Legislature(1999 - 2000)
04/12/2000 03:25 PM House L&C
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 297-BOARD OF CHIROPRACTIC EXAMINERS Number 1229 CHAIRMAN ROKEBERG announced that the next item of business would be CS FOR SENATE BILL NO. 297(L&C) am, "An Act relating to the licensing of chiropractors and to disciplinary actions against chiropractors." [The bill was sponsored by the Senate Health, Education and Social Services Committee, chaired by Senator Mike Miller.] Number 1252 SHARON CLARK, Staff to Senator Mike Miller, Alaska State Legislature, specified that the committee was working from CSSB 297 (L&C) am. She explained that this bill, requested by the Board of Chiropractic Examiners, amends the licensing statute for Alaska chiropractors. She read from the sponsor statement: Section 1 allows for a temporary permit to practice chiropractic in Alaska. The temporary license initially is for 60 days and may be extended by the Board of Chiropractic Examiners. It is subject to the same terms and conditions of a regular license. This section also provides for a licensee who does not practice in the state to hold an inactive license. The section finally provides for a retired licensee. A person holding a retired license may not practice chiropractic in the state. A person holding a retired license may apply for an active license subject to terms and conditions set by the board. Section 2 provides for new reasons why the Board of Chiropractic Examiners may refuse to issue a license in the state. These include conviction of a felony or other crimes that would affect the person's ability to practice competently and safely. Conviction of crime involving the unlawful procurement, sale, prescription, or dispensing of drugs, and attempting to practice after becoming unfit due to an infectious or contagious disease. Your consideration of this bill is appreciated. Number 1336 MS. CLARK explained that CSSB 297(FIN) am had been passed unanimously by the Senate. One amendment was adopted before the bill was passed. A concern had come up in committee about the word "physiotherapy." Senator Ellis had offered an amendment: On page 2, line 22, after the word "board," delete "physiotherapy examination" and insert "physiological therapeutic examination; and on page 2, line 23, after the word "examiners," insert "required by the board." That amendment was adopted, and the amended bill was passed by the Senate. MS. CLARK mentioned that someone had asked what "locum tenens" means. According to Black's Law Dictionary, it means "holding the place of deputy; a substitute, a lieutenant or a representative." Webster's Dictionary defines it as "one holding a place; a person, a physician or a member of the clergy who substitutes for another." CHAIRMAN ROKEBERG asked the intent behind having a retired license status. MS. CLARK said she would prefer to have Catherine Reardon from the Division of Occupational Licensing speak to that. Number 1500 DR. LOREN MORGAN, President, Alaska Chiropractic Society, testified by teleconference from Anchorage. He said he supports the bill, which provides continuity for the profession, locum tenens, and grounds for suspension. There has been no provision for temporary licensing or for retired licenses until now. CHAIRMAN ROKEBERG asked if there has been a need for temporary chiropractors. DR. MORGAN explained that a solo practitioner has difficulty taking care of his patients' needs while he or she is out of time. Right now, the only alternative is not to provide any care. CHAIRMAN ROKEBERG asked, "So you can't take a vacation?" DR. MORGAN agreed, "Yes, you're kind of stuck." CHAIRMAN ROKEBERG asked about the retired license. Number 1583 DR. MORGAN said a retired licensee would be for a person who has been licensed in the state and who leaves the state but may want to come back. This lowers the fees while he/she is not here in active practice, but maintains all of his/her continuing education and other credits while he/she is away. Number 1612 REPRESENTATIVE MURKOWSKI asked about the inactive license. Number 1630 DR. MORGAN said they are almost the same. A retired licensee would be for someone who is not going to practice but wants to remain involved in chiropractic activities. It would be a like a retired person maintaining some type of affiliation with his or her professional associates. REPRESENTATIVE MURKOWSKI said she was looking at the language of the bill, which says that if a person practices at all, even infrequently, he/she has to have to have an active license. She asked: If I am only going to practice four times a year, would I have an active license or a retired license? DR. MORGAN said she would have an active license. REPRESENTATIVE MURKOWSKI said she still did not understand why it is necessary to have an active, an inactive and a retired status. Number 1710 CATHERINE REARDON, Director, Division of Occupational Licensing, Department of Community and Economic Development, explained that the retired license status is basically for someone who does not intend to return to the profession, but who would like to continue to get to "call themselves a chiropractor" for emotional reasons. It acknowledges the professional credential one had during one's working life. It doesn't do anything other than that. The person cannot work. The reason for an inactive license is that one has have to keep up his/her continuing education because he/she may want to return to active practice. [The division] wants to ensure that when the person does [return to active practice], he/she is ready to practice competently. Number 1805 REPRESENTATIVE MURKOWSKI asked, "We get money from them for a retired license fee and they don't get to do anything?" MS. REARDON said that is correct. Some people want to pay to be a former chiropractor, more or less. REPRESENTATIVE BRICE, referring to discussion of another bill, said he thinks it is important, given that [the legislature] can use the fees coming in for retired licensing to pay for the inspections of unlicensed body piercers. [Laughter] Number 1844 MS. REARDON said she thinks the big motivation for the inactive status is because it is also a lesser price than for an active license, although it is not the one-time fee for retired status. The feeling of the board is that people who move elsewhere and do think they might return to Alaska are more likely to keep paying even though it is a lesser [license]. This will help the overall financing. REPRESENTATIVE MURKOWSKI asked what the retired license fee would be. MS. REARDON said she doesn't know; the fee would be set by regulation. She has no stake in having them be very high. The fee is not repeated and would not bring in a great deal of revenue. She indicated she would look for public comment on that point. REPRESENTATIVE MURKOWSKI wondered if this is done in other areas. MS. REARDON replied yes. She explained that physicians also have retired status. REPRESENTATIVE MURKOWSKI asked, "Do you give them some kind of a licensure or an endorsement?" MS. REARDON responded that they are given a retired license. REPRESENTATIVE MURKOWSKI stated that she is trying to equate this to the practice of law: When "you are ready to retire, you stop paying your bar dues - and that's a good thing - and you still get to call yourself a retired lawyer." MS. REARDON answered that for some reason, some people like to continue to pay and be on the roster. Number 1977 CHAIRMAN ROKEBERG commented: I've actually thought about this in the real estate statute - in expanding that section, repealing a sabbatical leave-type of a provision. Because of the licensure - continuing education - there's a lot of problems around that. Plus, usually a professional, not only do they pay the great State of Alaska that licensing fee biennially, they usually belong to a number of other professional associations and societies and so forth. And that may be one reason they want to have a retired status, so they can keep up their license, to keep up their national affiliation. REPRESENTATIVE MURKOWSKI referred to Section 2, page 4, lines 16 through 17, relating to the refusal to issue a license due to an infectious or contagious disease. She said she guessed that this makes sense, but she was trying to think of infectious diseases that one would want to "stay away from or that you would deny somebody a license based on the disease." She wondered what the thought was behind adding that to the bill. Number 2131 DR. MORGAN explained this was included to reduce any risk to the public. It is a public safety issue. REPRESENTATIVE BRICE and REPRESENTATIVE MURKOWSKI expressed curiosity regarding how it is defined. REPRESENTATIVE BRICE commented: Somebody in the early stages of HIV [Human Immunodeficiency Virus] infection obviously might not be ... contagious or a problem or anything else. Are they unfit at that point in time, or [at] what point in time do they become unfit? CHAIRMAN ROKEBERG replied: The board can impose disciplinary sanctions or refuse to issue a license, but it doesn't indicate revocation. There may be quirk in their licensing law. On the other hand, that's a question I'd direct to Ms. Reardon. I'm not sure this is legal under the Americans with Disabilities Act [ADA], depending on what the infectious disease was. REPRESENTATIVE BRICE said for a physical disability, that is already in statute. MS. REARDON added that it seems to be a subset of physical disabilities already included in statute. She said it is her assumption is that the board would have to find that the person was unfit to perform chiropractic work, not just that the person had an infectious disease of some type. This is why it would not violate the ADA. If it did not impact one's ability to practice as a chiropractor, she thinks it probably would be against the law. She does not know of any problems encountered that would have to led to the inclusion of this language in the bill. Number 2333 REPRESENTATIVE MURKOWSKI said she thinks the language is a "red flag." REPRESENTATIVE BRICE asked Ms. Clark, "Where did that come from? Did that just come from the chiropractors?" MS. CLARK said that is correct. MS. REARDON clarified that the language came from the board. It is her personal belief that elimination of the language would not create a problem. If there is some physical issue that makes someone unfit, "we're going to be able to do something about it under the current statute." She suspects the language came from the board's desire to be very consumer-protection-oriented. She does not know of any specifics. CHAIRMAN ROKEBERG referred to page 4, line 15, which adds "person's" and removes "licensee's". He pointed out that "licensee" is referenced throughout the entire bill. MS. REARDON explained, "It now applies to refusing a license, and so the person that they want to refuse a license to won't be a licensee yet." TAPE 00-48, SIDE A Number 0016 MITCH GRAVO, Lobbyist, Alaska Chiropractic Society, came forward to testify on CSSB 297(L&C) am. He said he hadn't talked to the board members who put this together. However, he thinks it is probably modeled after the other health care provider legislation in the state. If the committee changes it, he would suggest keeping either "infectious" or "contagious" because he does not think anyone would want a health care provider who had a contagious disease treating him or her. He believes there is a difference between being infected and having a disease that is contagious. A person can be infected without being able to transfer the infection. But he doesn't believe that anyone would want to be treated by a health care provider who had a contagious disease. That would be a public safety issue. REPRESENTATIVE BRICE said the question is whether infectious or contagious diseases are a subset of a physical disability. Number 0114 DR. MORGAN explained that "infectious and contagious" regarding with the licensee or the individual is if those things affect the doctor's ability to practice safely, not that he/she has the disability. It is a hands-on profession. MR. GRAVO pointed out that a change would require concurrence by the Senate, an additional step. REPRESENTATIVE BRICE said he does not know whether it is a big deal or not, but he is comfortable leaving it like it is. REPRESENTATIVE MURKOWSKI said she does not like it. She agreed with Ms. Reardon that it is contained within "physical disability." She thinks it is more problematic leaving it in. MS. REARDON stated: I did look up ... dentistry and medical licensing. ... They just refer to physical or mental disability. So, probably we're able to make responsible decisions without having this language here. REPRESENTATIVE MURKOWSKI made a motion to amend the bill by deleting "or an infectious or contagious disease" on page 4, lines 16 and 17. Number 0502 CHAIRMAN ROKEBERG asked Ms. Clark what the sponsor's representative would say about deleting that from the bill. MS. CLARK said, "He would probably be in support of whatever the sponsor wanted." She said that interestingly enough, this didn't come up in any of the discussions. CHAIRMAN ROKEBERG said, quite frankly, he thinks it runs the risk of running afoul of the ADA. Number 0553 MR. GRAVO said he did not think he could argue against [the amendment]. It just might complicate the bill's passage this session. Number 0574 MS. REARDON pointed out that there is a good public health and safety reason for the whole bill. She stated: It's not just the inactive, retired, locum tenens status. The really important thing about having this bill pass into law is that without it, it retains a giant loophole in chiropractic licensing, which is that there is a list of things you can discipline a license holder for, but there is nowhere where it says you can deny a license. That's the really important part of this whole bill, is where it says you can also deny a license. ... This is a bill that matters. And this has been a problem for the board, where they had people with fairly significant criminal backgrounds. And when they went to see why they could deny a license to that person, they found out they couldn't. Number 0626 REPRESENTATIVE HALCRO asked whether, if the bill were left unamended, the board couldn't create more specific rules regarding "Section C, physical or mental disability," to more closely reflect the physical or mental disability goal that the committee is trying to reach. Number 0661 MS. REARDON said: If what you are asking is, "Could the board write regulations that said that 'physical or infectious diseases' wording only applies to diseases that impact your ability to practice safely" or something like that, I would think that they probably could. I also think that even in the absence of that type of regulation, if we tried to actually discipline, to file an accusation against someone, or to deny a license and they appealed, that if it conflicted with the ADA, that the Department of Law would immediately yank us back and say, "No, you can't charge someone with something that doesn't relate to their ability to practice." CHAIRMAN ROKEBERG asked if any more regulations would have to be written because of this bill. Number 0712 MS. REARDON said there is the opportunity to write regulations. If they [the department] cared to write some regulations about how one could get back one's retired license, into active status, then the bill says they can write regulations on that. But there isn't any mandate. CHAIRMAN ROKEBERG reminded members that there was a motion before the committee. Number 0739 REPRESENTATIVE BRICE said he was going to oppose the motion for the simple reason that he would like a clearer definition of what this [legislation] has to do. He suggested that the bill could still be amended on the floor. CHAIRMAN ROKEBERG asked Representative Murkowski if she wished to maintain her motion or wanted to call Legislative Legal Services and asked for a legal opinion. REPRESENTATIVE BRICE urged the committee to withdraw the amendment. He said: It's not going to be on the floor tomorrow or even the next [day], at which point in time we can get this completely cleared up as to exactly how important that section is - whether there are actually areas where there have been infected chiropractors that are spreading disease and contagion and causing a problem, or whether or not this is just something people wanted to see (indisc.). CHAIRMAN ROKEBERG stated: My concern on the subject is that it may run afoul of some legal problems with the ADA. On the other hand, I believe it should be (indisc.) if there is unfitness on the part of the practitioner because of a disease. ... That's my concern. I would prefer to leave it in, also. MS. REARDON asked if a letter of intent would make people feel comfortable. CHAIRMAN ROKEBERG replied no. He said that he is concerned about the legal aspect of this issue. REPRESENTATIVE MURKOWSKI withdrew her motion. Number 0918 REPRESENTATIVE BRICE made a motion to move CSSB 297(L&C) am out of committee with individual recommendations. There be no objection, CSSB 297(L&C) am moved out of the House Labor and Commerce Standing Committee.
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