Legislature(1995 - 1996)

03/06/1995 10:15 AM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                         March 6, 1995                                         
                           10:15 a.m.                                          
  MEMBERS PRESENT                                                              
 Senator Lyda Green, Chairman                                                  
 Senator Loren Leman, Vice-Chairman                                            
 Senator Mike Miller                                                           
 Senator Judy Salo                                                             
  MEMBERS ABSENT                                                               
 Senator Johnny Ellis                                                          
  COMMITTEE CALENDAR                                                           
 SENATE BILL NO. 100                                                           
 "An Act relating to unfair discrimination against a physician                 
 assistant or acupuncturist under a group health insurance policy."            
 CS FOR HOUSE BILL NO. 39(JUD)                                                 
 "An Act relating to the authority of mobile intensive care                    
 paramedics, physician assistants, and emergency medical technicians           
 to pronounce death under certain circumstances."                              
 HOUSE JOINT RESOLUTION NO. 18 am                                              
 Relating to medical savings account legislation.                              
  PREVIOUS SENATE COMMITTEE ACTION                                             
 No previous action to record.                                                 
  WITNESS REGISTER                                                             
 Jack Heesch                                                                   
 Alaska Academy of Physician Assistants                                        
 P.O. Box 201608                                                               
 Anchorage, Alaska 99520                                                       
 POSITION STATEMENT:  Reviewed SB 100.                                         
 David Ford                                                                    
 2490 E 42nd Street                                                            
 Anchorage, Alaska 99508                                                       
 POSITION STATEMENT:  Discussed acupuncture.                                   
 Representative Therriault                                                     
 State Capitol                                                                 
 Juneau, Alaska 99801-1182                                                     
 POSITION STATEMENT:  Prime sponsor of HB 39.                                  
 Mark Johnson, Chief                                                           
 Emergency Medical Services                                                    
 Department of Health & Social Services                                        
 P.O. Box 110616                                                               
 Juneau, Alaska 99811-0616                                                     
 POSITION STATEMENT:  Supported HB 39.                                         
  ACTION NARRATIVE                                                             
 TAPE 95-10, SIDE A                                                            
 SHES - 3/6/95                                                                 
        SB 100 DISCRIMINATION UNDER GROUP HEALTH INS.                        
 Number 005                                                                    
 CHAIRMAN GREEN called the Senate Health, Education and Social                 
 Services (HESS) Committee to order at 10:15 a.m. and introduced               
 SB 100  as the first order of business before the committee.                  
 JACK HEESCH, Alaska Academy of Physicians Assistants, stated that             
 SB 100 prevents discrimination against physicians assistants and              
 acupuncturists.  He explained that under SB 100 a state licensed              
 practitioner who is covered under a group insurance policy would              
 require that the group insurer cover all similarly licensed                   
 practitioners.  The bill does not mandate that such services be               
 covered, SB 100 merely says that if the service is covered then all           
 such services should be covered.                                              
 Mr. Heesch pointed out that a physician assistant can provide                 
 approximately 75-80 percent of the same services as their principle           
 physician.  Physician assistants are trained to provide similar               
 medical services as the doctors with whom they work and their                 
 training is less expensive.  He stated that physician assistants              
 are more willingly to work in remote areas; this would provide some           
 solution to the access problems in rural Alaska.                              
 Mr. Heesch noted support for SB 100 for physician assistants by the           
 Alaska Health Care Coalition.  He discussed the support this                  
 legislation received last year and said that many groups had been             
 asked to provide letters of support.  He explained that since                 
 SB 100 does not mandate or require service, it would not effect               
 anyone fiscally.  The Department of Administration, Division of               
 Retirement and Benefits has provided a zero fiscal note.  An AETNA            
 representative did not believe that SB 100 would not effect them              
 fiscally.  Mr. Heesch pointed out that last year the Department of            
 Labor, Worker's Compensation, and the Department of Commerce,                 
 Division of Insurance, provided zero fiscal notes to this                     
 CHAIRMAN GREEN asked if anyone was in opposition to SB 100.  Upon             
 hearing no opposition, Chairman Green stated that she intended to             
 move SB 100 out of committee.  She asked if anyone would like to              
 waive the right to testify in order to move forward with this                 
 Number 090                                                                    
 DAVID FORD, Acupuncturist, stated that he had practiced in Alaska             
 for 11 years and nationally for 21 years.  He related his                     
 experience that acupuncturists treat those patients at the end of             
 the road.  Eighty-five percent of the patients of acupuncturists              
 have either complete remission of their symptoms or remission to              
 the point of living comfortably with their condition.  This has               
 been confirmed in a January 30, 1995 article in the Wall Street              
 Journal which stated that individuals receiving acupuncture saved            
 the American West Life Insurance Company 30-70 percent over those             
 only receiving medical practice.  He noted the various insurance              
 companies that currently cover acupuncture.                                   
 Mr. Ford pointed out that three states have mandated drug courts              
 which allow the choice of drug offenders and abusers to either go             
 to jail or receive acupuncture.  This program has a 75 percent                
 long-term success rate with those who receive acupuncture versus a            
 15 percent success rate with those who receive other treatment                
 methods.  He indicated that Alaska could save money by setting up             
 such a program; Anchorage spends $30,000 per drunk per year.  This            
 program could save money while helping those individuals to reenter           
 society as productive members.                                                
 SENATOR MILLER moved that SB 100 be moved out of committee with               
 individual recommendations.  SENATOR SALO objected.                           
 SENATOR SALO pointed out that last year there was an attempt to add           
 marital and family therapists to the list of providers.  She noted            
 that SB 100 did not have marital and family therapists on the list.           
 She offered an amendment to add marital and family therapists to              
 the list of acceptable providers.                                             
 SENATOR MILLER said that SB 100 would be forwarded to the Senate              
 Labor & Commerce Committee of which Senator Salo is a member.  He             
 suggested that perhaps, Senator Salo could have a written amendment           
 prepared for the Labor & Commerce Committee, the last committee of            
 referral for SB 100.                                                          
 SENATOR SALO indicated that would be appropriate and she removed              
 her objection.                                                                
 CHAIRMAN GREEN stated that without objections, SB 100 would be                
 forwarded out of committee with individual recommendations.                   
 SHES - 3/6/95                                                                 
             HB  39 AUTHORITY TO PRONOUNCE DEATH                             
 Number 192                                                                    
 CHAIRMAN GREEN introduced  HB 39  as the next order of business               
 before the committee.                                                         
 REPRESENTATIVE THERRIAULT, prime sponsor, explained that HB 39                
 would allow mobile intensive care paramedics, physicians                      
 assistants, and emergency medical technicians (EMT) to pronounce              
 death under specified circumstances.  They would pronounce death              
 after determining that a person has suffered irreversible cessation           
 of circulatory and respiratory functions when a physician is not              
 immediately available by radio or telephone.                                  
 Representative Therriault noted that currently when a member of an            
 emergency medical service begins CPR, they are required to continue           
 CPR until the person recovers, the EMT or physicians assistant are            
 relieved by a medical facility or a physician, the responding                 
 parties become physically exhausted, or a physician pronounces the            
 person dead.  Often in rural areas where physicians and medical               
 facilities are not immediately available, emergency medical                   
 response members are required to continue unproductive                        
 resuscitation.  Representative Therriault reviewed Sections 1 and             
 2 and the last page of HB 39 which specifies the situations in                
 which emergency medical response members could pronounce death.               
 HB 39 is practically identical to last year's legislation.                    
 MARK JOHNSON, Chief of the Emergency Medical Services, supported              
 HB 39.  Sometimes emergency medical responders in rural areas are             
 forced to do fruitless resuscitation.  He offered to answer any               
 questions from the committee.                                                 
 SENATOR SALO supported HB 39, however, is the 60 minutes of                   
 resuscitation required with hypothermia adequate.  MARK JOHNSON               
 said that few persons could last longer than 20 or 30 minutes, 60             
 minutes was chosen in order to encompass the possibility of                   
 miracles.  Those persons who have survived extended periods of                
 resuscitation have been near treatment facilities.                            
 Number 284                                                                    
 CHAIRMAN GREEN inquired as to rigor mortis and post mortem lividity           
 being used as the basis of death.  She noted that this was a                  
 question from physicians who had contacted her office.  MARK                  
 JOHNSON informed the committee that he had discussions with Dr.               
 Nakimora and Dr. Probst regarding this issue.  Mr. Johnson pointed            
 out that an amendment had been adopted on page 2, line 20 in which            
 the language "cardiac arrest, accompanied by post mortem lividity"            
 addresses the concerns of this issue.  Mr. Johnson commented that             
 in previous testimony, various emergency response members indicated           
 that lividity would not be the only determinant of death; it would            
 be a combination of circumstances.                                            
 CHAIRMAN GREEN stated that she intended to move this legislation.             
 SENATOR LEMAN moved that CS HB 39(JUD) be moved out of committee              
 with individual recommendations.  Hearing no objection, it was so             
 SHES - 3/6/95                                                                 
 Number 325                                                                    
 CHAIRMAN GREEN introduced  HJR 18  as the next order of business              
 before the committee and called an at ease at 10:36 a.m.                      
 At 10:37 a.m. Chairman Green called the committee back to order.              
 She noted that there was no one available to testify from                     
 Representative Kott's office and she asked if anyone present wanted           
 to testify.                                                                   
 SENATOR MILLER moved that HJR 18 am be moved out of committee with            
 individual recommendations.  Hearing no objections, it was so                 
 There being no further business before the committee, the meeting             
 adjourned at 10:39 a.m.                                                       

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