Legislature(1999 - 2000)
02/25/1999 01:38 PM Senate L&C
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 29-REQUIREMENTS FOR PHYSICIAN'S LICENSE
CHAIRMAN MACKIE called the Senate Labor and Commerce Committee
meeting to order at 2:38 p.m. and announced SB 29 to be up for
consideration.
MR. MARK HODGINS, staff to Senator Ward, sponsor of SB 29, said at
the end of the last meeting there was some opposition concerning
the time period for training American physicians. So, he took out
references to American and Canadian physicians' training and kept
the requirements for foreign physicians. The Medical Board
continues to support this change.
SENATOR LEMAN moved to adopt Lauterbach draft LS0270\H, dated
2/11/99. There were no objections and it was so ordered.
MR. HODGINS explained that the CS changes the requirements for
foreign physicians to practice in the State of Alaska. It requires
a three-year term that can be either an internship, a residency,
or to satisfactory performance of the duties and functions of an
intern/resident. A candidate must submit documentation to the
program which has to be approved by the American Board of Medical
Specialists. One other change is the citizen language, "citizen of
the United States or lawfully residing in the United States" and
the deletion of the phrase, "admitted for permanent residence".
SENATOR MACKIE asked if this change was one of the three things the
committee was originally trying to accomplish.
MR. HODGINS answered yes, this is one of the suggestions from the
Medical Board. There was a lot of opposition to this bill, because
the Board had not educated people. Therefore, they removed the
more controversial portions. Basically, he repeated, CSSB 29
increases the time limit from one year to three years for a foreign
applicant to satisfactorily perform the duties of resident
physician or intern at a recognized hospital. The time increase is
because of a variety of different foreign curriculums across the
world. Three years gives the Medical Board a good feeling that the
doctor has learned what is adequate for residents of the State of
Alaska.
CHAIRMAN MACKIE asked if there was currently a shortage of locally
trained doctors and if there was a need for foreign doctors now.
MR. HODGINS replied that there is a need for certain specialists,
not necessarily general practitioners. The Medical Board supports
this.
CHAIRMAN MACKIE asked if other states allow the same thing.
MR. HODGINS replied in other states licensure of immigrating
doctors requires from one year to three years. A majority of
states require two years and above. Alaska would be requiring the
most time. Nine states require one year, 16 states require two
years, and 29 states require three years.
CHAIRMAN MACKIE asked if we are the only state that doesn't allow
licensure of foreign doctors right now.
MR. HODGINS replied that all states allow foreign doctors; only the
residency requirements differ.
CHAIRMAN MACKIE asked if this bill does more than make the
requirements more stringent.
MR. HODGINS said that's all it does and added that it corresponds
with the Immigration Act of 1996 which changes the classification
of visa to H1B visa, a three year requirement.
SENATOR LEMAN asked what other states do for non-foreign medical
graduates regarding citizenship. Currently, you must be a citizen
of the U.S. or be admitted for permanent residence. The proposal
is to change that to "being a citizen" or to be "lawfully
residing."
MR. HODGINS responded that to be lawfully residing a person must
possess a H1B visa which he thought would bring us into conformance
with federal law and with what other states are doing.
SENATOR LEMAN questioned the requirements in sections 1 and 2 for
non-foreign and foreign medical graduates which don't have
corresponding provisions for citizenship.
MR. HODGINS explained that language on page 2, line 9, Section 1,
paragraph 5, "be a citizen of the United States or lawfully
residing in the United States" covers the immigration status.
MS. CATHERINE REARDON, Director, Division of Occupational
Licensing, said the division provides staff support to the Medical
Board and supports the changes in the most recent committee
substitute. She said there are two separate issues: can you get a
license if you don't have a green card, but you do have another
visa you would be working under in the United States; and, if you
went to school outside the country, regardless of your citizenship
status, should you be required to have additional years of training
in the U.S. She believed the State would not be out of compliance
with any federal law by leaving things as they are, but the Medical
Board and the department support changing them for public policy
reasons.
MS. REARDON believed there are no other states requiring U.S.
citizenship for a medical license. One other Alaska licensing
program requires U.S. citizenship, marine pilotage, which also
requires a U.S. Coast Guard license requiring citizenship.
Ideally, the State would like to remove the issue from the statute
altogether, but if it remains in law, it is an improvement to say
"or lawfully resides." There are doctors in Alaska right now
working for the federal government and they don't need a state
license although they can't work outside of their federal jobs or
switch jobs. While there is not a large number of these doctors,
she suspected this is what created the issue. The Board did not
expect this to be a very controversial topic, so it did not
highlight it in their January newsletter. The Board did, however,
ask for changes in training requirements.
MS. REARDON said that the Department of Law also suggested that,
when things like this have been contested in other states, the
courts ruled the federal government, not the state government
should determine who can work.
The issue of training foreign medical graduates is a separate
topic, because some of them could be U.S. citizens. They could be
Americans who intentionally went outside the U.S. to get their
medical training. The Board's figures indicate 43 other states
require three years of training.
MS. REARDON said initially, the Board thought there wasn't much
concern about this issue because of the poor response to the
newsletter. Now they are more aware of the issue and working on
it.
SENATOR LEMAN moved to pass CSSB29(L&C) with the accompanying zero
fiscal note from committee with individual recommendations. There
were no objections and it was so ordered.
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