Legislature(2021 - 2022)BUTROVICH 205

03/12/2021 01:30 PM Senate JUDICIARY

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01:38:17 PM Start
01:39:25 PM Confirmation Hearing(s)
01:51:23 PM SB65
02:12:14 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
+ Leg Legal Lawsuit on Governor's Appointees TELECONFERENCED
-- Testimony <Invited and Public> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
        SB 65-LIABILITY CONSULTING HEALTH CARE PROVIDER                                                                     
                                                                                                                                
1:51:23 PM                                                                                                                    
VICE CHAIR SHOWER announced the  consideration of SENATE BILL NO.                                                               
65  "An  Act  relating  to immunity  for  consulting  physicians,                                                               
podiatrists,  osteopaths,  advanced practice  registered  nurses,                                                               
physician assistants, dentists, optometrists, and pharmacists."                                                                 
                                                                                                                                
[CSSB 65(HSS) was before the committee.]                                                                                        
                                                                                                                                
1:51:45 PM                                                                                                                    
VICE   CHAIR  SHOWER   stated   the   committee  would   consider                                                               
amendments.                                                                                                                     
                                                                                                                                
1:52:43 PM                                                                                                                    
SENATOR KIEHL, speaking as sponsor,  said at the first hearing on                                                               
SB 65 Senator  Myers asked whether there was a  reason to exclude                                                               
federal hospitals from the definition  of a health care facility.                                                               
He  said  it  was  an  unintentional  exclusion,  so  his  office                                                               
prepared  an  amendment  to  include  federal  hospitals  in  the                                                               
definition.  He stated  it would  have a  limited application  in                                                               
Alaska  since most  medical practitioners  practicing at  federal                                                               
hospitals  are  federal  employees.  The federal  tort  law  that                                                               
allows a  person to  sue a federal  employee would  preempt state                                                               
law.   Still,  there   may  be   Alaska   licensed  health   care                                                               
professionals with privileges to  practice in a federal hospital,                                                               
so including  federal hospitals will ensure  that these hospitals                                                               
are covered under the provisions of SB 65.                                                                                      
                                                                                                                                
1:54:20 PM                                                                                                                    
SENATOR HUGHES  asked if Alaska  has any Native  health hospitals                                                               
and if so, whether "federal" would cover those.                                                                                 
                                                                                                                                
SENATOR  KIEHL answered  that the  Alaska  Native Medical  Center                                                               
(ANMC)  in Anchorage  is  owned  by a  nonprofit  covered by  the                                                               
bill's private nonprofit language.                                                                                              
                                                                                                                                
SENATOR HUGHES asked  if the hospital in Bethel, which  is run by                                                               
the Yukon-Kuskokwim  Health Corporation (YKHC)  is set up  in the                                                               
same way.                                                                                                                       
                                                                                                                                
SENATOR KIEHL responded that the  only category that might not be                                                               
covered  by private,  municipal, state,  or federal  would be  if                                                               
someone built  a tribal  hospital. He stated  that there  are not                                                               
any tribe-owned  hospitals in the  state to  date, and he  is not                                                               
aware of any proposals to build one.                                                                                            
                                                                                                                                
SENATOR HUGHES  asked if  the Alaska  State Hospital  and Nursing                                                               
Home  Association  (ASHNHA)  has  reviewed the  bill  since  that                                                               
organization would know if any hospitals would be excluded.                                                                     
                                                                                                                                
SENATOR  KIEHL  replied  that  ASHNHA had  written  a  letter  of                                                               
support.                                                                                                                        
                                                                                                                                
1:56:32 PM                                                                                                                    
SENATOR MYERS moved to adopt Amendment 1, [work order 32-                                                                       
LS0002\I.1]:                                                                                                                    
                                                                                                                                
                                                   32-LS0002\I.1                                                                
                                                         Fisher                                                                 
                                                         3/9/21                                                                 
                                                                                                                                
                          AMENDMENT 1                                                                                       
                                                                                                                                
                                                                                                                                
OFFERED IN THE SENATE                          BY SENATOR KIEHL                                                                 
     TO:  CSSB 65(HSS)                                                                                                          
                                                                                                                                
     Page 2, line 23:                                                                                                           
          Delete "or"                                                                                                           
          Following "state":                                                                                                    
          Insert ", or federal"                                                                                                 
                                                                                                                                
1:56:35 PM                                                                                                                    
VICE CHAIR SHOWER objected for discussion purposes.                                                                             
                                                                                                                                
1:57:03 PM                                                                                                                    
SENATOR  MYERS explained  Amendment 1.  He directed  attention to                                                               
page 2, line  23, which would add "federal" to  the definition of                                                               
health  care.  It  would read,  "private,  municipal,  state,  or                                                               
federal hospital."                                                                                                              
                                                                                                                                
1:57:45 PM                                                                                                                    
SENATOR REINBOLD, testifying via  teleconference, said the Senate                                                               
Health and  Social Services Standing  Committee heard SB  65. She                                                               
offered her support for Amendment 1.                                                                                            
                                                                                                                                
1:59:15 PM                                                                                                                    
VICE CHAIR SHOWER  removed his objection. There  being no further                                                               
objection, Amendment 1 was adopted.                                                                                             
                                                                                                                                
1:59:47 PM                                                                                                                    
VICE CHAIR SHOWER moved to invited testimony.                                                                                   
                                                                                                                                
2:00:24 PM                                                                                                                    
MELINDA  RATHKOPF, Physician;  Medical Director,  Allergy, Asthma                                                               
and Immunology Center  of Alaska, Anchorage, Alaska,  said she is                                                               
a pediatrician. She also serves on  the Board of Trustees for the                                                               
Alaska State Medical Association. She  spoke in support of SB 65.                                                               
She said  she is speaking  as a  specialist, noting that  for the                                                               
first 10 of 15 years,  the Allergy, Asthma, and Immunology Center                                                               
of Alaska was  the only allergy immunology practice  in the state                                                               
outside  of the  military.  She related  that  this practice  has                                                               
taken,  and  still  takes,  phone   calls  from  other  providers                                                               
throughout   Alaska  about   their  patients   with  allergy   or                                                               
immunology needs.  In the past  several years, their  most unique                                                               
role has  been screening  newborns for  a severe  combined immune                                                               
deficiency (SKID)  defect, which  can be life-threatening  if not                                                               
diagnosed immediately.  She said her  group is on  call statewide                                                               
to  consult on  any  newborn with  an  abnormal screening.  These                                                               
calls  are for  patients that  the  doctors in  her practice  may                                                               
never  meet,  but  the  doctors  give  their  expert  advice  and                                                               
guidance for  the care  of these  fragile infants.  She indicated                                                               
that  in these  instances  there  is never  a  doctor to  patient                                                               
relationship formed.  However, the  clinic may treat  the patient                                                               
later  for  an in-person  visit.  Typically,  these patients  are                                                               
cared for  by their  primary care providers.  The doctors  at her                                                               
clinic are never reimbursed, she said.                                                                                          
                                                                                                                                
2:02:38 PM                                                                                                                    
DR. RATHKOPF  explained that she might  get a call from  a Bethel                                                               
resident on  how to care  for an immune  issue or receive  a call                                                               
from a family practice doctor  in Fairbanks on a severe asthmatic                                                               
patient. Her  practice receives  calls from  providers throughout                                                               
Alaska on how  to care for patients, but the  doctors often never                                                               
meet the  patients. She  informed members  that her  practice has                                                               
seven  satellite clinics  in Alaska,  most of  which require  air                                                               
travel,  including  in  Ketchikan  or Valdez.  This  bill  allows                                                               
physicians  to  provide  advice without  fear  of  liability  for                                                               
advice given  without establishing a  doctor-patient relationship                                                               
or having seen the patient in person.                                                                                           
                                                                                                                                
2:03:46 PM                                                                                                                    
VICE CHAIR  SHOWER asked if  Alaska needs the  protection offered                                                               
by SB 65 more  than other states in the Lower  48 due to Alaska's                                                               
size and limited road system and isolated communities.                                                                          
                                                                                                                                
DR. RATHKOPF agreed that the  need is greater due to geographical                                                               
issues and since  Alaska has fewer specialists, many  of whom are                                                               
concentrated in Anchorage. Further,  inclement weather issues may                                                               
prevent patients from coming to Anchorage.                                                                                      
                                                                                                                                
2:05:37 PM                                                                                                                    
SENATOR  HUGHES thanked  her and  her colleagues  because of  the                                                               
time  spent assisting  patients without  receiving any  financial                                                               
reimbursement.  She asked  if her  phone  consults are  primarily                                                               
outside the  Anchorage Bowl  and if  primary care  physicians are                                                               
more likely to refer patients to  see her in person. She surmised                                                               
that she likely  takes more calls than her  counterparts in other                                                               
states.                                                                                                                         
                                                                                                                                
DR. RATHKOPF  agreed that her  practice likely takes  more calls.                                                               
Someone is  on call  24/7 in  the state  to assist  patients. She                                                               
added that being physicians and  providing expertise is what they                                                               
love and are  passionate about. She said she could  not imagine a                                                               
provider who is  unwilling to take these calls.  She related that                                                               
some  pressure   has  come  from  malpractice   carriers  on  the                                                               
liability  insurance issue.  She said  it is  fulfilling to  help                                                               
patients, many of whom are eventually seen by her practice.                                                                     
                                                                                                                                
2:07:41 PM                                                                                                                    
SENATOR  HUGHES  said  she  applauded  her  because  the  initial                                                               
consults  did not  result in  any  financial gain.  She said  she                                                               
appreciated the passion  she brings to help  Alaska residents who                                                               
face some of the problems she can address.                                                                                      
                                                                                                                                
2:07:57 PM                                                                                                                    
VICE CHAIR SHOWER asked if this is a problem in other states.                                                                   
                                                                                                                                
SENATOR KIEHL  responded that this  issue arose from  a Minnesota                                                               
Supreme  Court Case.  A doctor  provided  an unpaid  consultation                                                               
without forming  a doctor-patient  relationship or duty  of care,                                                               
which led to a lawsuit. He  related that this decision sent shock                                                               
waves throughout  the medical community. He  stated that insurers                                                               
like to  limit their  risk. In  some instances,  specialists were                                                               
advised not to take the calls.  However, he offered his view that                                                               
a better approach was to ensure  that those who truly do not have                                                               
a duty  of care are not  subject to litigation and  liability. SB
65 takes this approach, he  said. He mentioned that several other                                                               
states are  considering legislation similar to  this. He recalled                                                               
that this  concept has passed  in Idaho and several  other states                                                               
are considering this legislation.                                                                                               
                                                                                                                                
2:09:52 PM                                                                                                                    
SENATOR REINBOLD  characterized it as  a Good Samaritan  law. She                                                               
said she hopes to get this bill to the Senate floor soon.                                                                       
                                                                                                                                
2:11:55 PM                                                                                                                    
VICE CHAIR SHOWER held SB 65 in committee.                                                                                      

Document Name Date/Time Subjects
SB65 Amendment 3.12.21.pdf HHSS 4/27/2021 3:00:00 PM
SJUD 3/12/2021 1:30:00 PM
SB 65