer
- CONFIRMATIONS ADVANCED
Alaska Mental Health Trust Authority Board of Trustees
Brent Fisher - Anchorage
John Sturgeon - Anchorage
- CONFIRMATIONS ADVANCED
SENATE BILL NO. 241
"An Act relating to medical assistance demonstration projects
established by the Department of Health."
- BILL HEARING CANCELED
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
DAVID BARNES, Appointee
State Medical Board
Palmer, Alaska
POSITION STATEMENT: Testified as the governor's appointee to the
State Medical Board.
DAVID WILSON, Appointee
State Medical Board
Palmer, Alaska
POSITION STATEMENT: Testified as the governor's appointee to the
State Medical Board.
BRENT FISHER, Appointee
Alaska Mental Health Trust Authority Board of Trustees
Anchorage, Alaska
POSITION STATEMENT: Testified as the governor's appointee to the
Alaska Mental Health Trust Authority Board of Trustees.
JOHN STURGEON, Appointee
Alaska Mental Health Trust Authority Board of Trustees
Anchorage, Alaska
POSITION STATEMENT: Testified as the governor's appointee to the
Alaska Mental Health Trust Authority Board of Trustees.
ACTION NARRATIVE
3:31:21 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:31 p.m. Present at the
call to order were Senators Tobin, Kaufman, Dunbar, Giessel, and
Chair Wilson.
CHAIR WILSON turned the gavel over to Vice Chair Kaufman.
At ease
^CONFIRMATION HEARING(S):
CONFIRMATION HEARING(S):
STATE MEDICAL BOARD
3:32:53 PM
VICE-CHAIR KAUFMAN reconvened the meeting and announced the
consideration of governor's appointees David Barnes and David
Wilson to the State Medical Board.
3:33:14 PM
DAVID BARNES, Appointee, State Medical Board, Palmer, Alaska,
testified as the governor's appointee to the State Medical
Board. He provided an overview of his education and work
history, noting he completed his internal medicine residency in
Denver in 1999 and worked for major hospitals there before
moving to Alaska in 2003. He has worked extensively in inpatient
and outpatient medicine and has served on the medical board for
a year, expressing a desire to continue. His goal is to regulate
via the statutes the safe practice of medicine while ensuring
physicians have the freedom to practice appropriately,
recognizing Alaska's unique challenges, particularly the
difficulty in recruiting and retaining physicians due to its
remoteness. Barnes expressed concern about telemedicine, stating
that while it has helped, it also raises issues with out-of-
state physicians providing remote care without being connected
to Alaska.
3:36:45 PM
SENATOR TOBIN thanked Mr. Barnes for his comments, particularly
regarding ensuring physicians have the freedom to practice as
trained. She asked for his thoughts on the recent process
happening to physician assistants (PAs) that is within the
medical board's purview, specifically regarding a regulation
that was propagated. She inquired about the amount of feedback
received and Mr. Barnes' thoughts on the regulations and the
process. She expressed hope that everyone trained to provide
medical care would feel supported by the medical board.
3:37:35 PM
DR. BARNES explained that the issue began before his time on the
board, and he viewed it as a learning experience. Initially,
there was a push to increase the qualifications and hours
required for physician assistants (PAs), which seemed beneficial
but, in practice, exceeded the requirements for other
professionals like nurse practitioners. He noted that this
approach would have restricted access to care in remote
locations. After reviewing public testimony, the board
recognized it was not a good idea. Barnes believes the current
consensus is that if PAs are qualified and have reasonable
experience, they should be able to practice. He added that there
is supervision for PAs with the doctor / PA relationship.
3:38:49 PM
SENATOR TOBIN expressed appreciation for Dr. Barnes' insights
and found it helpful, noting that efforts are also underway to
ensure physician assistants can practice independently if they
have the necessary background and credentials along with having
received the adequate oversight that is available.
SENATOR TOBIN asked for insight into the current workload of the
medical board. She inquired about the main issues the board is
facing.
3:39:21 PM
DR. BARNES responded that the board handles numerous physician
complaints, which require significant review and has been the
biggest workload issue. He noted that the volume of cases is
variable, sometimes overwhelming but at other times lighter,
similar to his own work experience. Barnes mentioned that while
there are moments when he wishes for more board members, at
other times the current number feels sufficient.
3:40:18 PM
VICE-CHAIR KAUFMAN found no further questions for Dr. Barnes and
asked Mr. Wilson to begin his testimony.
3:40:35 PM
DAVID WILSON, Appointee, State Medical Board, Palmer, Alaska,
testified as the governor's appointee to the State Medical
Board. He provided a brief overview of his work history, stating
he is a pilot for Alaska Airlines and has lived in rural Alaska,
where he experienced the healthcare challenges native
communities face. He said his time flying residents around
Kodiak and also from St. Mary's to Bethel and transporting Yukon
Kuskokwim Health Corporation medical staff to villages helped
him appreciate the resilience and resourcefulness of Native
people and the commitment of healthcare professionals serving
them. Since moving to Palmer in 2000, Wilson's family has
benefited from excellent local medical care.
3:44:45 PM
MR. WILSON stated that his interest in serving on the State
Medical Board stems from a desire to give back to the medical
community. He sees the role of a public member as representing
two perspectives: first, the patient's perspective, particularly
from rural Alaska where logistical challenges in healthcare
access are significant; and second, his experience in human
factors analysis and aviation safety. He drew parallels between
the State Medical Board and the Professional Standards Board he
currently serves on. He highlighted the importance of unbiased
professionals pursuing truth with integrity, as both aviation
and medicine demand high levels of responsibility and life-
altering decision-making under pressure.
3:46:17 PM
MR. WILSON warned of the dangers of non-compliance, which he has
seen in aviation, often beginning early in a career and
sometimes being overlooked due to high demand for talent. He
emphasized that professionalism and non-compliance are
contagious, with the latter leading to confusion and distrust.
Wilson believes that behavioral deviations in regulated
industries like medicine and aviation are often driven by
external pressures, and addressing the root causes is essential
for meaningful improvement. He aims to bring his experience in
helping pilots resolve underlying issues to the Alaska State
Medical Board to foster professionalism and compliance.
3:48:13 PM
SENATOR TOBIN said his volunteer work is commendable. She asked
for his insights concerning PAs interactions with the medical
board, the regulatory process they face, and their ability to
work independently, especially in rural Alaska where medical
providers are needed.
3:49:06 PM
MR. WILSON explained that the issue of PA regulation was new to
him, and he approached it from an educational perspective,
without a strong opinion. He emphasized that, coming from a
rural Alaska Native community, his primary concern is ensuring
that care is not compromised. He noted that much of the public
feedback highlighted a shortage of PAs, which was driving the
push to change regulations.
MR. WILSON sought further information and learned that few PAs
are coming out of school, which he found concerning. He
suggested exploring solutions similar to the aviation industry,
where airlines have invested in flight schools to increase the
pilot supply through funding and grants. Additionally, after
speaking with organizations like the Yukon Kuskokwim Health
Corporation (YKHC), he found that staffing needs often exceed
available funding, which could also be a barrier.
3:51:32 PM
MR. WILSON further explained that, in aviation, regulations are
often shaped by the insurance underwriting community more than
by regulations. He gave an example of how minimum experience
levels for pilots, though set by the Federal Aviation
Administration (FAA), are often raised by insurers due to high
premiums for less-experienced pilots. He suggested that if PA
supervision and oversight are removed, the medical underwriting
community might respond similarly, making malpractice insurance
prohibitively expensive for PAs.
3:53:59 PM
MR. WILSON concluded by stating that responsible regulatory
limits are essential, as without them, the insurance industry
may intervene and impose high premiums or exclusions, making it
difficult for PAs to practice in rural areas due to perceived
risks.
3:54:32 PM
SENATOR TOBIN asked whether the State Medical Board would
provide oversight of PAs, whether they practice collaboratively
or untethered.
3:54:43 PM
MR. WILSON stated his belief that oversight would continue in
either instance, unless PAs decided to create their own board.
3:55:09 PM
VICE-CHAIR KAUFMAN opened public testimony on the confirmation
of Dr. Barnes and Mr. Wilson to the State Medical Board; finding
none, he closed public testimony.
^ALASKA MENTAL HEALTH TRUST AUTHORITY BOARD OF TRUSTEES
ALASKA MENTAL HEALTH TRUST AUTHORITY BOARD OF TRUSTEES
3:55:47 PM
VICE-CHAIR KAUFMAN announced the consideration of governor's
appointees Brent Fisher and John Sturgeon to the Alaska Mental
Health Trust Authority.
3:56:06 PM
BRENT FISHER, Appointee, Alaska Mental Health Trust Authority
Board of Trustees, Anchorage, Alaska, he stated he has served on
the board for three years and is seeking reappointment. He
currently serves as vice chair and has previously held the
positions of secretary and finance committee chair. Fisher
provided a brief history of his military service and education,
noting that he has 30 years of experience in various healthcare
sub-industries. He has also served on the board of directors for
several associations, is a Fellow in three medical groups, and
has published articles on various healthcare-related topics.
3:57:29 PM
MR. FISHER expressed that he has enjoyed his past three years on
the Trust Board and would like to continue serving, as several
projects are still in progress. He highlighted efforts to create
more transparency within the Trust, particularly regarding
operations and financial matters. One of the board's biggest
projects has been the Crisis Now initiative, which provides
mental health counseling and suicide prevention services. This
project aims to replace the traditional involvement of police
and troopers with crisis management teams. He noted that the
initiative has been growing across Alaska and will eventually
provide telephonic counseling services to all areas, including
remote villages. The Trust is also funding local crisis
management teams where possible.
3:58:56 PM
MR. FISHER emphasized the importance of collaborating with
community providers to support those with mental health
disorders and to offer preemptive assistance to children in
foster care before they require more intensive services. He
praised the current Board of Trustees and their collaboration
with staff to make these initiatives a reality and expressed his
desire to continue this work for another five-year term.
4:00:11 PM
VICE-CHAIR KAUFMAN invited Mr. Sturgeon to testify.
4:00:26 PM
JOHN STURGEON, Appointee, Alaska Mental Health Trust Authority
Board of Trustees, Anchorage, Alaska, shared that he has lived
in Alaska for 54 years. He served in the U.S. Navy and completed
two tours in Vietnam. He shared his education and work history
in forestry. He has also been a member of the Mental Health
Trust for the past five years. Additionally, he served on the
Board of Directors for Pacific Northwest Medical University,
which focuses on training doctors to work in rural and
underserved areas.
MR. STURGEON said that as chair of the Natural Resource
Committee for the Mental Health Trust, he has worked closely
with the Mental Health Land Trust Office to generate funds
through timber, mining, leases, and other resources, noting that
the Trust must earn all its revenue without government support.
He highlighted the Trust's focus on prevention programs, such as
Crisis Now and the foster care initiative, to which their
efforts added a couple million funded dollars. He expressed his
desire to continue serving on the Trust for another five years.
4:03:43 PM
VICE-CHAIR KAUFMAN opened public testimony on the appointments
of Mr. Fisher and Mr. Sturgeon to the Alaska Mental Health Trust
Authority Board of Trustees; finding none, he closed public
testimony.
4:04:11 PM
At ease
4:04:20 PM
VICE-CHAIR KAUFMAN reconvened the meeting.
4:04:22 PM
VICE-CHAIR KAUFMAN solicited the will of the committee.
4:04:46 PM
SENATOR TOBIN moved that the following appointees be forwarded
to a joint session for consideration:
State Medical Board
David Barnes - Palmer
David Wilson - Palmer
Alaska Mental Health Trust Authority Board of Trustees
Brent Fisher - Anchorage
John Sturgeon - Anchorage
SENATOR TOBIN reminded members that signing the report(s)
regarding appointments to boards and commissions in no way
reflects individual members' approval or disapproval of the
appointees; the nominations are merely forwarded to the full
legislature for confirmation or rejection.
4:04:52 PM
VICE-CHAIR KAUFMAN found no objection and in accordance with AS
39.05.080, the Senate Health and Social Services Standing
Committee forwarded the appointments to a joint session for
consideration.
4:04:55 PM
At ease
4:06:12 PM
VICE-CHAIR KAUFMAN reconvened the meeting.
4:06:39 PM
There being no further business to come before the committee,
Vice Chair Kaufman adjourned the Senate Health and Social
Services Standing Committee meeting at 4:06 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| David Barnes Medical Board App_Redacted.pdf |
SHSS 3/5/2024 3:30:00 PM |
SHSS March 5: Governor's Appointee - David Barnes, Alaska State Medical Board |
| David Barnes Medical Board Resume_Redacted.pdf |
SHSS 3/5/2024 3:30:00 PM |
SHSS March 5: Governor's Appointee: David Barnes, State Medical Board |
| David Wilson Medical Board App_Redacted.pdf |
SHSS 3/5/2024 3:30:00 PM |
SHSS March 5: Governor's Appointee - David Wilson, State Medical Board |
| David Wilson Medical Board Resume_Redacted.pdf |
SHSS 3/5/2024 3:30:00 PM |
SHSS March 5: Governor's Appointee - David Wilson, State Medical Board |
| Brent Fisher AMHTA Resume_Redacted.pdf |
SHSS 3/5/2024 3:30:00 PM |
SHSS March 5: Governor's Appointee - Brent Fisher, AMHTABOT |
| John Sturgeon AMHTA Bio_Redacted.pdf |
SHSS 3/5/2024 3:30:00 PM |
SHSS March 5: Governor's Appointee - John Sturgeon, AMHTABOT |