Legislature(1999 - 2000)
04/10/1999 10:06 AM FIN
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
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.