SB 65-LIABILITY CONSULTING HEALTH CARE PROVIDER  2:29:35 PM CHAIR REINBOLD reconvened the meeting and announced that the business before the committee would be SENATE BILL NO. 65, "An Act relating to immunity for consulting physicians, podiatrists, osteopaths, advanced practice registered nurses, physician assistants, dentists, optometrists, and pharmacists." [Before the committee was CSSB 65(HSS)]. 2:29:52 PM SENATOR KIEHL, speaking as sponsor, introduced his staff, CJ Harrell, as an intern through the University of Alaska Southeast and Ted Stevens Institute. 2:30:18 PM CJ HARRELL, Intern, Senator Jesse Kiehl, Alaska State Legislature, Juneau, Alaska, stated that she works as an intern for Senator Kiehl, sponsor of SB 65. She read the sponsor statement on behalf of Senator Kiehl: Within Alaska and other states, health care providers will seek the knowledge and expertise of fellow medical professionals to help them understand how to help their patient in an effective and timely matter. These conversations may be an official consultation, but often medical professionals have what are called "curbside consultations". This is when a patient's health care provider has an uncompensated informal consultation with another medical professional. These consulting medical professionals are often specialists, and do not have any relationship with the patient being discussed. It is a fast and effective way of sharing knowledge and expertise and in many ways is the backbone of medical care. It was not until 2 years ago in Minnesota that a health care provider who had no relationship to a patient was forced to defend themselves against a civil liability case. We fear that by not protecting those who have no relationship to a patient and are sharing their expertise through a curbside consultation, they will no longer feel comfortable aiding fellow health care providers in this way. This bill will allow curbside consultations to continue, but now without the fear of becoming subject to civil liability for a patient who they have no relationship to. 2:31:44 PM SENATOR KIEHL explained that the Senate Health and Education Committee made two changes to the bill. One change clarified a vague statement about preparing a report. The other change added chiropractors to the list of professionals who may give and receive curbside consultations without the risk of liability under the bill. SENATOR KIEHL reviewed the legal principles. He said the Minnesota Supreme Court case set out a new standard for medical liability. It did not require a doctor/and patient relationship. Therefore, it did not require the duty of care, one of the keystones of liability and torts. The goal of SB 65 is to preserve how medical malpractice liability has worked in Alaska, which is not to hold liable health care professionals who have never given care to patients. He offered his willingness to discuss the details. He emphasized that is the key to the legal issues in SB 65 CHAIR REINBOLD related her understanding that care includes vaccinations. SENATOR KIEHL answered that any health care professional who has given shots has a duty of care but would not be covered under the bill. 2:34:02 PM the patient is not a current or former patient of the consulting health care provider or of the consulting health care provider's practice." He asked why the sponsor did not allow liability to be removed from a former patient. SENATOR KIEHL answered that if a doctor treated a patient last week, they have established a doctor/patient relationship. SENATOR MYERS said that the timeliness of the visit seemed relevant. For example, if a doctor has not seen a patient and three years, he asked if a doctor/patient relationship would still exist. 2:35:17 PM SENATOR MYERS referred to page 2, line 23 of SB 65 to the definition of a health care facility. He said it does not mention federal hospitals. He noted that hospitals for veterans in Alaska would not be covered. SENATOR KIEHL answered that it was not the intent to exclude federal hospitals. He offered to research it and report back to the committee. 2:36:08 PM SENATOR MYERS referred to page 3, line 3 of SB 65. He said was surprised to see pharmacists listed. He related his understanding that pharmacists do not enter into the same relationship as other health care professionals such as doctors and nurses. He asked for clarification. SENATOR KIEHL agreed that the relationship is different. Pharmacists were added to the bill because of the frequency in which other medical providers consult pharmacists on the best medication to prescribe for their patients that a practice within their scope of practice. He pointed out that SB 65 is written such that the treating physician must treatment within their scope of practice. While a pharmacist can only work within their scope of practice, when a pharmacist provides advice to a doctor, the doctor is the treating physician who maintains the liability if something goes wrong. Last year, the legislature added pharmacists to the bill. He emphasized the importance of health care professionals obtaining expertise from pharmacists is valuable, such as when a drug is contraindicated. 2:38:52 PM SENATOR MYERS referred to the fiscal note analysis. He pointed out that the analysis states that immunity "may" apply instead of requiring that immunity "shall" apply. He was unsure if the Department of Law made an error or if it reflects the immunity in the bill. 2:39:41 PM SENATOR KIEHL responded that the fiscal note analysis clarifies the instances in which immunity applies. He agreed that the bill is not designed to "possibly" set out civil immunity but to create civil immunity. [SB 65 was held in committee].