Legislature(2009 - 2010)CAPITOL 106

03/25/2010 03:00 PM House HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Moved CSHB 309(HSS) Out of Committee
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
Moved CSHB 392(HSS) Out of Committee
        HB 392-INCENTIVES FOR CERTAIN MEDICAL PROVIDERS                                                                     
4:42:10 PM                                                                                                                    
CO-CHAIR KELLER  announced that  the final  order of  business be                                                               
HOUSE  BILL  NO.  392,  "An Act  establishing  a  loan  repayment                                                               
program and employment incentive  program for certain health care                                                               
professionals  employed  in  the  state;  and  providing  for  an                                                               
effective date."                                                                                                                
4:42:28 PM                                                                                                                    
CO-CHAIR  HERRON moved  to  adopt  proposed committee  substitute                                                               
(CS) for  HB 392,  26-LS1528\S, Mischel,  3/17/10 as  the working                                                               
4:42:46 PM                                                                                                                    
REPRESENTATIVE SEATON objected for discussion.                                                                                  
4:42:57 PM                                                                                                                    
NIKOOSH CARLO,  Staff to Representative Bob  Herron, Alaska State                                                               
Legislature, explained that  the change to Version S  was on page                                                               
5,  line   15,  and  it   inserted  "to  not  fewer   than  three                                                               
participants employed in very hard-to-fill positions."                                                                          
DR. CARLO explained that HB  392 created an incentive program and                                                               
loan  repayment program  within Department  of Health  and Social                                                               
4:46:19 PM                                                                                                                    
DR. CARLO, in  response to a questions about  the earlier Version                                                               
E, explained  that on page  5, line 12,  "continuing participant"                                                               
had been inadvertently deleted.                                                                                                 
The committee took an at-ease from 4:46 p.m. to 4:47 p.m.                                                                       
4:47:50 PM                                                                                                                    
REPRESENTATIVE  T. WILSON  asked  for a  definition of  "hard-to-                                                               
DR. CARLO  replied that  this definition would  be worked  out in                                                               
4:48:30 PM                                                                                                                    
CO-CHAIR KELLER asked for the determination of "hard-to-fill."                                                                  
DIANE   BARRANS,  Executive   Director,   Alaska  Commission   on                                                               
Postsecondary  Education  (ACPE),  replied  that  this  would  be                                                               
determined by Department of Health and Social Services.                                                                         
4:49:02 PM                                                                                                                    
REPRESENTATIVE  SEATON   asked  about   the  duration   for  loan                                                               
repayments  to  the  Washington, Wyoming,  Alaska,  Montana,  and                                                               
Idaho (WWAMI)  graduate medical education program.   He commented                                                               
that HB 392  had a six year loan repayment  program, and he asked                                                               
if there were any other programs of that duration.                                                                              
4:49:38 PM                                                                                                                    
MS.  BARRANS replied  that  the two  WWAMI  repayment terms  were                                                               
three  years  for underserved  areas  and  five years  for  urban                                                               
areas.    She said  that  it  was  important to  distinguish  the                                                               
fundamental  structure   of  WWAMI.    She   explained  that  the                                                               
agreement was entered  into when students entered  the first year                                                               
of  the  graduate  medical  program,  and  the  funds  were  paid                                                               
directly  to the  University of  Washington  School of  Medicine.                                                               
She pointed  out that if a  graduate did not return  to Alaska to                                                               
practice, the  service agreement would  convert into a  loan with                                                               
active repayment.  She said that  there was not a similar, active                                                               
program.  She explained that  there was a small teacher education                                                               
loan with  a similar structure  to WWAMI.   She pointed  out that                                                               
this  proposed program  could be  paid off  after three  years of                                                               
service, depending on the amount of debt.                                                                                       
4:52:01 PM                                                                                                                    
REPRESENTATIVE  SEATON questioned  that if  the proposed  program                                                               
was  for any  student  loans,  was it  necessary  to make  direct                                                               
payment to the loan holder, other  than an Alaskan state loan, or                                                               
just make the payment to the student.                                                                                           
4:53:05 PM                                                                                                                    
MS. BARRANS  said that this  program had evolved over  the years,                                                               
and that it  was only recently that the direct  incentive of cash                                                               
payment  was  included.    She opined  that  the  loan  repayment                                                               
language could  be vestigial  and that  some groups  believed the                                                               
student loan payment to be duplicative.                                                                                         
4:54:04 PM                                                                                                                    
REPRESENTATIVE SEATON  asked if  the reference  could just  be to                                                               
the Alaska student loan program.                                                                                                
MS. BARRANS  offered her  belief that this  would be  a different                                                               
objective  from the  original program.   She  explained that  the                                                               
broad education  loan eligibility  was to allow  recruitment from                                                               
out  of  state.    She  said   that  a  change  might  limit  the                                                               
4:55:22 PM                                                                                                                    
REPRESENTATIVE SEATON  offered his belief that  this change would                                                               
make  it  easier  administratively,  and  he  did  not  see  "any                                                               
4:56:05 PM                                                                                                                    
CO-CHAIR  KELLER  allowed  that   this  would  be  the  sponsor's                                                               
REPRESENTATIVE T. WILSON offered her  support and stated that the                                                               
doctor shortage was only going to worsen.                                                                                       
4:56:53 PM                                                                                                                    
CO-CHAIR  HERRON,  as the  prime  sponsor  of HB  392,  expressed                                                               
agreement with Representative Seaton.                                                                                           
4:58:04 PM                                                                                                                    
REPRESENTATIVE  SEATON  suggested  that  a  conceptual  amendment                                                               
would streamline the bill.                                                                                                      
CO-CHAIR  HERRON  asked  if  the  conceptual  agreement  was  for                                                               
another means to administer the loan program.                                                                                   
4:59:30 PM                                                                                                                    
REPRESENTATIVE  SEATON moved  to  adopt  Conceptual Amendment  1,                                                               
which he  explained would only  limit the loan repayment  be used                                                               
for  Alaska state  issue loans,  with the  remainder of  the same                                                               
amount to now be paid by direct incentive.                                                                                      
5:00:02 PM                                                                                                                    
REPRESENTATIVE T. WILSON objected  for discussion.  She expressed                                                               
concern that this would limit the participation.                                                                                
REPRESENTATIVE HOLMES  also objected for discussion.   She stated                                                               
her  agreement with  the  intent to  simplify  the paperwork  and                                                               
lower the  administrative cost.   She expressed concern  with any                                                               
unforeseen consequences  by somehow  "skewing who is  eligible to                                                               
receive the money."                                                                                                             
5:01:33 PM                                                                                                                    
REPRESENTATIVE SEATON  replied that the intent  was for repayment                                                               
to Alaska state loans, with the cap to remain the same.                                                                         
5:02:09 PM                                                                                                                    
REPRESENTATIVE T. WILSON removed her objection.                                                                                 
REPRESENTATIVE HOLMES removed her objection.                                                                                    
5:02:24 PM                                                                                                                    
DR.  CARLO emphasized  that  an applicant  was  eligible for  the                                                               
program whether or not they had any loans.                                                                                      
5:02:40 PM                                                                                                                    
There being no objection, Conceptual Amendment 1 was adopted.                                                                   
REPRESENTATIVE HOLMES expressed her support for HB 392.                                                                         
5:03:29 PM                                                                                                                    
CO-CHAIR  KELLER  stated his  discomfort  with  the necessity  to                                                               
subsidize  the salaries  of these  professionals,  and he  opined                                                               
that government  rate regulation  had removed any  incentives for                                                               
practice.   He reiterated  that the  current federal  health care                                                               
legislation could make it necessary to re-visit this bill.                                                                      
[Version S was adopted as the working draft.]                                                                                   
5:05:06 PM                                                                                                                    
REPRESENTATIVE  T.  WILSON  moved to  report  proposed  committee                                                               
substitute  (CS) for  HB 392,  26-LS1528\S, Mischel,  3/17/10, as                                                               
amended,  out of  committee with  individual recommendations  and                                                               
the accompanying  fiscal notes.   There being no  objection, CSHB
392  (HSS)  was  forwarded  from  the  House  Health  and  Social                                                               
Services Standing Committee.                                                                                                    

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