Legislature(2015 - 2016)BELTZ 105 (TSBldg)

04/02/2015 01:30 PM Senate LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Public Testimony --
+= SB 18 HEALTH CARE SHARE MINISTRY NOT INSURANCE TELECONFERENCED
Heard & Held
* SB 69 BD OF CHIROPRACTIC EXAMINERS; PRACTICE
Heard & Held
+ Bills Previously Heard/Scheduled: TELECONFERENCED
+ SB 44 RELIGIOUS UNION EXEMPTION: PERA & AKRR TELECONFERENCED
Moved SB 44 Out of Committee
         SB  69-BD OF CHIROPRACTIC EXAMINERS; PRACTICE                                                                      
                                                                                                                                
1:35:57 PM                                                                                                                    
CHAIR  COSTELLO   reconvened  the   meeting  and   announced  the                                                               
consideration  of  SB  69. "An  Act  relating  to  the  Board  of                                                             
Chiropractic  Examiners and  the practice  of chiropractic."  She                                                               
noted that this was the first hearing.                                                                                          
                                                                                                                                
1:36:25 PM                                                                                                                    
SENATOR  BILL  STOLTZE,  sponsor  of  SB  69,  introduced  SB  69                                                               
speaking to the following sponsor statement:                                                                                    
                                                                                                                                
     Healthcare and  wellness have developed  and progressed                                                                    
     over the  years, and  patient preferences  have changed                                                                    
     along with  them. In  some cases,  state laws  have not                                                                    
     kept up  with this  progress. Senate Bill  69 endeavors                                                                    
     to   update   and    clarify   the   statutes   guiding                                                                    
     chiropractic care in Alaska.                                                                                               
                                                                                                                                
     SB   69   addresses   training   and   utilization   of                                                                    
     chiropractic    clinical   assistants    and   interns;                                                                    
     strengthens  current  law   allowing  chiropractors  to                                                                    
     perform   school  physicals;   revises  penalties   for                                                                    
     fraudulent  practices;  and   updates  definitions  and                                                                    
     modernizes terminology.                                                                                                    
                                                                                                                                
     SB  69 makes  timely  changes to  our statutes  guiding                                                                    
     chiropractic    care,    resulting   in    chiropractic                                                                    
     physicians   being   able   to  treat   patients   more                                                                    
     efficiently and affordably.                                                                                                
                                                                                                                                
1:41:57 PM                                                                                                                    
SENATOR  GIESSEL  pointed out  that  in  addition to  physicians,                                                               
nurse  practitioners and  physician assistants  are qualified  to                                                               
perform  pre-participation   sports  physicals.   She  questioned                                                               
whether the  education statutes needed  to be updated  to include                                                               
chiropractors for performing those physicals.                                                                                   
                                                                                                                                
SENATOR STOLTZE admitted he didn't know.                                                                                        
                                                                                                                                
1:43:36 PM                                                                                                                    
CHAIR COSTELLO asked for a sectional analysis.                                                                                  
                                                                                                                                
1:43:48 PM                                                                                                                    
BRANDON BREFCZYNSKI, Staff, Senator Bill Stoltze, provided the                                                                  
following sectional analysis for SB 69:                                                                                         
                                                                                                                                
     Section 1:  Amends AS 08.20.055 by  adding new language                                                                  
     allowing   the   board   to   adopt   regulations   for                                                                    
     chiropractic   interns  and   preceptors,  chiropractic                                                                    
     clinical   assistants,  and   performance  of   patient                                                                    
     examinations.                                                                                                              
                                                                                                                                
     Section  2:  Amends   AS  08.20.100(b)  clarifying  how                                                                  
     chiropractors    can    accept   referrals,    allowing                                                                    
     chiropractors   to   perform  school   physicals,   and                                                                    
     allowing  the  employment   of  certified  chiropractic                                                                    
     clinical assistants, interns, and preceptors.                                                                              
                                                                                                                                
     Section  3:   Adds  new  subsection  to   AS  08.20.100                                                                  
     exempting from this  section chiropractic interns under                                                                    
     certain conditions.                                                                                                        
                                                                                                                                
     Section   4:   Amends   AS  08.20.160   regarding   the                                                                  
     requirements for temporary permits.                                                                                        
                                                                                                                                
     Section  5:  Adds new  section  to  AS 08.20  regarding                                                                  
     chiropractic clinical assistants.                                                                                          
                                                                                                                                
     Section 6: Amends 08.20.185 to modernize terminology.                                                                    
                                                                                                                                
      Section 7: Amends AS 08.20.200 by updating penalties                                                                    
     for unlicensed practice.                                                                                                   
                                                                                                                                
1:46:31 PM                                                                                                                    
SENATOR  GIESSEL  noted  that  her   question  was  answered;  AS                                                               
14.30.070 and  14.30.120 identify chiropractors as  being able to                                                               
perform   physical  examinations   for  students   and  education                                                               
programs.                                                                                                                       
                                                                                                                                
CHAIR  COSTELLO asked  what chiropractors  are  not qualified  to                                                               
diagnose.                                                                                                                       
                                                                                                                                
SENATOR STOLTZE deferred the question.                                                                                          
                                                                                                                                
SENATOR   COSTELLO   asked   if   the   bill   provides   further                                                               
clarification  that  chiropractors  are   able  to  perform  pre-                                                               
participation   physicals   because    that's   not   universally                                                               
understood.                                                                                                                     
                                                                                                                                
SENATOR STOLTZE replied  that's one reason, and he  hopes to hear                                                               
from one of the organizations.                                                                                                  
                                                                                                                                
CHAIR COSTELLO  requested a general  statewide overview  of which                                                               
schools   districts  do   and  do   not  accept   physicals  from                                                               
chiropractors.                                                                                                                  
                                                                                                                                
SENATOR STOLTZE agreed to provide the information.                                                                              
                                                                                                                                
CHAIR COSTELLO asked Mr. Parady to review the fiscal note.                                                                      
                                                                                                                                
1:50:09 PM                                                                                                                    
FRED  PARADY,   Deputy  Commissioner,  Department   of  Commerce,                                                               
Community and Economic  Development (DCCED), said SB  69 adds new                                                               
licensure  requirements  for  chiropractic  assistants  and  will                                                               
require   additional  administrative   procedures  to   authorize                                                               
chiropractic  interns and  preceptors. The  fiscal note  requests                                                               
one part time  licensing examiner for up to 14  hours per week to                                                               
manage the estimated additional  200 plus chiropractic assistants                                                               
and new intern preceptor approval processes.                                                                                    
                                                                                                                                
Professional   licensing   programs   within  the   Division   of                                                               
Corporations,  Business and  Professional Licensing  are entirely                                                               
receipt  supported so  the fiscal  note includes  no undesignated                                                               
general  funds. He  noted that  the  estimated cost  of $750  per                                                               
license likely will be lower based  on FY2014 data that shows the                                                               
314 licensees paid $450 per license.                                                                                            
                                                                                                                                
Responding  to  an earlier  question,  he  relayed that  when  he                                                               
worked   for   the   North   Slope   Borough   School   District,                                                               
chiropractors performed pre-performance sports physicals.                                                                       
                                                                                                                                
CHAIR  COSTELLO asked  if public  health  nurses are  able to  do                                                               
sports physicals.                                                                                                               
                                                                                                                                
SENATOR GIESSEL answered no.                                                                                                    
                                                                                                                                
1:53:10 PM                                                                                                                    
CHAIR COSTELLO opened public testimony.                                                                                         
                                                                                                                                
1:53:40 PM                                                                                                                    
SHARI   RYAN,   Executive  Administrator,   Alaska   Chiropractic                                                               
Society, introduced herself.                                                                                                    
                                                                                                                                
CHAIR  COSTELLO asked  about  the difference  in  training for  a                                                               
medical doctor and a chiropractic doctor.                                                                                       
                                                                                                                                
MS. RYAN replied the educational  requirements are comparable and                                                               
she would follow up with specifics.                                                                                             
                                                                                                                                
SENATOR STEVENS asked about  chiropractic clinical assistants and                                                               
interns.                                                                                                                        
                                                                                                                                
MS. RYAN  explained that a  chiropractic clinical  assistant does                                                               
therapy and assists the chiropractor.  Their training ranges from                                                               
a  two year  program at  the  Palmer College  of Chiropractic  to                                                               
online  programs.   A  chiropractic  intern  has   completed  the                                                               
required  training and  education and  wants on-the-job  training                                                               
supervised by a preceptor.                                                                                                      
                                                                                                                                
1:56:08 PM                                                                                                                    
CHAIR  COSTELLO  asked  how  many  chiropractors  are  performing                                                               
school physicals across the state.                                                                                              
                                                                                                                                
MS. RYAN offered to follow up with the information.                                                                             
                                                                                                                                
CHAIR COSTELLO asked what a physical costs.                                                                                     
                                                                                                                                
MS. RYAN offered to follow up with the information.                                                                             
                                                                                                                                
SENATOR  MEYER  asked  if other  states  allow  chiropractors  to                                                               
perform pre-participation sports physicals.                                                                                     
                                                                                                                                
MS. RYAN replied 35 states allow that.                                                                                          
                                                                                                                                
1:57:47 PM                                                                                                                    
PATRICIA  CONNERS   ALLEN,  D.C.,   Chair,  Board   of  Trustees,                                                               
University   of   Western   States,  said   she   has   practiced                                                               
chiropractic medicine in Juneau  since 1984 and previously served                                                               
on the  Board of Chiropractic  Examiners. She explained  that the                                                               
bill  allows the  Board of  Examiners to  establish a  process so                                                               
that chiropractic  interns can come  to Alaska and  be supervised                                                               
by a preceptor doctor.                                                                                                          
                                                                                                                                
1:59:23 PM                                                                                                                    
EDWARD J.  BARRINGTON, D.C., representing himself,  reported that                                                               
he serves on the Board of  Chiropractic Examiners and is chair of                                                               
two committees  in the Alaska Chiropractic  Society. He explained                                                               
that chiropractors  practice in  primary care and  their training                                                               
and diagnostic  capabilities exceeds  their practice  statute. SB
69  will update  the  statutes to  bring the  law  closer to  the                                                               
current  training and  education of  chiropractic physicians.  It                                                               
also clarifies  that chiropractic physicians are  able to perform                                                               
pre-participation  sports physicals.  The Alaska  School Athletic                                                               
Association (ASAA)  has requested  that the  statute specifically                                                               
include   the  pre-participation   language.  Chiropractors   are                                                               
currently  authorized to  perform  physicals  on children  before                                                               
they enter school  and to keep them out of  sports activities. It                                                               
makes sense that  they should also be authorized  to perform pre-                                                               
participation sports physicals.                                                                                                 
                                                                                                                                
SB 69 will  also help regulate the training  and certification of                                                               
chiropractic clinical assistants.  Medical assistants are trained                                                               
and often  work in  chiropractic offices but  they are  not under                                                               
the auspices  of the  Board of  Chiropractic Examiners.  The bill                                                               
also provides a name change for the peer review committee.                                                                      
                                                                                                                                
2:05:39 PM                                                                                                                    
JAMES  F.  HESTON,  member,   Board  of  Chiropractic  Examiners,                                                               
described SB  69 as  basic housekeeping  that has  been discussed                                                               
for  years. However,  the  $700 licensing  fee  described in  the                                                               
fiscal note misrepresents the intention,  which was simply to get                                                               
statutory   authority   to    adopt   regulations   to   regulate                                                               
chiropractic assistants. The  board would like to  use a national                                                               
certification program  provided through  an organization  such as                                                               
the  Federation of  Chiropractic Licensing  Boards for  training,                                                               
testing, and two-year certification. He  noted that the board had                                                               
yet to vote to support this in a resolution but it was likely.                                                                  
                                                                                                                                
CHAIR COSTELLO said  she didn't intend to move the  bill today so                                                               
there was  time for the  resolution to pass before  the committee                                                               
took any action.                                                                                                                
                                                                                                                                
2:07:37 PM                                                                                                                    
TODD CURZIE  D.C., President, Alaska Chiropractic  Society (ACS),                                                               
stated  that ACS  coordinates continuing  education and  training                                                               
for its members,  many of whom are also active  in other national                                                               
organizations.  ACS  supports  SB  69 as  a  responsible  way  to                                                               
modernize chiropractic practices and protect the public.                                                                        
                                                                                                                                
2:09:06 PM                                                                                                                    
CHAIR  COSTELLO announced  that she  would keep  public testimony                                                               
open and hold SB 69 for further consideration.                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
SB 69 - Version A.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Sponsor Statement.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Fiscal Note.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Hearing Request.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Sectional Analysis.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Support Letter Dr. Campbell.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Support Letter Logan University.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Support Letter Palmer College.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 69 - Support Letter Univ. Western States.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
SB 18 - Version H.PDF SL&C 4/2/2015 1:30:00 PM
SB 18
SB 18 - Sponsor Statement.pdf SL&C 4/2/2015 1:30:00 PM
SB 18
SB 18 - Fiscal Note.pdf SL&C 4/2/2015 1:30:00 PM
SB 18
SB 18 - HCSM Summary.pdf SL&C 4/2/2015 1:30:00 PM
SB 18
SB 18 - Catholic Anchor Article.pdf SL&C 4/2/2015 1:30:00 PM
SB 18
SB 18 - ACA Exemption.pdf SL&C 4/2/2015 1:30:00 PM
SB 18
AG Opinion - Occupational Licensing 1991.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
ASBCE Newsletter Excerpt - 2003.pdf SL&C 4/2/2015 1:30:00 PM
SB 69
2015.04.08 Alaska State Medical Association Letter.pdf SL&C 4/2/2015 1:30:00 PM
SB 69