Legislature(1999 - 2000)

04/10/1999 10:06 AM FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
                                                                                                                                
 SENATE BILL NO. 88                                                                                                             
                                                                                                                                
"An Act relating to licensure of dietitians and                                                                                 
nutritionists; and providing for an effective date."                                                                            
                                                                                                                                
 CS FOR SENATE BILL NO. 88(L&C)                                                                                                 
                                                                                                                                
"An Act relating to licensure of dietitians and                                                                                 
nutritionists; and providing for an effective date."                                                                            
                                                                                                                                
                                                                                                                                
Senator Donley briefly explained the legislation.  He said                                                                      
there was a zero fiscal note and no impact on the State.                                                                        
At the request of the department he explained the two                                                                           
changes from version "M" and version "K".                                                                                       
                                                                                                                                
JOHN WRAY, Bartlett Memorial Hospital was invited to join                                                                       
the committee.  He represented the American Dietitians                                                                          
Association.  Further, he thanked Senator Donley for                                                                            
introducing this bill.                                                                                                          
                                                                                                                                
Senator Phillips voiced his concern regarding the bill.                                                                         
                                                                                                                                
(Arrival of Senator P. Kelly at approximately 9:24 a.m.)                                                                        
                                                                                                                                
Senator Parnell asked that Senator Phillips ask one                                                                             
question at a time.                                                                                                             
                                                                                                                                
Senator Phillips continued voicing the concern of his                                                                           
constituents.  Consumers said they could go to the American                                                                     
Dietitian Association; and there were further concerns for                                                                      
the exemptions on page three.  Those included:  no money to                                                                     
police the bill, no enforcement, creating another                                                                               
bureaucracy; should be a grandfather clause; exemption on                                                                       
page three, line twenty.  Those were the main concerns.                                                                         
                                                                                                                                
Mr. Wray asked if they were all a concern?  Senator Donley                                                                      
asked the concern for exemptions?                                                                                               
                                                                                                                                
Mr. Ray responded.  He said he could answer most of the                                                                         
concerns.  The CS has gone through a lot of rewrite.  He                                                                        
wrote the original bill after a lot of research.  The                                                                           
American Dietetic Association was satisfied with this bill.                                                                     
A situation was created where they would have to pay $668                                                                       
every two years to be licensed.  They felt this was not                                                                         
going to work.  (Teleconference connection temporarily                                                                          
cut.)  After statutes are written from the A.G.'s office                                                                        
the licensing process will be renewals and therefore the                                                                        
costs will go down.  He said this was the "price of doing                                                                       
business".  Occupational licensing has said they can deal                                                                       
with this matter and it would not cause an increase of                                                                          
their staff.  There was confusion about the status of two                                                                       
classes of dietitians.  He clarified for Senator Phillips                                                                       
that there are things a nutritionist does that a dietitian                                                                      
does not.  Currently, there was no professional                                                                                 
organization equivalent for nutritionists.                                                                                      
                                                                                                                                
(Teleconference reconnected.)                                                                                                   
                                                                                                                                
Mr. Wray continued.  It was not the intent of this bill to                                                                      
put people out of work.  Therefore, it does not include a                                                                       
"grandfather clause".  Personally, he has been member of                                                                        
the American Dietetic Association for seventeen years.  He                                                                      
does not recall if there are by-laws that would cause                                                                           
concern that ADA could revoke anyone's license.  However,                                                                       
he could not answer this question directly.                                                                                     
                                                                                                                                
Regarding the exemptions, the original bill had thirteen.                                                                       
The rationale for this is straightforward.  For example, he                                                                     
referred to military individuals being stationed somewhere                                                                      
for a two-year period.  Almost all licensure bills in the                                                                       
U.S. exempt military individuals.  He noted for the                                                                             
committee that probably everyone would not be happy with                                                                        
this bill.                                                                                                                      
                                                                                                                                
Senator Phillips said he thought the original idea of this                                                                      
bill was for consumer protection.                                                                                               
                                                                                                                                
Co-chair Torgerson asked if there was anything in the bill                                                                      
regarding military services and being exempt.                                                                                   
                                                                                                                                
Mr. Wray said that Elmendorf Air Force base  has two                                                                            
dietitians on staff that are military.  He does not believe                                                                     
that if one got out of the military they would still have                                                                       
to apply for a license.  However, Mr. Wray said he would                                                                        
look into this and get the correct information back to the                                                                      
committee.  Co-chair Torgerson said he appreciated that                                                                         
because it would have to be fixed.                                                                                              
                                                                                                                                
Senator Green questioned about dietitian licensure, page                                                                        
two of version "M".   Mr. Wray advised that there was no                                                                        
internship for nutritionists.                                                                                                   
                                                                                                                                
Senator Green asked about qualifications.  Mr. Wray asked                                                                       
if this was with respect to nutritionists?   Senator Green                                                                      
said it was on page two, lines fifteen through seventeen.                                                                       
Mr. Wray explained the way the qualifications system                                                                            
worked.  There are five or six individuals around the state                                                                     
providing valuable services for the State of Alaska and                                                                         
they should be recognized.                                                                                                      
                                                                                                                                
Senator Green said there should be a fiscal note on the                                                                         
anticipated costs for Medicare.  This was a concern for                                                                         
her.                                                                                                                            
                                                                                                                                
Co-chair Torgerson concurred.  He requested the department                                                                      
be available to answer these questions.                                                                                         
                                                                                                                                
Mr. Wray said there was not a provision within Medicare for                                                                     
nutrition therapy to be reimbursed.  There was a well-                                                                          
established but limited criteria for Medicaid, however, to                                                                      
his knowledge nothing for Medicare.                                                                                             
                                                                                                                                
Senator Green said if there is reimbursement being                                                                              
anticipated at some time they should be made aware of it                                                                        
and plan for it now.                                                                                                            
                                                                                                                                
Senator Leman asked if 900 hours of work experience                                                                             
represented a year of work?  According to his calculations                                                                      
it was really about half a year. Mr. Wray stood corrected.                                                                      
                                                                                                                                
LINDA WILD, Nutritionist was invited to join the committee.                                                                     
She identified herself as being a nutritionist licensed in                                                                      
Washington State.  She gave her money each year because                                                                         
licensed recognition was important and gave one                                                                                 
professional credentials.  People feel comfortable knowing                                                                      
that the particular individual has met certain criteria in                                                                      
their field.  She felt that dietitians and nutritionists                                                                        
should be put on the same field as other health care                                                                            
individuals.                                                                                                                    
                                                                                                                                
With regards to the two classes, both dietitians and                                                                            
nutritionists should be recognized.  They both must have                                                                        
the necessary work experience.                                                                                                  
                                                                                                                                
In response to a query from Co-chair Torgerson she said she                                                                     
paid $200 bi-annually to Washington State.  She explained                                                                       
that she was on her way to becoming a registered dietitian.                                                                     
                                                                                                                                
Senator Green commented briefly.  Ms. Wild said she was a                                                                       
certified nutritionist in the State of Washington.  Senator                                                                     
Green asked about her qualifications as related to Alaska.                                                                      
Ms. Wild said because she was qualified in Washington State                                                                     
she was able to "walk" into her position in Alaska.  She                                                                        
referred to "midwives" and explained the terms for                                                                              
certification or licensing were basically the same.                                                                             
                                                                                                                                
CATHERINE REARDON, Director, Division of Occupational                                                                           
Licensing, Department of Commerce and Economic Development                                                                      
was invited to join the committee.  Co-chair Torgerson                                                                          
asked why this fiscal note was so expensive.  Ms. Reardon                                                                       
said the original cost was $28,000/year.  She referred to                                                                       
her explanation of the costs.  One thing she left out was                                                                       
investigative time.  She expected the costs to slow down as                                                                     
time passed.                                                                                                                    
                                                                                                                                
Senator Phillips asked if anyone from the Department of                                                                         
Health and Social Services was available to answer any                                                                          
questions.                                                                                                                      
Ms. Reardon said she was not aware of anyone present.                                                                           
Senator Phillips had question for Medicare and Medicaid.                                                                        
He wanted to know the potential costs.                                                                                          
                                                                                                                                
Co-chair Torgerson felt there needed to be work done on the                                                                     
"grandfather" clause and other possible amendments. Senator                                                                     
Donley said he would try to make changes more clear.                                                                            
                                                                                                                                
(Tape #85 switched to Side B at log number 597.)                                                                                
                                                                                                                                
Co-chair Torgerson HELD SB 88 in committee.  He then called                                                                     
HB 27.                                                                                                                          
                                                                                                                                

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