HB 269-IMMUNITY FOR VOL. HEALTH CARE PROVIDER  1:05:05 PM CHAIR KELLER announced the first order of business would be HOUSE BILL NO. 269, "An Act providing immunity for certain licensed temporary health care providers who provide free health care services." [CSHB 269(HSS) is before the committee.] 1:05:35 PM REPRESENTATIVE GRUENBERG moved to adopt proposed committee substitute (CS) for HB 269, Version 28-LS1251\C, Wallace, 2/28/14, as the working document. [CHAIR KELLER indicated an objection.] 1:06:23 PM JANE PIERSON, Staff, Representative Steve Thompson, Alaska State Legislature, stated that in accordance with Representative Gruenberg's suggestion, on page 2, line 8, following the word "consent" the language "in writing" was inserted. Per the Board of Nurses suggestion on page 2, lines 14-18, the following language was inserted: "; and (C) provides the person receiving  health care services with written notice of the name of a  licensed health care provider in the state that the person  receiving health care services may contact for emergency follow- up care within 30 days after a procedure is performed."  1:07:30 PM REPRESENTATIVE LEDOUX questioned whether the person contacted for emergency follow-up care is required to perform the service free of charge. MS. PIERSON answered "No," it would not mean [free] although the MOM event is providing services for 30 days following the event. REPRESENTATIVE LEDOUX further questioned Ms. Pierson whether it would not mean [free of charge], although the Alaska Mission of Mercy (AKMOM) event is providing [free] services for 30 days following the event. 1:08:21 PM DAVID LOGAN, DDS, Alaska Dental Society, clarified that for the MOM event all care and follow-up care is provided without charge. 1:09:19 PM CHAIR KELLER removed his objection. There being no further objection, Version C was before the committee. 1:09:33 PM CHAIR KELLER re-opened public testimony. 1:09:41 PM  REPRESENTATIVE GRUENBERG referred to a 2/26/14 memorandum from Megan Wallace, Legislative Counsel, directed to Representative Wes Keller, which he assumed is a result of questions emanating before the bill arrived in the House Judiciary Standing Committee. He requested someone knowledgeable explain the memorandum so the committee can determine whether more work is required on the bill. 1:11:19 PM MS. PIERSON, referring to the memorandum from Megan Wallace, dated 2/26/14, directed attention to the first question and offered her understanding that HB 269 does not specifically affect AS 09.65.300(a), Military Courtesy License. However, it may create some ambiguity for temporary courtesy license holders as the bill currently includes only one type of temporary courtesy license and covers the definition of health care provider. 1:12:01 PM REPRESENTATIVE GRUENBERG quiered whether it is the sponsor's desire that HB 269 be altered to also cover military courtesy licenses. MS. PIERSON responded with her belief that [HB 269] does [cover military courtesy license]. She explained that if the goal is for temporary licenses to be under all health care providers and not specifically under dental providers licensed through boards, she directed attention to question 2 which reads that "the bill may create some ambiguity as it relates to the inclusion of these temporary licenses" since HB 269 only specifically includes temporary courtesy licenses issued under AS 08.01.062 [in the definition] of "health care provider." However, there is a chance the court could interpret the language to mean that only persons holding temporary courtesy licenses issued under the statute are eligible for immunity. MS. PIERSON, referring to question 4, pointed out that if the goal is for all medical providers to be covered under this, then Ms. Wallace recommended revising the [new] language in Section 1(a)(1) to read: "in this paragraph, health care provider includes a health care provider who holds a temporary license or permit." The aforementioned would then cover chiropractors, physicians, nurses, and dentists. 1:14:22 PM REPRESENTATIVE GRUENBERG stated his preference that language in the bill is clear rather than ambiguous. 1:15:10 PM CHAIR KELLER questioned Representative Gruenberg regarding what he is specifically suggesting, as the language in Version C has reduced the ambiguity. 1:15:29 PM REPRESENTATIVE GRUENBERG expressed the need to have language that is clear and relates the [sponsor's] preference. He said he didn't want to put forth legislation that would breed litigation. 1:16:15 PM DR. LOGAN referred to the proposed language on page 2 [of the 2/26/14 memorandum] and opined that deleting the term "courtesy" and inserting [language to the effect of] "all temporary licenses and permits" would include courtesy licenses, temporary licenses, and locum tenens licenses and the language would only affect health care providers in this statute performing free health care services. Although the ADS does not mind the language speaking solely for courtesy licenses since the dental board does not offer temporary licenses, he proffered that there is wisdom in making it all inclusive to remove possible ambiguity. 1:18:14 PM REPRESENTATIVE GRUENBERG highlighted that the only person who has testified on the bill is Dr. Logan on behalf of the dentists. He recommended that prior to expanding the legislation to include physicians, nurses and chiropractors those boards should testify as to their preference to the committee. He then questioned whether the intent of the sponsor is to leave [the language to address only] temporary courtesy licenses with dentists. MS. PIERSON related her belief that this goes to the original legal opinion Representative Thompson received from Legislative Legal and Research Services, which questioned why this bill is even necessary as the matter is already covered. However, since the Department of Law's (DOL) response was that it may or may not be covered, the sponsor decided to "tighten up" the language and ensure there is not a lengthy court case to determine whether or not these dentists are covered for this function. In further response to Representative Gruenberg, Ms. Pierson confirmed that the bill's language is sufficiently tight for the dentists. 1:20:28 PM The committee took a brief at-ease. 1:22:22 PM REPRESENTATIVE GRUENBERG questioned Ms. Wallace whether she believes the bill's intention is to cover this particular dental program [AKMOM] and no other licenses, and if there is ambiguity in the language. MEGAN WALLACE, Attorney at Law, Legislative Legal Counsel, Legislative Legal and Research Services, Legislative Affairs Agency explained the bill currently is drafted to define health care provider to include courtesy licenses issued under AS 08.01.062. She opined that it is under Business and Professions, Centralized Licensing and that provision applies to a list of boards cited in AS 08.01.010. The legislation as drafted does not only pertain to dentists as it applies temporary courtesy licenses issued by any of the boards under AS 08.01.010 that issue a courtesy license through the provision in AS 08.01.062, she explained. 1:23:57 PM REPRESENTATIVE GRUENBERG conveyed his impression that according to Ms. Wallace's testimony, the drafted legislation applies to more than dentists and more than this license. If the aforementioned is the case, he suggested the language in HB 269 should be clarified and clearly limited to dentists with temporary courtesy licenses. SARA CHAMBERS, Administrative Operations Manager, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community, and Economic Development, advised that her understanding is concurrent with that of Ms. Wallace in that as HB 269 currently drafted, would include any health care provider as stated. She explained that the courtesy licensing section, AS 08.01.062, is a broad centralized authority that defers to [the state's] licensing boards and programs to then create regulations to manage how the boards and programs define and govern a courtesy license. This could be expressed in different ways by different boards and certainly health care provider is defined in the bill. Ms. Chambers offered to provide clarification of the difference between a temporary license and a courtesy license. 1:25:59 P M CHAIR KELLER recalled earlier remarks that the bill may pose a problem for health care providers who have not been present to testify and asked Ms. Chambers if she anticipated any concerns with the change embodied in HB 269. MS. CHAMBERS, noting that she is not speaking on behalf of any of the boards, related that in the past she has not been presented with a situation that would seem to be in conflict [with HB 269]. Although from an administrative standpoint it would pose no additional conflict or burden, she deferred to the boards to make that determination. 1:27:08 PM REPRESENTATIVE GRUENBERG expressed the need to be on firm ground before making a change. Therefore, Representative Gruenberg stated his preference to limit the language to temporary courtesy licenses for dentists. 1:27:54 PM MS. PIERSON directed attention to the committee member's packets wherein there are letters of support from the Alaska Pharmacists Association and the Alaska State Medical Association. The concerns expressed by the Alaska Board of Nursing, have been alleviated and therefore she anticipated a letter of support from the board. Although the sponsor has not heard from the Board of Chiropractic Examiners, she said she does not know the amount of pro bono chiropractic work that is performed. 1:28:46 PM CHAIR KELLER proposed the committee proceed forward with HB 269 as it had not yet been heard in the Alaska State Senate. He opined that the bill has been duly notified on the record and if the legislature has not heard from the Alaska State Board of Chiropractic Examiners by the time HB 269 is in the House Rules Standing Committee or in the Senate, it can be assumed there is not a problem. 1:29:16 PM REPRESENTATIVE GRUENBERG noted that most of the referenced letters favor the extension [of immunity] to them. 1:29:46 PM CHAIR KELLER closed public testimony. 1:30:04 PM REPRESENTATIVE LYNN moved to report CSHB 269, Version 28- LS1251\C, Wallace, 2/28/14, out of committee with individual recommendations and the accompanying fiscal notes. 1:30:34 PM REPRESENTATIVE GRUENBERG objected for discussion and directed a question to Ms. Wallace. He stated that the committee's [intent] is that the bill include the [Alaska State Medical Board, Alaska Board of Nursing, and the Alaska State Board of Chiropractic Examiners] and questioned Ms. Wallace whether she was aware of clarifying language to eliminate ambiguity in that regard. MS. WALLACE advised that the bill will cover temporary courtesy licenses for the professions listed in the centralized licensing statute. She noted that the only possibility for ambiguity is whether the definition of health care provider is to include persons or health care providers who hold "other kinds of temporary licenses or permits." In other words, [the ambiguity] is whether the [sponsor] is limiting the scope of AS 09.65.300(a) to only cover health providers who have a temporary courtesy license under AS 08.01.062 or whether the bill is to also include health care providers who hold temporary licenses or permits under other statutes. 1:32:15 PM REPRESENTATIVE GRUENBERG clarified that the question has become the type of license that may be covered is not normally a question within the House Judiciary Standing Committee's jurisdiction. Although the committee is aware of the dentist's licensing structure, there has not been any testimony from the other professions or their types of licenses. 1:33:04 PM The committee took a brief at-ease. 1:34:15 PM MS. PIERSON assured the committee that as HB 269 moves forward, she will endeavor to work with Ms. Chambers and the boards regarding health care providers under "other" temporary licenses and permits to determine what they are and what is covered. She noted that if there is a problem, the bill will go to the House Rules Standing Committee before going to the House floor. 1:34:57 PM REPRESENTATIVE GRUENBERG requested a list of professions and licenses covered under HB 269 before it goes to the floor. REPRESENTATIVE GRUENBERG removed his objection. There being no objections CSHB 269(JUD) was reported from the House Judiciary Standing Committee.