SB 71-PHYSICIAN LICENSURE CHANGES CHAIRMAN MACKIE announced SB 71 to be up for consideration. DR. SARAH ISTO, Chair of the State Medical Board, explained that SB 72 resolves licensure problems for the Board, updates Alaska statutes in relation to other states, and corrects unintended problems within the current law. DR. ISTO said the State Medical Board supports the bill. DR. ISTO explained there have been several difficulties over the past few years that this bill is intended to remedy. There are seven specific problems SB 71 deals with. First, the Board is not currently able to consider the fact that an applicant is a convicted felon, unless the felony was committed during the practice of medicine. The Board would like to be able to consider felony and misdemeanor offenses when they relate to an applicant's fitness to practice. Second, DR. ISTO said this bill will prevent delays and interruptions in the delivery of patient care. Currently, if a person is short of continuing education credits, they are supposed to stop work immediately. SB 71 will allow a person to continue practicing while a minor deficiency is corrected. Next, DR. ISTO explained SB 71 will fix a problem for residents being trained as doctors. Currently, only one-year permits and licences are awarded, though this is a three-year program in Anchorage. This bill will allow residents to be licenced after two years. Also, Section 5 removes a prohibition on considering anything short of a suspension or revocation in another state. DR. ISTO said the Board needs to be able to consider other disciplinary actions and this section of the bill simply "extends the language into modern day discipline uses." Section 6 deals with citizenship. Alaska is the only state that requires this, and DR. ISTO remarked she does not think this is pertinent to a doctor's competence. There are people who are legally in the U.S. that are not able to see patients in Alaska, and DR. ISTO said she would like to see this requirement deleted. Section 7 deals with foreign medical graduates who come from medical schools that are not accredited by the U.S. or Canada. Currently, a person is required to have completed one year of post graduate training in an accredited school. Forty-seven other states require a person to have completed three years of post graduate training in an accredited school of medicine. She would like to see Alaska adopt the three year standard. Additionally, people who graduate from accredited schools after 1995 would be required to have two years of post-graduate training. SENATOR KELLY expressed concern about language on page 4, line 28 of the bill which gives the Board too much latitude and discretion to consider misdemeanor offenses. DR. ISTO replied the language of the bill requires the misdemeanor to be "substantially related to the qualifications, functions or duties of the licensee" in order to be considered by the Board. SENATOR KELLY agreed that is the initial language, but the bill goes on to say "or a misdemeanor in this or any other jurisdiction." SENATOR KELLY stated, "That's any misdemeanor . . . I don't want to give the Board that kind of discretion." DR. ISTO said she still reads the bill to allow consideration of a misdemeanor only as it relates to fitness to practice. SENATOR KELLY maintained that even if the consideration is tied to fitness to practice, "That's just a lot of discretion to give to a group of people who control their own profession." He asked why it is necessary to give the Board discretion to reject an application by a person who has committed a misdemeanor. DR. ISTO stated it is not the intention of the Board to "lightly decline applicants because they had some misdemeanor." She said she believes the Board would be willing to modify this, if they were still given the discretion to consider felonies. SENATOR MACKIE asked if this section deals with the Board imposing sanctions on licensees who have been convicted. He said his concern is that a person who has committed a misdemeanor may be denied the opportunity to practice medicine. DR. ISTO said she had only intended the Board be able to consider these things, not necessarily act on them or "sanction somebody or refuse a new applicant." She repeated it was not the intent of the Board to include language that would allow denial of a license or sanction for a misdemeanor "of no consequence to the practice of medicine." Again, she said she would agree to softening of the language if the Board retained the right to consider felonies. SENATOR MACKIE thought that was the current law. MS. ISTO explained felonies could be considered only if they occur as part of a person's duties as a physician. SENATOR MACKIE asked who wanted the misdemeanor language. He thought an example of a misdemeanor the Board might want to consider would help the committee understand the motivation behind the proposed amendments. DR. ISTO suggested the Board may wish to consider a recent DWI. SENATOR DONLEY suggested the committee was going back over the same ground and "somebody should either propose something or we should hold the bill over." SENATOR KELLY reiterated he is uncomfortable with the idea of tying a misdemeanor to the fitness to practice. He said this could be a subjective judgement of whomever happens to be on the Medical Board at the time. It is an expansion of the Board's power that makes him nervous. SENATOR DONLEY agreed. SENATOR MACKIE proposed he would hold the bill over while they worked on this issue. Number 532 MS. CATHERINE REARDON, Director of the Division of Occupational Licencing, testified that the Department strongly supports the bill. She noted that the Medical Board is interested in licencing people quickly and does not attempt to block applications unnecessarily. She suggested the Board may wish to consider misdemeanors involving recent substance abuse, and said there is a need to consider felonies unrelated to the practice of medicine. She mentioned there is always a right to a due process hearing, which checks irresponsible application of a person's history by the Board. She stated the bill has a zero fiscal note and the Department supports it. CHAIRMAN MACKIE thanked everyone for their testimony and said they would hold SB 71 and adjourned the meeting at 2:28 p.m.