Legislature(2021 - 2022)BUTROVICH 205

03/08/2021 01:30 PM Senate JUDICIARY

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01:32:56 PM Start
01:33:50 PM Confirmation Hearing(s)
02:29:35 PM SB65
02:41:34 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 65 LIABILITY CONSULTING HEALTH CARE PROVIDER TELECONFERENCED
Heard & Held
Alaska Police Standards Governor Appointees
        SB 65-LIABILITY CONSULTING HEALTH CARE PROVIDER                                                                     
                                                                                                                                
2:29:35 PM                                                                                                                    
CHAIR  REINBOLD reconvened  the  meeting and  announced that  the                                                               
business before  the committee would  be SENATE BILL NO.  65, "An                                                               
Act relating to immunity  for consulting physicians, podiatrists,                                                               
osteopaths,  advanced   practice  registered   nurses,  physician                                                               
assistants,  dentists,  optometrists, and  pharmacists."  [Before                                                               
the committee was CSSB 65(HSS)].                                                                                                
                                                                                                                                
2:29:52 PM                                                                                                                    
SENATOR  KIEHL, speaking  as sponsor,  introduced  his staff,  CJ                                                               
Harrell, as an intern through  the University of Alaska Southeast                                                               
and Ted Stevens Institute.                                                                                                      
                                                                                                                                
2:30:18 PM                                                                                                                    
CJ   HARRELL,  Intern,   Senator   Jesse   Kiehl,  Alaska   State                                                               
Legislature, Juneau, Alaska,  stated that she works  as an intern                                                               
for  Senator  Kiehl, sponsor  of  SB  65.  She read  the  sponsor                                                               
statement on behalf of Senator Kiehl:                                                                                           
                                                                                                                                
     Within Alaska  and other states, health  care providers                                                                    
     will  seek  the  knowledge   and  expertise  of  fellow                                                                    
     medical professionals  to help  them understand  how to                                                                    
     help their  patient in an effective  and timely matter.                                                                    
     These  conversations may  be an  official consultation,                                                                    
     but often  medical professionals  have what  are called                                                                    
     "curbside consultations".                                                                                                  
                                                                                                                                
     This is  when a patient's  health care provider  has an                                                                    
     uncompensated   informal   consultation  with   another                                                                    
     medical   professional.    These   consulting   medical                                                                    
     professionals are  often specialists,  and do  not have                                                                    
     any relationship  with the patient being  discussed. It                                                                    
     is a  fast and effective  way of sharing  knowledge and                                                                    
     expertise and in  many ways is the  backbone of medical                                                                    
     care.                                                                                                                      
                                                                                                                                
     It  was not  until  2  years ago  in  Minnesota that  a                                                                    
     health  care  provider who  had  no  relationship to  a                                                                    
     patient  was  forced  to defend  themselves  against  a                                                                    
     civil liability  case. We fear  that by  not protecting                                                                    
     those who  have no  relationship to  a patient  and are                                                                    
     sharing    their   expertise    through   a    curbside                                                                    
     consultation,  they  will  no longer  feel  comfortable                                                                    
     aiding fellow health care providers in this way.                                                                           
                                                                                                                                
     This   bill  will   allow  curbside   consultations  to                                                                    
     continue, but now without the  fear of becoming subject                                                                    
     to  civil liability  for  a patient  who  they have  no                                                                    
     relationship to.                                                                                                           
                                                                                                                                
2:31:44 PM                                                                                                                    
SENATOR  KIEHL explained  that the  Senate  Health and  Education                                                               
Committee made  two changes to  the bill. One change  clarified a                                                               
vague statement about preparing a  report. The other change added                                                               
chiropractors  to the  list  of professionals  who  may give  and                                                               
receive  curbside consultations  without  the  risk of  liability                                                               
under the bill.                                                                                                                 
                                                                                                                                
SENATOR  KIEHL  reviewed  the  legal   principles.  He  said  the                                                               
Minnesota Supreme Court  case set out a new  standard for medical                                                               
liability. It did not require  a doctor/and patient relationship.                                                               
Therefore,  it did  not  require the  duty of  care,  one of  the                                                               
keystones  of liability  and  torts.  The goal  of  SB  65 is  to                                                               
preserve how medical malpractice  liability has worked in Alaska,                                                               
which is  not to hold  liable health care professionals  who have                                                               
never  given care  to  patients. He  offered  his willingness  to                                                               
discuss the details.  He emphasized that is the key  to the legal                                                               
issues in SB 65                                                                                                                 
                                                                                                                                
CHAIR  REINBOLD  related  her understanding  that  care  includes                                                               
vaccinations.                                                                                                                   
                                                                                                                                
SENATOR KIEHL answered that any  health care professional who has                                                               
given shots  has a duty  of care but  would not be  covered under                                                               
the bill.                                                                                                                       
                                                                                                                                
2:34:02 PM                                                                                                                    
the patient is not a current  or former patient of the consulting                                                               
health care provider or of  the consulting health care provider's                                                               
practice." He  asked why the  sponsor did not allow  liability to                                                               
be removed from a former patient.                                                                                               
                                                                                                                                
SENATOR KIEHL  answered that if  a doctor treated a  patient last                                                               
week, they have established a doctor/patient relationship.                                                                      
                                                                                                                                
SENATOR  MYERS  said that  the  timeliness  of the  visit  seemed                                                               
relevant. For  example, if a  doctor has  not seen a  patient and                                                               
three  years, he  asked if  a  doctor/patient relationship  would                                                               
still exist.                                                                                                                    
                                                                                                                                
2:35:17 PM                                                                                                                    
SENATOR  MYERS referred  to  page 2,  line  23 of  SB  65 to  the                                                               
definition  of  a health  care  facility.  He  said it  does  not                                                               
mention federal  hospitals. He noted that  hospitals for veterans                                                               
in Alaska would not be covered.                                                                                                 
                                                                                                                                
SENATOR  KIEHL answered  that it  was not  the intent  to exclude                                                               
federal hospitals. He  offered to research it and  report back to                                                               
the committee.                                                                                                                  
                                                                                                                                
2:36:08 PM                                                                                                                    
SENATOR MYERS referred  to page 3, line  3 of SB 65.  He said was                                                               
surprised   to   see   pharmacists   listed.   He   related   his                                                               
understanding  that  pharmacists  do  not  enter  into  the  same                                                               
relationship as  other health care professionals  such as doctors                                                               
and nurses. He asked for clarification.                                                                                         
                                                                                                                                
SENATOR  KIEHL   agreed  that  the  relationship   is  different.                                                               
Pharmacists were  added to the  bill because of the  frequency in                                                               
which  other medical  providers consult  pharmacists on  the best                                                               
medication  to  prescribe  for their  patients  that  a  practice                                                               
within their  scope of  practice. He  pointed out  that SB  65 is                                                               
written such  that the treating  physician must  treatment within                                                               
their scope of practice. While  a pharmacist can only work within                                                               
their scope of  practice, when a pharmacist provides  advice to a                                                               
doctor, the  doctor is the  treating physician who  maintains the                                                               
liability  if something  goes wrong.  Last year,  the legislature                                                               
added pharmacists  to the bill.  He emphasized the  importance of                                                               
health  care professionals  obtaining expertise  from pharmacists                                                               
is valuable, such as when a drug is contraindicated.                                                                            
                                                                                                                                
2:38:52 PM                                                                                                                    
SENATOR MYERS  referred to the  fiscal note analysis.  He pointed                                                               
out that  the analysis states  that immunity "may"  apply instead                                                               
of requiring  that immunity "shall"  apply. He was unsure  if the                                                               
Department of  Law made an error  or if it reflects  the immunity                                                               
in the bill.                                                                                                                    
                                                                                                                                
2:39:41 PM                                                                                                                    
SENATOR KIEHL  responded that the fiscal  note analysis clarifies                                                               
the instances in which immunity  applies. He agreed that the bill                                                               
is  not designed  to "possibly"  set  out civil  immunity but  to                                                               
create civil immunity.                                                                                                          
                                                                                                                                
[SB 65 was held in committee].                                                                                                  

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