Legislature(2003 - 2004)

02/10/2003 03:15 PM House L&C

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
HB  73-EXTEND STATE MEDICAL BOARD                                                                                             
                                                                                                                                
Number 1546                                                                                                                     
                                                                                                                                
CHAIR ANDERSON announced a hearing on  HOUSE BILL NO. 73, "An Act                                                               
extending the termination date of the State Medical Board."                                                                     
                                                                                                                                
REPRESENTATIVE DAHLSTROM,  sponsor of  HB 73, testified  that the                                                               
bill extends the termination date  of the State Medical Board for                                                               
four years.   She  described the  membership of  the eight-member                                                               
board, which is appointed by the governor.  She also said:                                                                      
                                                                                                                                
     The board  serves the  public interest  by establishing                                                                    
     the minimum education  and work-experience requirements                                                                    
     that   individuals  must   meet   to  become   licensed                                                                    
     physicians,  osteopaths,  podiatrists, paramedics,  and                                                                    
     physician  assistants.   The board  further serves  the                                                                    
     public  interest  by investigating  complaints  against                                                                    
     licensed professionals  and taking  disciplinary action                                                                    
     when  appropriate   and  necessary.    The   board  has                                                                    
     consistently  proven  to   be  efficient;  therefore  I                                                                    
     recommend that  the State Medical Board  be extended to                                                                    
     June  30,  [2007], and  I  urge  you  to vote  for  its                                                                    
     passage.                                                                                                                   
                                                                                                                                
Number 1641                                                                                                                     
                                                                                                                                
REPRESENTATIVE ROKEBERG  asked why the sponsor  didn't follow the                                                               
recommendation of the legislative  audit report for an eight-year                                                               
extension.                                                                                                                      
                                                                                                                                
KIMBERLY HANGER, Staff to  Representative Nancy Dahlstrom, Alaska                                                               
State Legislature, quoted AS 08.03.020,  which sets the four-year                                                               
extension for  a board  unless it  is continued  or reestablished                                                               
for a longer period.                                                                                                            
                                                                                                                                
REPRESENTATIVE ROKEBERG  noted that the legislature  can continue                                                               
the  board  longer  than  the four-year  period  if  it  chooses,                                                               
depending on the  level of confidence the legislature  has in the                                                               
board's work.   The board  has been in the  headlines frequently,                                                               
holding  disciplinary hearings,  and perhaps,  he surmised,  that                                                               
means it's doing  a good job.   It's a judgment call  how long to                                                               
extend  the  sunset provision.    Often,  the legislative  audits                                                               
expose problems in the statute or  the regulations of a board.  A                                                               
shorter  sunset  period  allows the  legislature  to  review  the                                                               
results of previous changes to the law.                                                                                         
                                                                                                                                
Number 1811                                                                                                                     
                                                                                                                                
PAT  DAVIDSON, Legislative  Auditor, Legislative  Audit Division,                                                               
Alaska State  Legislature, explained  that the audit  report [No.                                                               
08-20017-02]  recommended an  eight-year  extension  to 2011  for                                                               
several  reasons.   Auditors found  that the  board was  actively                                                               
working on statutory  and regulatory development of  items in the                                                               
public interest.   The board  was functioning smoothly  and there                                                               
were no  financial problems  with its  operations.   It's unusual                                                               
for  her office  to recommend  such  a lengthy  extension of  the                                                               
board,  she said,  and  the statutes  indicate  a preference  for                                                               
four-year  extensions.   She reminded  legislators that  they can                                                               
ask her agency to review a board if they see problems.                                                                          
                                                                                                                                
MS. DAVIDSON  answered Representative Lynn's questions  about the                                                               
details of board  members' terms and appointments.   She said the                                                               
eight members'  terms are four-years  and staggered;  members are                                                               
appointed by the governor and approved by the legislature.                                                                      
                                                                                                                                
MS.  DAVIDSON replied  to Representative  Rokeberg's query  about                                                               
the  statute   controlling  the  extension  of   the  boards,  AS                                                               
08.03.020.  She said the  statute gives legislators leeway to put                                                               
whatever year they'd like on the termination date.                                                                              
                                                                                                                                
Number 1965                                                                                                                     
                                                                                                                                
MS. DAVIDSON, as requested  by Representative Rokeberg, explained                                                               
the  one-year  closeout  period  provided by  state  law  if  the                                                               
legislature  chooses not  to  extend the  termination  date of  a                                                               
board.  She explained that  the licensing function may remain and                                                               
be administered  by the Division  of Occupational  Licensing even                                                               
if the  board dissolves.  When  a board shuts down,  the division                                                               
loses the  voice of the  professionals it  is regulating.   It is                                                               
more difficult to make changes  in statute and regulations, which                                                               
as  a result  tend to  get  stale.   Because a  board only  meets                                                               
several times a  year, those activities would  get shelved during                                                               
a wind-down year.                                                                                                               
                                                                                                                                
MS. DAVIDSON  answered a question from  Representative Guttenberg                                                               
about the State Medical Board's  taking an active role in shaping                                                               
state laws and regulations.   She said its members testify before                                                               
the legislature on  bills and develop regulations  to support the                                                               
statutes.                                                                                                                       
                                                                                                                                
REPRESENTATIVE  GUTTENBERG noted  the  board's 413  investigative                                                               
cases referenced  in the  audit and  asked whether  any resulting                                                               
legal challenges handled  by the Department of  Law have affected                                                               
the board's budget.                                                                                                             
                                                                                                                                
MS. DAVIDSON replied  that most times when the  Department of Law                                                               
does  work  associated with  a  licensing  board, the  department                                                               
charges the board for those services.                                                                                           
                                                                                                                                
Number 2135                                                                                                                     
                                                                                                                                
REPRESENTATIVE DAHLSTROM  said that as  the sponsor of  the bill,                                                               
she favors the  four-year period because the  medical industry is                                                               
changing so  rapidly, and this  allows the legislature  to review                                                               
the board again in four years.                                                                                                  
                                                                                                                                
MS.  HANGER noted  that the  committee's bill  packet includes  a                                                               
letter from the  former director of the  Division of Occupational                                                               
Licensing,   Catherine  Reardon,   agreeing   with  the   audit's                                                               
recommended eight-year extension.                                                                                               
                                                                                                                                
Number 2176                                                                                                                     
                                                                                                                                
REPRESENTATIVE GATTO agreed with the  sponsor's choice of a four-                                                               
year extension.   He  commented that a  board might  increase its                                                               
activities as  it sees  a termination date  approaching.   He has                                                               
followed the news  of the board's investigations  reported in the                                                               
newspaper.   He has  worked as  a paramedic  in Anchorage  for 28                                                               
years  and  is familiar  with  some  of the  professionals  being                                                               
investigated.                                                                                                                   
                                                                                                                                
MS.  DAVIDSON  replied  to Representative  Guttenberg's  question                                                               
about  whether  a board's  activity  increases  as it  nears  its                                                               
termination date.   She said it depends on  the particular board.                                                               
Some  boards  prefer  to  have  their  sunset  extension  handled                                                               
separately from  any changes to  their governing statues.   Other                                                               
boards may be going through growing  pains and may be more active                                                               
before a sunset review.                                                                                                         
                                                                                                                                
Number 2355                                                                                                                     
                                                                                                                                
RICK  URION,   Director,  Division  of   Occupational  Licensing,                                                               
Department  of   Community  &  Economic  Development,   said  the                                                               
division supports  HB 73 and asked  the committee to pass  it on.                                                               
He said the department has no  problem with either a four-year or                                                               
eight-year  extension of  the board.    Setting the  term of  the                                                               
board  does not  affect the  four-year term  of the  members, and                                                               
he's  not aware  of any  boards that  become more  active at  the                                                               
approach of sunset.                                                                                                             
                                                                                                                                
TAPE 03-7, SIDE B                                                                                                             
Number 2370                                                                                                                     
                                                                                                                                
MR.  URION said  the Medical  Board is  extremely active  and has                                                               
handled  a number  of disciplinary  actions,  which causes  their                                                               
administrative  costs  to  rise.    He  discussed  how  diplomacy                                                               
actions  affect  the licensing  fees,  and  for professions  with                                                               
fewer members, that can have a  severe impact.  He said the State                                                               
Medical Board  is about  $190,000 in the  hole, and  he predicted                                                               
next  year  will  be  a  quieter  year  with  less  investigative                                                               
activity.  The fee for physicians  is $590 as of the beginning of                                                               
the year, and the next renewal is in 2004.                                                                                      
                                                                                                                                
MR. URION  replied to Representative  Lynn's question  about when                                                               
an investigation becomes public.   He said under current division                                                               
policies,  a  complaint  becomes  public right  away.    But  the                                                               
division is  working on  adding an intermediate  step in  which a                                                               
complaint  would be  screened for  validity  before beginning  an                                                               
investigation.                                                                                                                  
                                                                                                                                
Number 2139                                                                                                                     
                                                                                                                                
REPRESENTATIVE GATTO asked how a  patient can take action against                                                               
an  incompetent  physician.    He  also  questioned  whether  the                                                               
medical profession is truly self-policing.                                                                                      
                                                                                                                                
MR. URION  replied that  the patient can  file a  complaint about                                                               
the  doctor with  the  Division of  Occupational  Licensing.   He                                                               
added that  it's easier for  physicians to assess  the competency                                                               
of their peers,  now that they've been relieved  of the liability                                                               
under a change in state law [AS 08.64.362] several years ago.                                                                   
                                                                                                                                
CHAIR  ANDERSON invited  Mr. Urion  to brief  the committee  at a                                                               
future meeting  about complaint procedures and  the budget impact                                                               
of these procedures.                                                                                                            
                                                                                                                                
Number 1935                                                                                                                     
                                                                                                                                
REPRESENTATIVE  DAHLSTROM,   in  response  to  a   question  from                                                               
Representative  Rokeberg,  said  she   is  not  comfortable  with                                                               
increasing the  four-year extension, but  she is willing  to talk                                                               
to Senator Con Bunde, who is sponsoring a similar bill.                                                                         
                                                                                                                                
Number 1856                                                                                                                     
                                                                                                                                
REPRESENTATIVE LYNN moved  to report HB 73 out  of committee with                                                               
individual  recommendations  and  the accompanying  fiscal  note.                                                               
There being  no objection,  HB 73 was  reported from  House Labor                                                               
and Commerce Standing Committee.                                                                                                
                                                                                                                                

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