SB 14-MEDICAL BOARD; MEDICAL REVIEW ORG.  1:34:16 PM CHAIR COSTELLO announced the consideration of SB 14. "An Act relating to the appointment of a mobile intensive care paramedic to the State Medical Board; relating to medical review organizations; relating to immunity pertaining to automated external defibrillators; and providing for an effective date." She noted that this was the second hearing and public testimony was closed. She asked for a motion to adopt the work draft committee substitute (CS). 1:34:29 PM SENATOR GIESSEL moved to adopt the proposed CS for SB 14, labeled 29-LS0025\E, as the working document. SENATOR MEYER objected for discussion purposes. 1:34:54 PM WESTON EILER, Staff, Senator Mia Costello, explained that version E: changes the composition of the State Medical Board ("board") by removing one public seat when it sunsets and adding one licensed paramedic; removes the repealer section relating to defibrillators; and amends the effective date to 3/1/2017. SENATOR MEYER removed his objection. CHAIR COSTELLO announced that without further objection, version E was before the committee. She advised that she reviewed licensing boards and their membership and found that there are 12 in Alaska that have just one public seat. SENATOR GIESSEL expressed concern that sunsetting one public seat dilutes the voice of the consumer. She assumed that maintaining the current number of seats rather than adding one was done for economic reasons. CHAIR COSTELLO said the reason for keeping the number the same is to maintain the current balance of medical members. This is in line with other boards and commissions like the Board of Dental Examiners that has eight industry seats and one public member and the Board of Chiropractic Examiners that has four industry seats and one public member. 1:39:41 PM SENATOR STEVENS voiced concern that paramedics would be making decisions about licensing and disciplinary actions for physicians. He noted that this wouldn't happen in the university setting. MR. EILER suggested Mr. Shilling speak to Senator Steven's concern. SENATOR GIESSEL said she shares the concern that this would diversify the composition of a professional regulatory board. 1:41:18 PM JORDAN SHILLING, Staff, Senator John Coghill, stated that paramedics and physicians are two entirely different professions and the relationship is different than between a professor and an associate professor. He said the sponsor feels strongly that if this board is to regulate the paramedics, then they ought to have a voice. SENATOR GIESSEL questioned how someone who is a pre-hospital professional could understand the issues of a professional who is in the hospital. MR. SHILLING relied the paramedics similarly might question whether physicians are qualified to regulate their profession without a paramedic voice at the table. He opined that there were probably similar discussions when the legislature initially contemplated adding a physician assistant (PA) to the board. SENATOR GIESSEL said she could honestly argue for a separate paramedic board. MR. SHILLING offered his belief that paramedics would be very satisfied to have a board that regulates EMTs and paramedics. 1:44:31 PM SENATOR STEVENS asked if physicians have taken a position on the bill. MR. SHILLING relayed that the physicians who have served on the State Medical Board in the past have been supportive. He noted that the sponsor hasn't heard opposition from physicians other than their guild. CHAIR COSTELLO noted the committee had documented support from the American Medical Association (AMA) for the current version of the bill. She also pointed out that the 2017 effective date provides a window of opportunity for further discussion, including for a separate board. 1:45:43 PM SENATOR MEYER opined that this is the best way forward at this time. CHAIR COSTELLO noted that the next committee of referral could probably zero the $7,000 receipts services in the fiscal note in light of the CS. SENATOR GIESSEL highlighted that the licensees will pay just as they would if it were a separate paramedic board. CHAIR COSTELLO found no further questions or comments and solicited a motion. 1:47:34 PM SENATOR GIESSEL moved to report the CS for SB 14, labeled 29- LS0025\E, from committee with individual recommendations and attached fiscal note(s). CHAIR COSTELLO announced that without objection, CSSB 14(L&C) is reported from the Senate Labor and Commerce Standing Committee.