HB 38-UNIVERSITY INSTITUTES OF LAW AND MEDICINE  8:26:12 AM CHAIR DICK announced that the next order of business would be HOUSE BILL NO. 38, "An Act authorizing the establishment of institutes of medicine and law at the University of Alaska." 8:27:20 AM REPRESENTATIVE SCOTT KAWASAKI, Alaska State Legislature, stated that HB 38 would authorize the establishment of Institutes of Medicine and Law at the University of Alaska. He reported on the difficulty of providing enough doctors and lawyers for the needs of the state. 8:29:35 AM ALICIA MARYOTT, Staff, Representative Scott Kawasaki, Alaska State Legislature, presented HB 38, paraphrasing from the sponsor statement, which read as follows [original punctuation provided]: Alaska remains one of only six states that have no medical school and the only state without a law school. Alaska has a shortage of doctors which is likely to worsen as the state's population increases and ages. The cost of healthcare and legal services will only continue to rise. That is why it is time to invest in education and build the workforce Alaska will need for the next 20 years. Law and medical students are required to go out of state for their education, therefore Alaska suffers even more. Most students tend to remain in the area in which they earn their degrees. Conversely, the 'Alaska Family Medicine Residency' has an extremely high rate of return in which 70% of the 55 graduates have remained in Alaska. By enabling the University of Alaska to build schools of medicine and law; it creates a better foundation for future doctors and lawyers to stay in Alaska for their higher education. Alaska shouldn't deny opportunity to the best and brightest and export their talents, nor import professionals from the lower 48 who don't have a connection to the state. They deserve the chance to attend medical or law school, without the high cost of transferring out of state, possibly moving back, tuition, and without the limitations set on programs such as WWAMI which only allows 20 students per year into medical school. I urge your support encouraging the University of Alaska to train the next generation of Alaskan doctors and lawyers through House Bill 38. 8:31:57 AM MS. MARYOTT, addressing the fiscal note, said that the cost was indeterminate. She relayed that HB 38 would authorize studies to be conducted for the establishment of Medical and Law Schools. 8:33:05 AM REPRESENTATIVE P. WILSON asked if the University of Alaska had indicated the number of students that could attend a medical school. 8:33:34 AM MS. MARYOTT, in response to Representative P. Wilson, said that currently there were only 20 students admitted to the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) program, and that there was a waiting list. 8:33:53 AM REPRESENTATIVE SEATON opined that a problem with WWAMI was that the required medical residency positions weren't available in Alaska, and that this could also be a limitation for a medical school. 8:34:58 AM REPRESENTATIVE KAWASAKI agreed that residencies were a factor in "getting doctors to Alaska." He pointed out that a pediatrics residency had recently been established. He reported that half of physicians licensed in the US were foreign trained as there were not enough medical personnel graduating from US schools each year to serve the needs of the population. 8:36:34 AM REPRESENTATIVE P. WILSON agreed that more doctors and nurses were needed, but she questioned the need for more lawyers. 8:37:01 AM REPRESENTATIVE KAWASAKI explained that Alaska was the only state in the union which didn't have a law school. He pointed out that many issues, such as tribal sovereignty and mineral leasing, were unique to Alaska, and that the legal community would be enhanced by in-state training. 8:38:25 AM REPRESENTATIVE FEIGE asked how many unfilled physician positions existed in Alaska. REPRESENTATIVE KAWASAKI replied that there were not enough physicians in the nation, and that there was a shortage in Alaska. 8:39:34 AM REPRESENTATIVE FEIGE commented that there was a balance of students coming to and leaving Alaska to work in the medical profession, and that a lot of other factors entered into the attraction of a facility to medical professionals. He suggested that the problem be more closely defined as to whether there were other issues for attracting medical professionals. 8:42:25 AM REPRESENTATIVE KAWASAKI, in response to Representative Feige, referred to earlier reports defining critically needed jobs within Alaska, and stated that medical professionals always topped the list. 8:43:09 AM REPRESENTATIVE SEATON asked if the proposed medical school would include dental training. 8:44:19 AM REPRESENTATIVE KAWASAKI replied that the proposed bill had been left "appropriately broad" to allow the Board of Regents to address the need. 8:45:08 AM MARSHALL SEVERSON stated his support for HB 38. He reported that he was a lifelong Alaskan, and had been educated at the University of Alaska. He opined that Alaskans should not have to leave the state to further their education in medicine or law. He pointed out that Alaska was the only state without a law school. He expressed concern with "a legal culture wholly formed outside the state of Alaska, taught by professors in schools with no Alaska sensitivity or fundamental understanding of the complex aspects of Alaska and its unique needs." He offered his belief that a local law school would improve legal services. He suggested that it would make better economic sense to spend educational resources within the state on both schools of medicine and law. 8:48:26 AM REPRESENTATIVE P. WILSON asked if he was an attorney. MR. SEVERSON replied that he was not an attorney. 8:48:50 AM REPRESENTATIVE P. WILSON commented that, as there was a shortage of nurses in Alaska, there was a need for more nurses, but she was not sure of the need for more attorneys. 8:49:47 AM WENDI COMPTON shared that she was a graduate of University of Alaska, and that she supported HB 38. She expressed her desire to attend law school, but stated that she did not want to leave her family while she attended school outside the state. She pointed out that there were not any incentive programs to support Alaskan students going to law school. She stated that the cap on federal student loans for law students, $158,000, would barely cover tuition, whereas the cap on student loans for medical students was significantly higher. She stated: Alaskan students interested in pursuing a career in law are significantly disadvantaged. We do not qualify for in-state student discounts for the law schools we apply to unless we change our residency. Most law schools provide in-state student residency discounts which can be up to 10 percent of the student's tuition. She continued and pointed out: Alaskan students interested in going to law school are required to pay more money in tuition and have to make the hard choice to leave our families, jobs and community ties behind while we attend school in another state. She offered her belief that a law school in Alaska would keep law students in Alaska, where they would work for Alaskans, and "help preserve the Alaskan way of life." 8:52:33 AM DAN KENNEDY, CPA, addressed the proposed Institute of Law, and said that his graduating high school daughter was going to attend University of Alaska Anchorage (UAA), with the desire to then attend a law school. He pointed out that his daughter was the valedictorian of her high school class, and he suggested that, if she leaves Alaska for school, it would be another example of the "brain drain" from Alaska. MR. KENNEDY offered his comments on the medical school proposal. He reported that his other daughter was studying at the Air Force Academy, with a desire to become a flight surgeon. He noted that this also required education outside Alaska. He pointed out that both his daughters were raised in Alaska, and he reflected on the enhanced benefits for Alaska if they remained in the state. 8:58:30 AM WENDY REDMAN, Executive Vice President, University of Alaska Statewide Systems, stated support for HB 38, and acknowledged the increasing shortage of physicians in Alaska. She noted that there were existing medical education programs in the state, with an ongoing review to increase these opportunities. She reported that the University of Alaska (UA) was continually working with the Alaska Health Care Coalition and the Alaska Workforce Investment Board for options to expand medical education and physician placement. She noted that the short term options to a medical school included expansion of the WWAMI program, cash incentives for physicians to practice in underserved communities, enhancement of the telemedicine capabilities, and addition of medical residencies throughout Alaska. She said that the need for a law school was not as well documented. She reported that the University was not currently prepared to commit to the development of either a medical or law school without further review and analysis of the costs and infrastructure requirements. She pointed out that everything that was currently being put into place were necessary elements in order for a medical school to exist. She offered support for HB 38. 9:03:20 AM REPRESENTATIVE KAWASAKI pointed out that many law students do not practice law, but that the use of an advanced degree was valuable. He asked Ms. Redman if a law school in Alaska would make monetary sense, and he opined that the facilities were already available. He directed attention to the immediate success of the nursing program at UA. 9:05:01 AM MS. REDMAN replied that the need should justify the cost, as law was an expensive program to offer, and that a needs assessment was necessary. 9:06:51 AM REPRESENTATIVE SEATON questioned if the limited number of WWAMI residencies in Alaska was a problem. He asked if there were any residencies available in Alaska. 9:07:27 AM SUZANNE TRYCK, Alaska WWAMI representative, agreed that it was a limiting factor, and explained that, in 2014, there would be more medical school graduates than there were residency training opportunities. She listed the 12 residencies in Alaska Family Medicine, the 4 residencies in pediatrics, and the psychiatry and family medicine residencies that were being developed. She reminded the committee that residencies accepted nationwide applicants, not just from WWAMI schools. 9:09:23 AM REPRESENTATIVE KAWASAKI restated the interest of Alaskans to have these facilities available in Alaska. [HB 38 was held over.]