Legislature(2001 - 2002)

02/12/2002 01:35 PM L&C

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    ALASKA STATE LEGISLATURE                                                                                    
                SENATE LABOR & COMMERCE COMMITTEE                                                                             
                        February 12, 2002                                                                                       
                            1:35 p.m.                                                                                           
MEMBERS PRESENT                                                                                                               
Senator Ben Stevens, Chair                                                                                                      
Senator Alan Austerman                                                                                                          
Senator Loren Leman                                                                                                             
Senator John Torgerson                                                                                                          
Senator Bettye Davis                                                                                                            
MEMBERS ABSENT                                                                                                                
All Members Present                                                                                                             
COMMITTEE CALENDAR                                                                                                            
SENATE BILL NO. 263                                                                                                             
"An Act relating to the subsequent  acquisition of title to, or an                                                              
interest in,  real property by a  person to whom the  property has                                                              
purportedly been granted  in fee or fee simple;  and providing for                                                              
an effective date."                                                                                                             
     MOVED CSSB 263(L&C) OUT OF COMMITTEE                                                                                       
SENATE BILL NO. 274                                                                                                             
"An Act relating to issuance of a locum tenens permit for a                                                                     
physician or osteopath; and providing for an effective date."                                                                   
     HEARD AND HELD                                                                                                             
PREVIOUS COMMITTEE ACTION                                                                                                     
SB 263 - No previous action to record.                                                                                          
SB 274 - No previous action to record.                                                                                          
WITNESS REGISTER                                                                                                              
Ms. Annette Kreitzer                                                                                                            
Staff to Senator Leman                                                                                                          
State Capitol Bldg.                                                                                                             
Juneau AK 99811                                                                                                                 
POSITION STATEMENT:  Commented on SB 263 for sponsor.                                                                         
Mr. Rick Harris, Sr. Vice President                                                                                             
Natural Resources                                                                                                               
Sealaska Corp.                                                                                                                  
One Sealaska Plaza                                                                                                              
Juneau AK 99801                                                                                                                 
POSITION STATEMENT: Supported SB 263.                                                                                         
Mr. Jon Tillinghast                                                                                                             
Counsel to Sealaska Corp.                                                                                                       
One Sealaska Plaza                                                                                                              
Juneau AK 99801                                                                                                                 
POSITION STATEMENT: Supported SB 263.                                                                                         
Mr. Randall Burns                                                                                                               
Alaska Psychiatric Institute                                                                                                    
2900 Providence Dr.                                                                                                             
Anchorage AK 99508                                                                                                              
POSITION STATEMENT: Commented on SB 274.                                                                                      
Mr. Jim Jordan, Executive Director                                                                                              
Alaska State Medical Association                                                                                                
Off net                                                                                                                         
POSITION STATEMENT:  Commented on SB 274.                                                                                     
Ms. Catherine Reardon, Director                                                                                                 
Division of Occupational Licensing                                                                                              
Department of Community and Economic Development                                                                                
P.O. Box 110806                                                                                                                 
Juneau AK 99811                                                                                                                 
POSITION STATEMENT:  Commented on SB 274.                                                                                     
Ms. Lorraine Derr                                                                                                               
Alaska State Hospital Association                                                                                               
426 Main Street                                                                                                                 
Juneau AK 99801                                                                                                                 
POSITION STATEMENT: Supported SB 274.                                                                                         
ACTION NARRATIVE                                                                                                              
TAPE 02-4, SIDE A                                                                                                             
Number 001                                                                                                                      
                SB 263-REAL PROPERTY CONVEYANCES                                                                            
CHAIRMAN BEN STEVENS called the Senate Labor & Commerce Committee                                                             
meeting to order at 1:35 p.m. and announced SB 263 to be up for                                                                 
MS. ANNETTE KREITZER, Staff to Senator Leman, sponsor of SB 263,                                                                
said this bill was requested by Sealaska and attempts to resolve                                                                
a legal dilemma. She explained:                                                                                                 
     Under the  Alaska Native  Claims Settlement Act  (ANCSA)                                                                   
     village  corporations   own  surface  estate   to  lands                                                                   
     conveyed under ANCSA, but regional  corporations own the                                                                   
     subsurface  estate. Where estate  is passed to  a person                                                                   
     by a  quit claim deed, only  the rights the  grantor had                                                                   
     are passed  to the grantee, so the village  corporations                                                                   
     cannot pass on  the right to disturb the  surface of the                                                                   
     property   so  that   shareholders   could  build,   for                                                                   
     instance,  a home.  To correct  this SB  263 amends  the                                                                   
     conveyance  statutes to allow  after acquired title  for                                                                   
     shareholders.  There have  been some  concerns that  the                                                                   
     legislation as  introduced was too broad and  would have                                                                   
     unintended  impacts  and  for  that reason  you  have  a                                                                   
     committee   substitute   in   your   packets,   LS1318\J                                                                   
     Bannister 2/12/02.  On page 2,  lines 3 -  6, subsection                                                                   
     (b) - this is the subsection  we believe will ameliorate                                                                   
     the concerns  that the  Department of Natural  Resources                                                                   
SENATOR DAVIS moved to adopt the CS to SB 263. There were no                                                                    
objections and it was so ordered.                                                                                               
MR. RICHARD HARRIS, Sr. Vice President, Natural Resources,                                                                      
Sealaska Corp. and MR. JON TILLINGHAST, Counsel to Sealaska, said                                                               
they appreciated consideration of this bill.                                                                                    
MR. HARRIS explained:                                                                                                           
     It [this bill] was driven by  a problem that we began to                                                                   
     encounter in  which village corporations  had subdivided                                                                   
     their  property  and  conveyed  some of  their  land  to                                                                   
     shareholders.  In  doing  those  transactions,  in  some                                                                   
     cases we  had worked with  the village corporations  and                                                                   
     actually gave them a subsurface  easement, which allowed                                                                   
     people to develop the subsurface  in terms of putting in                                                                   
     foundation, water  lines, sewers and sewer  lines, to be                                                                   
     able to move  sand and gravel around on the  estate that                                                                   
     belonged  to Sealaska. In  some circumstances,  however,                                                                   
     subdivisions  were created and  the subsurface  easement                                                                   
     was not  completed or transferred  to the recipients  of                                                                   
     the property.  We estimate that we have right  now about                                                                   
     500 -  600 people who own  lots in Southeast  Alaska who                                                                   
     don't  have  a  clear  title.  They  are  currently  the                                                                   
     subsurface   in   some   way,   probably   without   the                                                                   
     appropriate easement.  This legislation would  enable us                                                                   
     to  create   the  easement,  pass  it  to   the  village                                                                   
     corporation  who would then,  by virtue of that  action,                                                                   
     would allow the easement, which  we are willing to grant                                                                   
     to be transferred down to people.  The effect is that we                                                                   
     clear up their title.                                                                                                      
SENATOR TORGERSON  questioned the  wording of the  purpose section                                                              
and  asked  if  they  were trying  to  accomplish  more  than  one                                                              
MR. TILLINGHAST replied that they could say "the purpose".                                                                      
SENATOR TORGERSON asked  why they referred to "some  cases" in the                                                              
purpose section.                                                                                                                
MR.  TILLINGHAST replied  with  the exceptions  the  bill has  for                                                              
state  conveyances  and  municipalities   and  the  University  of                                                              
Alaska, it is probably now more accurate to say "in some cases".                                                                
CHAIRMAN STEVENS asked if that was (b) on page 2.                                                                               
MR. TILLINGHAST replied yes.                                                                                                    
SENATOR  TORGERSON asked  if  they needed  to  mention the  Mental                                                              
Health Trust  since it is a trust,  not an agency of  the state or                                                              
the executive branch.                                                                                                           
MR.  TILLINGHAST  said  they  would  have  no  objection  to  that                                                              
SENATOR LEMAN said he supported this legislation.                                                                               
SENATOR TORGERSON  moved to adopt amendment  #1 on page  1, line 7                                                              
delete  "one"  and insert  "the"  and on  page  2,  line 6  insert                                                              
"Mental  Health Trust".  There were  no objections  and it  was so                                                              
SENATOR LEMAN  moved to  pass CSSB 263  (L&C) from committee  with                                                              
individual recommendations.  There were  no objections and  it was                                                              
so ordered.                                                                                                                     
1:49 p.m.                                                                                                                       
             SB 274-PHYSICIANS' LOCUM TENENS PERMITS                                                                        
CHAIRMAN STEVENS announced SB 274 to be up for consideration.                                                                   
SENATOR  OLSON,  sponsor of  SB  274,  thanked the  committee  for                                                              
bringing up this bill. It allows  the State Medical Board to issue                                                              
a locum tenens permit to a physician  or osteopath for purposes of                                                              
employment evaluation.                                                                                                          
     Their  Association  believes that  the  use  of a  locum                                                                   
     tenens permit  in this way will enhance  the recruitment                                                                   
     of qualified doctors for permanent  positions within the                                                                   
     The  issue  of recruitment  is  a matter  of  increasing                                                                   
     concern for the Medical Association  because of both the                                                                   
     aging population of Alaskan  practitioners and the small                                                                   
     number  of Alaskans  that graduate  from medical  school                                                                   
     every year.  Over 50 percent  of Alaska's 2,000  medical                                                                   
     doctors  are past the  age of  50. Typically, the  WWAMI                                                                   
     medical  program produces  eight new  doctors per  year.                                                                   
     Replacement of  retiring physicians and  osteopaths will                                                                   
     increasing   depend   on   the    recruitment   success.                                                                   
     Statistics indicate that the  Alaska physician workforce                                                                   
     is already  under represented  in comparison with  other                                                                   
     western states.                                                                                                            
     SB  274  temporarily  permits an  invited  physician  to                                                                   
     practice   medicine   for   60   days   for   employment                                                                   
     evaluation. This  bill also allows the medical  board to                                                                   
     further  extend a  240  day time  limit  in a  situation                                                                   
     where a locum tenens doctor,  who is substituting for an                                                                   
     Alaskan   physician,  is   providing   a  critical   and                                                                   
     essential service.                                                                                                         
CHAIRMAN STEVENS asked  if he could explain his  last sentence and                                                              
if the 240 day time limit exists now.                                                                                           
SENATOR OLSON  replied that it does.  In order for a  physician to                                                              
get a  substitute, if there  are five slots,  they all have  to be                                                              
filled.  Otherwise the  pressure  on  the other  four  gets to  be                                                              
intense,  especially  when dealing  with  four-wheeler  accidents,                                                              
gunshot incidents or trying to get  people out to villages to have                                                              
village clinics.  This allows a physician  to get a permit  for 60                                                              
days  as  a  substitute  for  a   returning  doctor.  The  Medical                                                              
Association has  requested this legislation  to give  clinics time                                                              
to see if a  temporary doctor would complement  the other doctors'                                                              
SENATOR AUSTERMAN asked what happens currently.                                                                                 
SENATOR OLSON explained that now  when someone gets a locum tenens                                                              
permit, the  physician has to leave  the site before he  fills the                                                              
SENATOR TORGERSON asked who the "designee" is.                                                                                  
SENATOR  OLSON replied  that  the Medical  Board  is comprised  of                                                              
physicians  who are  practicing  within the  state,  two from  the                                                              
general public,  and one who is  a physician assistant.  They meet                                                              
four times  a year. When something  comes up and a  decision needs                                                              
to be  made, the  designee to  make the  decision is normally  the                                                              
executive director who currently is Ms. Leslie Abel.                                                                            
MR.  RANDALL BURNS,  Chief Executive  Officer, Alaska  Psychiatric                                                              
Institute (API) supported SB 274.  He said in many cases hospitals                                                              
have  staff physicians  and when  they  have a  vacancy, they  use                                                              
locum tenens  to fill the vacancy  while they try to choose  a new                                                              
doctor. They  are not substituting  doctors; they actually  have a                                                              
vacancy.  The  Medical  Board  has taken  the  position  that  the                                                              
current statute doesn't allow for  locum tenens to be used in that                                                              
capacity [to  fill a  vacant position that  does not  have another                                                              
doctor coming  back to work]. He  said he had language  that would                                                              
fix that problem.                                                                                                               
MS.   CATHERINE   REARDON,   Executive   Director,   Division   of                                                              
Occupational Licensing,  said she staffs the State  Medical Board,                                                              
which is  a group of volunteers  that meets quarterly.  She emails                                                              
the members on issues of concern  between meetings. At this point,                                                              
she  has heard  from  only  two members  on  this bill,  but  both                                                              
expressed  concern  and  individual   opposition.  The  Board  has                                                              
regulations implementing the locum  tenens statute and 12AAC40.036                                                              
     A physician who is not currently  licensed in this state                                                                   
     may apply for  a locum tenens permit for  the purpose of                                                                   
     substituting for a physician  licensed in this state who                                                                   
     (1) is temporarily absent from  the practice location at                                                                   
     which the applicant  applies, or (2) is not  expected to                                                                   
     return  to the  practice location,  if  issuance of  the                                                                   
     locum tenens permit is necessary  to temporarily provide                                                                   
     essential medical  services to the public or  to protect                                                                   
     the public health and safety.                                                                                              
So, she  said, the current  Board regulations  do provide  for the                                                              
possibility of  a locum  tenens for a  vacancy rather than  just a                                                              
substitute  while someone  is on  leave, but the  Board must  feel                                                              
that it is necessary to provide essential  medical services to the                                                              
public or  protect the  public health and  safety and  she thought                                                              
that  was  where  the  issue  has come  up.  The  Board  has  this                                                              
regulation  that  acknowledges  that  sometimes a  vacancy  is  an                                                              
appropriate  reason for  locum  tenens; the  Board  feels that  it                                                              
needs to  be essential,  not just whenever  you have a  vacancy or                                                              
not  because   you  aren't  proceeding   promptly  to   fill  your                                                              
CHAIRMAN STEVENS asked if they were  taking regulation and putting                                                              
it into statute.                                                                                                                
MS. REARDON  said no; she doesn't  agree that the Board  no longer                                                              
issues locum tenens  for vacancy reasons. She thinks  that they do                                                              
and she is differing  with Mr. Burns whether the  Board will issue                                                              
for vacancy purposes. This Board  has sent out the message that it                                                              
should only be  used for vacancy purposes when all  other means of                                                              
getting a completely licensed physician have been exhausted.                                                                    
SENATOR TORGERSON  asked where was  the letter of  opposition from                                                              
the Board.                                                                                                                      
MS. REARDON replied that she just  informal wording in emails from                                                              
the two members, which she would show him.                                                                                      
SENATOR TORGERSON  asked when the  Board would have a  position on                                                              
the bill.                                                                                                                       
MS. REARDON  replied that their next  regular board meeting  is in                                                              
April. She will probably get more  individual comments until then.                                                              
MR.  JIM   JORDAN,  Executive   Director,  Alaska  State   Medical                                                              
Association, said  that basically there were two  reasons why they                                                              
were interested in the enactment of this bill.                                                                                  
     The  first and primary  reason is  recruitment. The  one                                                                   
     area that is  not currently allowed for under  the locum                                                                   
     tenens  permitting  system is  for the  use  of a  locum                                                                   
     tenens permit  in the circumstance  when a physician  is                                                                   
     being  evaluated  for potential  employment  at a  later                                                                   
     date.  That  is the  primary  reason the  State  Medical                                                                   
     Association wants this bill.                                                                                               
He  said Alaska  has  relatively  few  doctors compared  to  other                                                              
states  and we  have a  workforce that  is rapidly  aging and  the                                                              
replacement task  is going  to be quite  large. The second  reason                                                              
has to do with the extension of the  240-day limit in the two-year                                                              
period in which  locum tenens circumstances are  allowed for. They                                                              
want to provide physicians in areas that are underserviced.                                                                     
2:10 p.m.                                                                                                                       
SENATOR AUSTERMAN  asked what the  definition was of  locum tenens                                                              
and asked if physicians and radiologists  were classified the same                                                              
SENATOR  OLSON replied  that the interpretation  for locum  tenens                                                              
has  to  do  with the  temporary  permitting  of  a  physician  to                                                              
practice medicine  in whatever location  he is called to.  He said                                                              
that radiologists are  covered in this bill; they  are a medically                                                              
licensed person  who has either  an MD degree  or a DO  (Doctor of                                                              
Osteopathy)  who has  done a residency  in radiology  and in  many                                                              
cases has fulfilled the number of  years to become Board eligible.                                                              
Many have gone on the take the Board exams and become certified.                                                                
CHAIRMAN STEVENS  asked if he would  work through the  concerns of                                                              
API  within two  weeks and asked Ms. Reardon if  she would convene                                                              
the State Board and get a recommendation within that time, also.                                                                
SENATOR TORGERSON  suggested looking  at a different  timeline for                                                              
filling vacancies instead of the 240 days.                                                                                      
MS.  LORRAINE  DERR,  Alaska  State   Hospital  and  Nursing  Home                                                              
Association, supported SB 274. She  said that Mr. Burns is part of                                                              
her organization and  the problem comes in in  interpretation. The                                                              
Board is talking about temporary  or essential services. Using the                                                              
Fairbanks Hospital  that was trying  to find a psychiatrist  as an                                                              
example,  she said  that they  are  difficult to  find right  now.                                                              
There becomes a  difficulty between are they recruiting  to find a                                                              
psychiatrist or are they using locum  tenens to fill the position.                                                              
"There has been a tug of war there."                                                                                            
There has  also been a  tug of war  in the interpretation  of what                                                              
temporary is.  This legislation is  an attempt to clarify  some of                                                              
those issues. The Association supports  reworking the definitions.                                                              
CHAIRMAN STEVENS  said they would  hold the bill for  further work                                                              
and adjourned the meeting at 2:15 p.m.                                                                                          

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