Legislature(1995 - 1996)
03/06/1995 10:15 AM Senate HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE 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 Acupuncturist 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 legislation. 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 legislation. 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 ordered. SHES - 3/6/95 HJR 18 SUPPORT MEDICAL SAVINGS ACCT LEGISLATION 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 ordered. There being no further business before the committee, the meeting adjourned at 10:39 a.m.