Legislature(2001 - 2002)
04/29/2002 03:20 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
SB 274-PHYSICIANS' LOCUM TENENS PERMITS CHAIR MURKOWSKI announced that the first order of business would be CS FOR SENATE BILL NO. 274(L&C), "An Act relating to issuance of a locum tenens permit for a physician or osteopath; and providing for an effective date." Number 0158 REPRESENTATIVE HALCRO moved to adopt Version 22-LS1393\L, Lauterbach, 4/29/02, as the working document. There being no objection, Version L was before the committee. CHAIR MURKOWSKI reminded committee members that at the last hearing of CSSB 274(L&C) there was concern with regard to the language in Section 2 requiring that the locum tenens permits "shall" be extended for an additional 60 days. The language in Section 2 has been expanded in Version L so that it says: "the board may refuse to grant a license under AS 08.64.240". Version L also adds paragraphs (2)-(4) under Section 3 in order to provide greater public safety by specifying the items to be obtained in a background check. Number 0325 JEFF BULLOCH, Alaska State Medical Association, informed the committee that representatives from the association spoke with the sponsor and suggested that on page 2, line 10, the language "or its designee" be deleted. Therefore, a denial would go before the full board where due process would occur and the person being denied would be allowed to be present. CHAIR MURKOWSKI asked if the sponsor is comfortable with the amendments encompassed in Version L. Number 0399 SENATOR DONNY OLSON, Alaska State Legislature, speaking as the sponsor of SB 274, said that he agreed with the majority of Version L. However, the [focus] of the bill is directed at rural Alaska where there have been difficulties obtaining and holding replacement physicians. With regard to the language on page 2, line 10, Senator Olson expressed concern with denials for extensions. Therefore, he suggested that the language "or its designee" be deleted from page 2, line 10. In response to Representative Halcro, Senator Olson specified that normally the designee is the executive director. Deleting the aforementioned language would move away from personality difficulties. CHAIR MURKOWSKI pointed out that the language "or its designee" is also found on line 17 of page 2. Therefore, she asked if Senator Olson would like the language deleted in that location as well. SENATOR OLSON answered, "Not at this point." CHAIR MURKOWSKI directed attention to page 2, line 26, which requires a "completed application form and the fee required for licensure under this chapter." She recalled that at the last hearing there was discussion regarding at what point should the locum tenens physician obtain licensure in Alaska versus relying on the locum tenens permit. She asked if the language on page 2, line 26, is acceptable. SENATOR OLSON said that he agrees that those staying in Alaska indefinitely or permanently should have a permanent license. However, there are exceptions. For instance, there may be cases in which individuals may have difficulties obtaining a fully certified diploma. Number 0920 REPRESENTATIVE ROKEBERG asked if the language on page 2, line 26 was part of the amendment he made at the last hearing. CHAIR MURKOWSKI replied yes. She recalled that Representative Rokeberg had requested that references to various background checks should be included. The clearance report from the U.S. Drug Enforcement Administration (DEA) was added because [the Division of Occupational Licensing] sent an e-mail saying that it [wasn't mentioned because the representative from the division didn't think of it at the time]. In further response to Representative Rokeberg, Chair Murkowski said that her notes reflect discussion of [inserting] the language on page 2, line 26. REPRESENTATIVE ROKEBERG remarked that paragraph (4) forces the [locum tenens permit holder] to make the application. CHAIR MURKOWSKI said that her notes reflect that [the committee] wanted to encourage full-time active licensure after 180 days [in state on a locum tenens permit]. REPRESENTATIVE ROKEBERG pointed out that there is a 240-day limitation now, which [with the language in Version L] seems to exceed the 240-day limitation. If one wanted a 30-day extension beyond the 240 days, then the individual would have to apply for licensure. CHAIR MURKOWSKI said she believes that is correct. REPRESENTATIVE ROKEBERG remarked that he wasn't sure why that would be done. SENATOR OLSON commented that if a person is in the state for 240 days and requests an extension, then the individual should apply for full licensure. REPRESENTATIVE ROKEBERG questioned whether paragraphs (1)-(3) are necessary if [paragraph (4)] is included. CHAIR MURKOWSKI reminded everyone that [at the last hearing] there was discussion of an individual who had been [practicing] in the state for almost 240 days and the individual had decided to practice in Alaska. However, the individual was going to miss a window for application and would not be able to practice [while obtaining full licensure] without the inclusion of Section 3. Chair Murkowski recalled that Representative Rokeberg had wanted to ensure that the necessary checks had occurred if indefinite extensions were going to be allowed. REPRESENTATIVE ROKEBERG agreed. He said that if subsection (f) is limited to what Chair Murkowski described, then that would be acceptable so long as the sponsor viewed it as acceptable. SENATOR OLSON said that he didn't have a problem with that. However, he suggested checking with the executive director [of ASMA] or someone from the Division of Occupational Licensing in order to be sure that there isn't something he is unaware of. MR. BULLOCH related that after reviewing the CS, ASMA felt that Section 3 was fine. Number 1300 REPRESENTATIVE HALCRO moved that the committee adopt Amendment 1, which reads as follows: Page 2, line 10, Delete "or its designee" REPRESENTATIVE ROKEBERG objected. He pointed out that on page 1, line 5, the legislation refers to a "member of the board" whereas Section 2 (e) refers to "the board", which he viewed as problematic. REPRESENTATIVE HALCRO pointed out that because the legislation outlines that only the board can grant a request for an extension. He related his belief that only the board should be allowed to grant a temporary permit. In response to Representative Meyer, Representative Halcro confirmed that the language "executive secretary" on page 1, line 5, would have to be deleted. CHAIR MURKOWSKI reminded the committee that there was a due process concern in that if there was going to be a denial of an extension, then the individual who made the request should have the opportunity to present to the board the reasons why the permit should be continued. That concern was the reasoning behind deleting "or its designee", she explained. In response to Representative Rokeberg, Chair Murkowski confirmed that the board or its designee could make the initial extension. Only upon denial was due process a concern. REPRESENTATIVE ROKEBERG maintained his objection. He related his understanding that the initial permit under Sections 1 and 2 can be granted by the board, a member of the board, or its executive secretary. The 60-day extension can be granted by the board or its designee. However, only the board can hand down a refusal to grant an extension. REPRESENTATIVE HALCRO asked if there is any due process protecting an individual who is denied an initial permit. SENATOR OLSON related his understanding that denial of [an initial permit application] can be taken to the full board for reconsideration. CHAIR MURKOWSKI surmised then that this language would be consistent with what's currently in statute. She specified that the intent is to provide due process when there is denial of a permit during any point in the process. She explained that the board can deny an extension but a designee of the board cannot because denial of the permit gets into the previously discussed issue of due process. REPRESENTATIVE HALCRO, in response to comments by Representative Rokeberg, explained that Amendment 1 accomplishes what Representative Rokeberg wants because only the board can refuse to grant a request for an extension. Once one is given a license and returns for renewal or extension, the board or its designee can grant the extension. However, if the designee denies the extension request, then the due process is going before the board at its next meeting. REPRESENTATIVE ROKEBERG disagreed. Number 1905 CATHERINE REARDON, Director, Division of Occupational Licensing, Department of Community & Economic Development, testified via teleconference. Ms. Reardon explained that the Alaska State Medical Board and the Division of Occupational Licensing are under the Administrative Procedures Act. Therefore, both entities are required to provide the right to appeal or contest a board action. A denial of a permit, license, or right always triggers the right to appeal. REPRESENTATIVE ROKEBERG asked if the [locum tenens physician] would be allowed to practice pending the appeal. MS. REARDON said the [locum tenens physician] would not be allowed to practice pending the appeal if the initial permit had expired. In further response to Representative Rokeberg, Ms. Reardon explained that the appeal would be to the board, which almost always delegates the actual hearing to the hearing officer and considers the hearing officer's proposed decision. Although the board has the option of hearing the case, it rarely does so. Ms. Reardon turned to Sections 2 and 3 of [Version L] and stressed that two different types of extensions are being addressed. REPRESENTATIVE ROKEBERG pointed out that Section 3 refers to the essential medical services extension. Representative Rokeberg questioned why the language "or its designee" would need to be deleted on page 2, line 10, when there is already a statutory right of appeal to the board. CHAIR MURKOWSKI related her understanding that leaving in the aforementioned language would place the designee in the position of granting or denying a permit, although the permittee would have the right to appeal to the board. MS. REARDON agreed with Chair Murkowski's understanding. She surmised that the policy question is whether to delegate or designate a denial or whether such a decision should be made by the board itself. She pointed out that the boards don't have to delegate or designate these decisions. REPRESENTATIVE ROKEBERG maintained his objection because the language is adequate and waiting for an actual board meetings could take some time. The designee of the board is specified because the [denial] is an administrative function. CHAIR MURKOWSKI asked if the sponsor, having heard Ms. Reardon's comments, had anything to add. SENATOR OLSON acknowledged that Representative Rokeberg has some valid concerns. However, deletion of the language "or its designee" moves away from frivolous rejections and allows the board to make the decision for the refusal. Although the board holds quarterly meetings, there are provisions to hold teleconferences when someone feels strongly that someone should be refused. The difficulty with [waiting for quarterly meetings] is that there is a period of time in which the applicant or permittee isn't of use to anyone because of the inability to work and thus is an added burden on the facility with which the individual works. The committee took an at-ease in order for Chair Murkowski to pass the gavel to Vice Chair Halcro. VICE CHAIR HALCRO asked Senator Olson if he supported the deletion of the language "or its designee" from the legislation. SENATOR OLSON replied yes. Number 2260 REPRESENTATIVE ROKEBERG pointed out that a telephonic board meeting would be required for a 60-day extension. He asked if this board can take action on a telephonic basis when the issue is a refusal of a permit. MS. REARDON replied yes. In further response to Representative Rokeberg, Ms. Reardon said that she was comfortable with the removal of the aforementioned language. REPRESENTATIVE ROKEBERG asked if Ms. Reardon would like to provide the drafter freedom to craft the language rather than having a limited amendment. MS. REARDON said she wasn't sure what the language would look like. TAPE 02-68, SIDE B MS. REARDON expressed concern that if language describing the permit denial process is inserted, there could be unforeseen consequences. REPRESENTATIVE ROKEBERG removed his objection but maintained his discomfort with the language, which he said should be cleaned up. There being no objection, Amendment 1 was adopted. Number 2327 REPRESENTATIVE MEYER moved to report HCS CSSB 274, Version 22- LS1393\L, Lauterbach, 4/29/03, as amended out of committee with individual recommendations and the accompanying zero fiscal note. There being no objection, HCS CSSB 274(L&C) was reported from the House Labor and Commerce Standing Committee. The committee took a brief at-ease.
| Document Name | Date/Time | Subjects |
|---|