Legislature(1993 - 1994)

03/01/1994 03:00 PM House HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
           HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                         
                       STANDING COMMITTEE                                      
                          March 1, 1994                                        
                            3:00 p.m.                                          
  MEMBERS PRESENT                                                              
  Rep. Cynthia Toohey, Co-Chair                                                
  Rep. Con Bunde, Co-Chair                                                     
  Rep. Gary Davis, Vice Chair                                                  
  Rep. Al Vezey                                                                
  Rep. Pete Kott                                                               
  Rep. Harley Olberg                                                           
  Rep. Irene Nicholia                                                          
  Rep. Tom Brice                                                               
  MEMBERS ABSENT                                                               
  Rep. B. Davis (excused)                                                      
  COMMITTEE CALENDAR                                                           
  HB 267:   "An Act increasing elementary and secondary                        
            instructional units for certain school districts                   
            with 800 or fewer students in average daily                        
            membership; and providing for an effective date."                  
            PASSED OUT OF COMMITTEE                                            
  HB 361:   "An Act making an appropriation to the Department                  
            of Education for support of kindergarten, primary,                 
            and secondary education and community schools                      
            programs; and providing for an effective date."                    
            PASSED OUT OF COMMITTEE                                            
  *HB 507:  "An Act relating to licensure by the State Medical                 
            Board and temporary permits for certain                            
            PASSED OUT OF COMMITTEE                                            
  *HB 324:  "An Act extending the termination date of the                      
            Board of Dental Examiners; and providing for an                    
            effective date."                                                   
            PASSED OUT OF COMMITTEE                                            
  HB 320:   "An Act relating to public school health personal                  
            safety education."                                                 
            PASSED OUT OF COMMITTEE                                            
  *HB 472:  "An Act relating to referrals involving dental                     
            PASSED OUT OF COMMITTEE                                            
  (* First public hearing.)                                                    
  WITNESS REGISTER                                                             
  LARRY LABOLLE, Legislative Aid                                               
  Rep. Richard Foster                                                          
  Alaska State Legislature                                                     
  State Capitol                                                                
  Juneau, Alaska 99801-1182                                                    
  Phone:  (907) 465-3789                                                       
  Position Statement:  Answered questions on HB 267                            
  WANDA COOKSEY, Representative                                                
  Single School District Consortium                                            
  P.O. Box 240052                                                              
  Douglas, Alaska 99824-0052                                                   
  Phone:  (907) 586-9073                                                       
  Position Statement:  Supplied fiscal information on HB 267                   
                       to the committee                                        
  DR. ROY BOX, Optometrist                                                     
  16185 Lena Loank Rd.                                                         
  Juneau, Alaska 99801                                                         
  Phone:  (907) 789-3175                                                       
  Position Statement:  Answered questions on HB 472                            
                       (spoke via teleconference)                              
  DR. DAVID MCGUIRE, Chairman                                                  
  Alaska State Medical Board                                                   
  448 Laurel St., Ste. 202                                                     
  Anchorage, Alaska 99508                                                      
  Phone:  (907) 562-4142                                                       
  Position Statement:  Answered questions on HB 472                            
                       (spoke via offnet)                                      
  DR. DON LEHMANN, President                                                   
  Alaska State Medical Association                                             
  700 Katlian St. #E                                                           
  Sitka, Alaska 99835                                                          
  Phone:  (907) 747-5861                                                       
  Position Statement:  Testified in support of HB 507                          
  DR. DAN PITTS, Former President                                              
  Alaska Dental Society                                                        
  155 Smith Way                                                                
  Soldotna, Alaska 99669                                                       
  Phone:  (907) 262-4989                                                       
  Position Statement:  Testified in support of HB 472                          
                       (spoke via offnet)                                      
  PREVIOUS ACTION                                                              
  BILL:  HB 267                                                                
  SPONSOR(S): REPRESENTATIVE(S) FOSTER,Mackie,Menard,Olberg,                   
  JRN-DATE    JRN-PG                     ACTION                                
  03/31/93       875    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  03/31/93       875    (H)   HES, FINANCE                                     
  01/31/94      2204    (H)   SPONSOR SUBSTITUTE                               
  01/31/94      2204    (H)   HES, FINANCE                                     
  02/02/94      2230    (H)   COSPONSOR(S):OLBERG,NICHOLIA,                    
  02/16/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  02/16/94              (H)   MINUTE(HES)                                      
  BILL:  HB 361                                                                
  SHORT TITLE: APPROP: EDUCATION FUNDING FOR FY 95                             
  SPONSOR(S): FINANCE                                                          
  JRN-DATE    JRN-PG                     ACTION                                
  01/11/94      2032    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  01/11/94      2033    (H)   HES, FINANCE                                     
  02/02/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  02/14/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  02/14/94              (H)   MINUTE(HES)                                      
  BILL:  HB 507                                                                
  JRN-DATE    JRN-PG                     ACTION                                
  02/16/94      2416    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  02/16/94      2416    (H)   HES, LABOR & COMMERCE                            
  03/01/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  BILL:  HB 324                                                                
  SHORT TITLE: EXTEND BOARD OF DENTAL EXAMINERS                                
  SPONSOR(S): REPRESENTATIVE(S) BUNDE                                          
  JRN-DATE    JRN-PG                     ACTION                                
  01/03/94      2012    (H)   PREFILE RELEASED                                 
  01/10/94      2012    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  01/10/94      2012    (H)   HES, FINANCE                                     
  03/01/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  BILL:  HB 320                                                                
  SPONSOR(S): REPRESENTATIVE(S) TOOHEY,Hudson,Brice,Bunde,                     
  JRN-DATE    JRN-PG                     ACTION                                
  01/03/94      2011    (H)   PREFILE RELEASED                                 
  01/10/94      2011    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  01/10/94      2011    (H)   HES, FINANCE                                     
  01/21/94      2127    (H)   COSPONSOR(S):BRICE,BUNDE,                        
  01/21/94      2127    (H)   COSPONSOR(S):NORDLUND,OLBERG,                    
  01/21/94      2127    (H)   COSPONSOR(S):  SITTON                            
  02/09/94      2328    (H)   COSPONSOR(S):  B. DAVIS                          
  02/24/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  02/24/94              (H)   MINUTE(HES)                                      
  BILL:  HB 472                                                                
  SPONSOR(S): REPRESENTATIVE(S) G.DAVIS BY REQUEST                             
  JRN-DATE    JRN-PG                     ACTION                                
  02/14/94      2375    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  02/14/94      2375    (H)   HES, JUDICIARY                                   
  03/01/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  ACTION NARRATIVE                                                             
  TAPE 94-32, SIDE A                                                           
  Number 000                                                                   
  CHAIR BUNDE called the meeting to order at 3:06 p.m., noted                  
  members present and announced the calendar.  He mentioned                    
  that Tanana and Galena were observing the meeting via                        
  teleconference.  He brought HB 267 to the table.                             
  HB 267 - REVISE FOUNDATION FORMULA, SMALL SCHOOLS                            
  Number 005                                                                   
  CHAIR BUNDE said that the bill had been discussed previously                 
  and that it provides for single site schools to be included                  
  in the foundation formula.  He asked for further discussion.                 
  REP. VEZEY said, "I'd like to know a little more about the                   
  basis of these numbers and what these numbers really                         
  translate to, into dollars and adjustments."                                 
  CHAIR BUNDE stated for the record that Rep. Brice arrived at                 
  3:08 p.m.  He then asked for clarification of which numbers                  
  Rep. Vezey was referring to.                                                 
  REP. VEZEY said "the factors."                                               
  Number 076                                                                   
  REP. OLBERG offered the assistance of Larry LaBolle.                         
  Number 080                                                                   
  LARRY LABOLLE, Legislative Aid to Rep. Richard Foster, Prime                 
  Sponsor of HB 267, stated that he did not have a fiscal note                 
  included in his bill packet to refer to.                                     
  REP. OLBERG interjected that the fiscal note exactly matches                 
  the amount of last year's appropriation.                                     
  MR. LABOLLE said the fiscal note dated February 1, 1994, is                  
  for $3,372,100 for fiscal year (FY) 1995.                                    
  Number 143                                                                   
  REP. VEZEY said, "my question was more specifically... the                   
  factor 1.12 for schools with membership below 250 and 1.08                   
  for schools with membership below 525 and 1.06 with schools                  
  with membership below 800."                                                  
  MR. LABOLLE said those are calculations that were derived by                 
  Dr. Cole, who is the author of the foundation formula.  He                   
  indicated that Dr. Cole came back and did a study of the                     
  foundation unit and offered these recommendations when the                   
  study was completed.                                                         
  REP. VEZEY asked when the study was done.                                    
  MR. LABOLLE replied that it was conducted two years ago.                     
  Number 173                                                                   
  REP. VEZEY asked if there was anything in the bill packets                   
  pertaining to Dr. Cole's study.                                              
  MR. LABOLLE said that he personally had a copy of the report                 
  which showed how those figures were derived.                                 
  REP. VEZEY said he would appreciate receiving a copy.                        
  CHAIR BUNDE asked if there was other information to support                  
  those figures.                                                               
  Number 200                                                                   
  WANDA COOKSEY, Representative, Single Site School                            
  Consortium, offered fiscal information to Rep. Vezey.                        
  REP. OLBERG asked Chair Bunde to identify Wanda Cooksey for                  
  the record.                                                                  
  Number 229                                                                   
  CHAIR BUNDE said it was his intention to pass HB 267 out of                  
  committee and on to the Finance Committee.                                   
  REP. VEZEY made a motion to pass HB 267 out of committee                     
  with individual recommendations and accompanying fiscal                      
  CHAIR BUNDE, hearing no objections, declared HB 267 was so                   
  moved.  He then brought HB 361 to the table.                                 
  HB 361 - APPROPRIATION:  EDUCATION FUNDING FOR FY 95                         
  CHAIR BUNDE stated that the HB 361 and a committee                           
  substitute (CS) were both addressed previously.  He said HB
  361 was before the committee.  He asked the pleasure of the                  
  REP. BRICE clarified that it was the original bill HB 361                    
  that was before the committee.                                               
  REP. TOOHEY made a motion to pass HB 361 out of committee                    
  with individual recommendations and accompanying fiscal                      
  Number 278                                                                   
  CHAIR BUNDE clarified and said there is no fiscal note                       
  because it is an appropriation.                                              
  Hearing no objections, CHAIR BUNDE stated that HB 361 was so                 
  CHAIR BUNDE then asked for a subcommittee report from Rep.                   
  G. Davis and Rep. Vezey regarding HB 362.                                    
  REP. VEZEY said that Rep. G. Davis and he had not gotten                     
  together for that subcommittee meeting and questioned the                    
  date that Chair Bunde had asked for them to produce their                    
  CHAIR BUNDE asked if the committee could have an update by                   
  CHAIR BUNDE then brought HB 507 before the committee.                        
  HB 507 - LICENSING OF OPTOMETRISTS & PHYSICIANS                              
  Number 340                                                                   
  REP. TOOHEY stated that Section 1 of the bill addresses the                  
  concerns of the State Medical Board to interview an                          
  applicant for licensure in person.  She indicated that the                   
  board would like the section to be expanded to include a                     
  designated representative.  She said because of the large                    
  geographical area of the state and the expense involved in                   
  traveling, the change would be prudent.  She said the                        
  provision would allow actively licensed physicians who have                  
  been previously approved by the board to interview                           
  applicants.  She further stated that Section 2 deals with                    
  granting temporary permits for locum tenens for the purpose                  
  of providing temporary medical coverage for an unserved area                 
  as approved by the board.  She said the board wishes to                      
  amend that section of statute to allow locum tenens                          
  physicians to practice for limited periods of time.  Locum                   
  tenens licenses would serve as 60 day permits in remote                      
  areas with the knowledge and scrutiny of the board.  She                     
  said under current status locum tenens permits may only be                   
  issued to physicians who are substituting for an absent                      
  physician.  She said the legislation would allow for a                       
  temporary permit to be issued to a physician who would be                    
  practicing in an area that does not have a residing                          
  physician.  She said the same requirements for a full                        
  license are expected for temporary licensure.                                
  REP. TOOHEY indicated those requirements as being:  proof of                 
  education, residency or internship, Federation of State                      
  Medical Board approval, and at least one verification from                   
  another state where the physician is licensed.  She further                  
  stated that in Section 3 of the bill, the locum tenens                       
  permit may be issued to a nonresident optometrist for the                    
  purpose of assisting or substituting for an optometrist                      
  licensed under AS 08.72.172.  She said if a practitioner in                  
  a remote area of Alaska becomes seriously ill or injured and                 
  must leave temporarily, presently the physician must close                   
  down the clinic.  She said the proposal would allow a                        
  specialist, perhaps in the area of subnormal vision and                      
  visual therapy, to be scheduled to assist local doctors                      
  where specialist care does not exist now.                                    
  REP. TOOHEY said Dr. David McGuire, Chairman of the Alaska                   
  State Medical Board, was on line to answer any questions                     
  pertaining to Sections 1 and 2 of the bill.  She also said                   
  that Dr. Roy Box was available via teleconference from                       
  Wrangell to discuss Section 3.  She said there were others                   
  in the audience from the Alaska Medical Association who                      
  could assist with questions.                                                 
  CHAIR BUNDE explained that Dr. McGuire was in the process of                 
  connecting with offnet.  He asked Rep. Toohey if she had                     
  further testimony.                                                           
  CHAIR TOOHEY said she was finished.                                          
  CHAIR BUNDE asked for Dr. Roy Box to testify.                                
  Number 468                                                                   
  DR. ROY BOX, Optometrist, stated that the problem is that                    
  there is a limited number of doctors and all have                            
  established offices, so if an optometrist needs to leave his                 
  office, it's almost impossible to get someone to fill in.                    
  He said if there was a broader selection of licensed doctors                 
  from other parts of the country, it would be easier to                       
  maintain uniform care for patients.  He further stated that                  
  his profession is emerging into specialty areas; i.e.,                       
  subnormal vision; and those practitioners are often located                  
  in the larger metropolitan areas in other states.                            
  CHAIR BUNDE asked for questions. There were none.  He then                   
  went to Dr. McGuire in Anchorage.                                            
  Number 523                                                                   
  DR. DAVID MCGUIRE, Chairman, Alaska State Medical Board,                     
  testified via offnet on HB 507.  He stated that existing                     
  statute requires the board to interview all applicants for                   
  permanent and temporary licenses.  He said the board                         
  suggested having designated reviewers.  He felt that having                  
  designated examiners would ease the burden of travel for                     
  physicians coming to Alaska to be licensed.  He urged the                    
  passage of HB 507 to allow for designated reviewers.                         
  Number 603                                                                   
  CHAIR BUNDE encouraged Dr. McGuire in his endeavors.                         
  REP. OLBERG read the definition of locum tenens from the                     
  dictionary.  Locum tenens:  a person, especially a physician                 
  or member of the clergy, who substitutes for another.                        
  Number 630                                                                   
  CHAIR BUNDE asked if there were any further questions or                     
  Number 633                                                                   
  DR. LEHMANN, President, Alaska State Medical Association,                    
  testified in Juneau in support of HB 507.  He stated that                    
  the proposal was a good start and could be made even better.                 
  He said the current system of licensure was unnecessarily                    
  cumbersome because of the interview.  He asserted that the                   
  problem, especially in rural areas, of obtaining licensure                   
  is that it is unduly expensive, cumbersome, and sometimes                    
  precludes having adequate physician coverage in various                      
  parts of the state.  He offered that his interview for                       
  licensure took no longer than two minutes and he felt that                   
  the interview itself does not accomplish much.  He explained                 
  that he informally interviewed 30 physicians and only one                    
  said that he had a meaningful interview.                                     
  DR. LEHMANN related an incidence where a doctor from the                     
  Virginia Mason Clinic in Washington came to conduct a                        
  specialty clinic in Sitka.  The doctor had to fly from Sitka                 
  to Anchorage, drive a rental car to Wasilla, and interview                   
  with a layperson of the board, who did not have his                          
  interview material with him.  Dr. Lehmann lamented that the                  
  interview consisted of, "Hi.  How are you?"  He said the                     
  process seems ineffective.                                                   
  DR. LEHMANN indicated that on line 5, under Section 1, if                    
  the word "shall" could be changed to "may" it would allow                    
  the board to interview everybody at their discretion,                        
  including the option of eliminating the interview process                    
  completely.  The proposed amendment would allow the board to                 
  interview anyone they so choose, and consequently the board                  
  would be able to spend more time hunting down "nefarious                     
  Number 734                                                                   
  REP. VEZEY suggested that the words "in person" be deleted                   
  from Section 1, instead of adding the word "may," indicating                 
  that in this age of technology, telecommunications and                       
  audiovisual communication is becoming more acceptable.                       
  DR. LEHMANN said he was unsure what a telephonic interview                   
  would accomplish.                                                            
  REP. VEZEY asked what an in person interview would                           
  DR. LEHMANN maintained that if the interviewer has serious                   
  concerns regarding the applicant, it is important to conduct                 
  the interview in person.                                                     
  REP. VEZEY disagreed due to the factors of the time, money,                  
  and travel that are involved.  He said because of the                        
  geographical expanse of Alaska, the state is forced to look                  
  to other means of communication.  He reiterated that he had                  
  no problem changing the word "may" to "shall," but he felt                   
  that the words "in person" were too restrictive for the                      
  DR. LEHMANN said that he would have no problems adding the                   
  words or telephonically to interview the person.                             
  REP. VEZEY stated that it would be redundant.  He also said                  
  that interactive video is an option.                                         
  Number 791                                                                   
  DR. LEHMANN said, "I did not want to step on any toes from                   
  the state medical board.  And this way, they would still                     
  have their option to interview anybody they chose."                          
  CHAIR BUNDE asked Dr. McGuire's reaction to the issue being                  
  DR. MCGUIRE asserted that the medical board is held to a                     
  high standard.  He related a story of an interviewee who                     
  appeared for his licensure review and was noticeably                         
  psychotic.  He said that another interviewee was granted                     
  licensure and sometime later the interviewee showed obvious                  
  signs of psychosis.  He indicated that in those instances a                  
  telephonic interview would not have sufficed.  He felt that                  
  there were legal implications as to the interviewees that                    
  are asked to interview in person and those who are not.  He                  
  said the board's approach is to have everybody interviewed                   
  so as to avoid legal problems.                                               
  Number 856                                                                   
  CHAIR BUNDE stated for the record that Reps. Brice,                          
  Nicholia, Olberg, Kott, Vezey, Toohey and Bunde were                         
  present.  He then said that he values the interpersonal, in                  
  person, visual, and nonverbal aspects of an interview.  He                   
  felt that substituting the word "may" with "shall" would                     
  only invite litigation.                                                      
  REP. VEZEY said there is no substitute for a credentials and                 
  reference check.  He said he found the interview process the                 
  least useful tool in selecting qualified personnel.  He                      
  reiterated that in person interviews are very archaic.                       
  Number 900                                                                   
  CHAIR TOOHEY maintained that the issue should be decided by                  
  the medical community.                                                       
  Number 905                                                                   
  CHAIR BUNDE took an informal poll as to those in favor of                    
  the word remaining "shall" and those who would prefer the                    
  word to be "may."  The poll unanimously favored using the                    
  word "may."  He polled again, asking if the words "in                        
  person" should be deleted or if the word "telephonically"                    
  should be added.                                                             
  CHAIR TOOHEY interjected and said she would accept a                         
  friendly amendment that indicates in person or by telephone.                 
  CHAIR BUNDE asked if Rep. Toohey was proposing an amendment.                 
  CHAIR TOOHEY said she would make the proposal at the                         
  pleasure of the committee.                                                   
  CHAIR BUNDE told Rep. Toohey to address the proposal and the                 
  committee would vote.                                                        
  Number 942                                                                   
  REP. BRICE said it was his understanding that there was                      
  still concerns regarding the word telephonically.                            
  CHAIR BUNDE asked for the amendment so the committee could                   
  further discuss the issue.                                                   
  REP. OLBERG asked if it was Rep. Vezey who suggested                         
  deleting the words "in person."                                              
  CHAIR BUNDE said yes.                                                        
  Number 954                                                                   
  REP. VEZEY made a motion to amend HB 507, Section 1, line 5,                 
  to change the word "shall" to "may."                                         
  CHAIR BUNDE asked for discussion.  He then expressed his                     
  opposition to the amendment.  He reiterated his concerns                     
  pertaining to legal problems that could be inherent by                       
  changing the word to "may."  He called for a vote.  Reps.                    
  Toohey, Vezey, Olberg, Nicholia, and Brice voted "yea" and                   
  Reps. Kott and Bunde voted "nay."                                            
  CHAIR BUNDE stated that HB 507 as amended was before the                     
  committee.  He then asked for further discussion.                            
  Number 012                                                                   
  REP. VEZEY made a motion to amend HB 507, Section 1, line 6,                 
  by deleting the words "in person."                                           
  CHAIR BUNDE stated that the committee had heard the                          
  amendment and asked for further discussion.  There was none.                 
  REP. OLBERG asked, "does the use of the word `may' mean                      
  allow for `may not'?"                                                        
  REP. BRICE said yes.                                                         
  CHAIR BUNDE said that word "may" would allow for an                          
  interviewee to be interviewed in person, not in person, or                   
  not at all.  He asked Rep. Vezey if that was his                             
  REP. VEZEY said yes.  He felt that in person is unduly                       
  restrictive and felt that its deletion would not invite                      
  CHAIR BUNDE asked if Rep. Vezey still preferred to delete                    
  the words "in person" as opposed to having the line read                     
  "may be interviewed in person."                                              
  REP. VEZEY said once the words have been changed from                        
  "shall" to "may," the sentence becomes permissive, and                       
  leaving the words "in person" becomes redundant.                             
  REP. OLBERG suggested going back to the use of the word                      
  "shall" and then deleting the words "in person."  He then                    
  read the sentence, "All applicants for licensure shall be                    
  interviewed by at least one member of the board or the                       
  board's designated representative."                                          
  Number 069                                                                   
  CHAIR BUNDE declared that there was an amendment before the                  
  committee.  He asked for further discussion.                                 
  DR. MCGUIRE said that his prior comments were still germane                  
  and indicated that it was up to the legislature to decide                    
  what the rules were going to be.                                             
  CHAIR BUNDE reiterated the intent of the amendment.  He                      
  asked Dr. McGuire if under those guidelines would he                         
  continue to interview applicants.                                            
  Number 100                                                                   
  DR. MCGUIRE said a common ground must be found and the                       
  decision should be that of the legislature.  He said the                     
  board would comply.                                                          
  CHAIR BUNDE said there was no intention within the bill as                   
  amended to require an interview to be conducted                              
  telephonically.  He then asked for further discussions or                    
  any objections.  Chair Bunde stated his objection for the                    
  record.  He then called for a vote.                                          
  Number 126                                                                   
  CHAIR TOOHEY clarified by saying that the intent of the                      
  amendment was to remove the words "in person."                               
  Reps. Vezey, Olberg, and Toohey voted "yea" and Reps. Bunde,                 
  Kott, Nicholia, and Brice voted "nay."                                       
  Number 135                                                                   
  CHAIR BUNDE stated that the amendment failed.  He asked for                  
  further discussion.                                                          
  DR. MCGUIRE asked if the provision for the designated                        
  representative had survived the process.                                     
  CHAIR BUNDE said yes, the issue was not discussed at all.                    
  Number 152                                                                   
  CHAIR BUNDE closed public testimony and asked the pleasure                   
  of the committee for HB 507 as amended.                                      
  REP. KOTT made a motion to pass HB 507 as amended out of                     
  committee with individual recommendations.                                   
  CHAIR BUNDE, hearing no objections, declared HB 507 was so                   
  moved.  He then brought HB 324 to the table.                                 
  HB 324 - EXTEND BOARD OF DENTAL EXAMINERS                                    
  TAPE 94-32, SIDE B                                                           
  Number 000                                                                   
  CHAIR BUNDE passed the gavel to Rep. Toohey to preside over                  
  the remainder of the meeting.                                                
  Number 019                                                                   
  REP. CON BUNDE said that before the committee was HB 324,                    
  which extends the termination date for the Board of Dental                   
  Examiners and provides for an effective date.  He said that                  
  the Board of Dental Examiners did sunset on June 30, 1993.                   
  He explained that the board was in the process of phasing                    
  itself out.  He further explained that the board's role is                   
  to regulate and control licensing permits and revocation of                  
  licenses in the dental profession.  He then cited other                      
  responsibilities of the board.  Chair Bunde indicated that                   
  Mr. Sam Kito, Representing the Alaska Dental Association,                    
  was available for questions.                                                 
  Number 092                                                                   
  CHAIR TOOHEY asked if there were any questions for Mr. Kito.                 
  There were none.                                                             
  REP. BUNDE made a motion to pass HB 324 out of committee                     
  with individual recommendations.                                             
  CHAIR TOOHEY, hearing no objections, declared HB 324 so                      
  CHAIR TOOHEY indicated for the record that Rep. G. Davis                     
  arrived at 3:50 p.m.  She then brought HB 320 to the table.                  
  HB 320 - PUBLIC SCHOOL HEALTH AND SAFETY EDUCATION                           
  CHAIR TOOHEY stated that there was a committee substitute                    
  (CS) that had been previously adopted for HB 320 and then                    
  asked for comment from Rep. G. Davis.                                        
  Number 142                                                                   
  REP. G. DAVIS said his concerns about mandates and the issue                 
  of grade level/content appropriateness had been resolved.                    
  He said content of education is at the discretion of the                     
  school district and there is an opt-out inclusion within the                 
  REP. BRICE asked if the opt-out clause was new.                              
  CHAIR TOOHEY said no.                                                        
  Number 191                                                                   
  REP. OLBERG asked if the fiscal note was still for $452,000.                 
  CHAIR TOOHEY said the fiscal note had been revised to show                   
  $39,400.  She said the decrease was the result of removing                   
  mandates on everything except the HIV/AIDS curriculum.  She                  
  said all other health educational programs would be strongly                 
  REP. BUNDE made a motion to pass CSHB 320 out of committee                   
  with accompanying fiscal note.  He then indicated that Rep.                  
  Vezey had pointed out that a voice vote was required in an                   
  open hearing.  Reps. Brice, Nicholia, Olberg, Toohey, Bunde,                 
  and G. Davis verbally voted "yea."  The CS for HB 320 was so                 
  Number 282                                                                   
  CHAIR TOOHEY brought HB 472 to the table.                                    
  HB 472 - REFERRALS INVOLVING DENTAL SERVICES                                 
  CHAIR TOOHEY asked Rep. G. Davis to address the bill.                        
  Number 303                                                                   
  REP. GARY DAVIS stated that HB 472 will prohibit the receipt                 
  of compensation by a dentist for referring a person to                       
  another dentist or dental practice.  He further stated that                  
  the receipt of compensation by a person or advertisement                     
  that refers a dental service is prohibited, unless the                       
  compensation for referral is disclosed at the time of                        
  referral.  He maintained that the proposal would ensure that                 
  patients would be referred to a dentist or a dental practice                 
  as a result of the quality of service.  He said the bill was                 
  before the committee as a result of the American Dental                      
  Association, Principles of Ethics and Professional Code of                   
  Conduct.  He said that it is against their code to solicit                   
  patients in any form through referrals.  He stated that the                  
  legislation would put some of the American Dental                            
  Association's ethics in statute.                                             
  CHAIR TOOHEY asked for questions.                                            
  Number 348                                                                   
  REP. VEZEY asked why the committee was attempting to codify                  
  the ethical standards of any professional organization.                      
  REP. G. DAVIS replied that the initial attempt was made                      
  through a resolution, but Legal Services felt there was room                 
  in statute for the provisions.  He also said Mr. Sam Kito                    
  from the Alaskan Dental Association was present to answer                    
  REP. BUNDE asked if the legislation was inspired by any                      
  specific cases concerning unethical "kickbacks."                             
  Number 338                                                                   
  REP. G. DAVIS said the request was based specifically on the                 
  1-800 number agencies that advertise for referrals.                          
  CHAIR TOOHEY stated that Dr. Dan Pitts from Soldotna was on                  
  line to answer questions.                                                    
  Number 407                                                                   
  DR. DAN PITTS, Former President, Alaska Dental Society,                      
  testified via offnet from Soldotna in support of HB 472.  He                 
  stated that the emphasis of the bill is to protect the                       
  public.  He stated that the code of ethics indicates that it                 
  is unethical for any dentist to make payment to another                      
  person or entity for referral of a patient for professional                  
  services.  He said commercial referral agencies violate that                 
  code.  He said the advertising is false and misleading.  He                  
  explained that most commercial referral services have had no                 
  contact with the Alaska Dental Society to check the                          
  credentials of the dentists they are referring.  He felt                     
  that practice to be very misleading.  He also noted that                     
  only a few dentists are getting referrals from the service                   
  and that the dentists are paying the commercial referral                     
  services for the referrals.  He reiterated that this                         
  practice is unprofessional and unethical.  He said the                       
  legislation is in line with the Alaska Dental Association's                  
  principles of ethics and professional conduct.                               
  Number 497                                                                   
  REP. BUNDE related a situation whereby dentists who utilize                  
  the commercial referral service could possibly pass a                        
  patient around for various dental work to be done only for                   
  the goal of padding their bills.  He indicated that type of                  
  situation to be the only problem he could see.  He further                   
  stated that the notion of the referral service is just a                     
  commercial entity that is selling a product for dentists.                    
  He felt if the dentists are not getting their money's worth,                 
  the dentist should stop buying the product, hence the                        
  services to go out of business.  He saw the issue as two                     
  separate problems.                                                           
  DR. PITTS said the thrust of the bill is to have the                         
  commercial referral service disclose to the patient that                     
  they are paid by dentists for these referrals.  He said                      
  patients are misled because they believe the commercial                      
  referral service is an official referral service that gives                  
  an objective referral.  He stated that the issue is a                        
  nationwide problem and that other states have legislation                    
  that prohibits this particular practice.                                     
  Number 552                                                                   
  REP. BUNDE clarified that the legislation would mandate that                 
  a commercial referral service disclose within conversation                   
  with a potential referral patient that the referral agency                   
  is paid by dentists for their services.                                      
  DR. PITTS agreed.                                                            
  REP. G. DAVIS said that the legislation would include                        
  additional review by the dental boards and indicated the                     
  provision on page 2, line 1.                                                 
  Number 585                                                                   
  REP. BUNDE cited the zero fiscal note and asked if the                       
  professional dental board would be the official policing                     
  agency.  He further questioned if a complaint could be                       
  brought to the board if disclosure is not made.                              
  REP. G. DAVIS said that the board already has the                            
  responsibility of oversight.                                                 
  REP. BUNDE said that it is also the board's responsibility                   
  to decide on ethics.  He said it would be a breach of dental                 
  ethics to not disclose.  He then said that the referral                      
  services are not dentists, so the board cannot fine someone                  
  who is not a dentist for violation of dental ethics.                         
  REP. G. DAVIS deferred to Dr. Pitts.                                         
  DR. PITTS assumed that the legislation would make it clear                   
  as to how the commercial referral services would have to                     
  operate.  He reiterated the thrust of the proposal to be                     
  that of disclosure to the patient.                                           
  REP. BUNDE clarified that kickbacks between two dentists is                  
  a violation of dental ethics that could be brought up before                 
  the dental board.                                                            
  DR. PITTS said yes.                                                          
  REP. BUNDE asserted that the board has no way of addressing                  
  the ethics issue of commercial referral services because                     
  they are not dentists.  He then asked if there were any                      
  services that were run by dentists.                                          
  Number 646                                                                   
  DR. PITTS said no referral services are run by dentists.  He                 
  felt for a commercial referral service to refer a patient                    
  would be "pretty close to practicing dentistry."                             
  REP. BUNDE said the commercial referral agencies are                         
  currently doing just that.  He commented that the issue                      
  could also be raised if he was to tell his friends that he                   
  needs a route canal and his friends suggest a dentist.                       
  DR. PITTS said that a commercial entity would be practicing                  
  dentistry by referring the patient to a dentist.                             
  REP. BUNDE stated that the difference may be his friends                     
  would not get paid for the referral.                                         
  CHAIR TOOHEY asked for further questions.                                    
  Number 674                                                                   
  REP. VEZEY asked Dr. Pitts if the adherence to the                           
  professional ethics standards is a condition of licensure.                   
  DR. PITTS said yes.  He said the proposal focuses on the                     
  commercial referral services, not on dentists.                               
  REP. VEZEY indicated that under Title 836.315 there is no                    
  provision made for the adherence to the professional ethics                  
  standards as being a requirement of licensure or grounds for                 
  DR. PITTS said the a definition of the board's purpose is to                 
  pass judgement on the ethical standards of the profession.                   
  Number 724                                                                   
  REP. VEZEY said he felt the added wording was really                         
  unnecessary, and further stated that he thinks the board                     
  does not have the authority to revoke a license for                          
  unethical behavior.  He said he knew the board to have the                   
  authority to revoke licensure on the grounds of professional                 
  incompetence, but not for unethical behavior.                                
  REP. BUNDE interjected and said the sponsor statement                        
  indicates that the Board of Dental Examiners is charged with                 
  developing ethics policy.                                                    
  REP. VEZEY said the sponsor statement is not codified in                     
  REP. BUNDE agreed that Rep. Vezey brought up an interesting                  
  REP. VEZEY suggested that Dr. Pitts look at the board's                      
  statutory authority, because he did not believe the board                    
  has any authority in enforcing ethics.  He stated that the                   
  board only had authority to enforce professional standards.                  
  Number 759                                                                   
  DR. PITTS questioned if professional standards are the same                  
  as ethics.                                                                   
  REP. VEZEY stated that professional competence implies                       
  technical competence.                                                        
  DR. PITTS reiterated that the bill specifically addresses                    
  disclosure by the commercial referral services.                              
  REP. VEZEY said Dr. Pitts was referring to Section 2 that                    
  amends Title 45, which is a chapter on unfair trade                          
  practices.  He further stated that the section dealing with                  
  the authority of the board of licensing is in Title 8.  He                   
  again stated that he did not believe the board has the                       
  authority to revoke a license for unethical behavior.  He                    
  suggested Dr. Pitts look into the matter.                                    
  DR. PITTS said that he is not a board member and would have                  
  to talk with a board member.  He said he had always assumed                  
  that the dental board has the authority to revoke a license                  
  for unethical behavior.                                                      
  CHAIR TOOHEY asked the pleasure of the committee.                            
  REP. VEZEY said he answered his own question.                                
  Number 829                                                                   
  CHAIR TOOHEY asked again the pleasure of the committee.                      
  REP. VEZEY made a motion to pass HB 472 out of committee                     
  with individual recommendations.                                             
  CHAIR TOOHEY, hearing no objections, declared HB 472 so                      
  Seeing no further business before the committee CHAIR TOOHEY                 
  ADJOURNED the meeting at 4:15 p.m.                                           

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