HOUSE FINANCE COMMITTEE April 8, 1994 5:30 P.M. TAPE HFC 94 - 115, Side 2, #000 - end. TAPE HFC 94 - 116, Side 1, #000 - #112. CALL TO ORDER Co-Chair Larson called the House Finance Committee meeting to order at 5:30 P.M. PRESENT Co-Chair Larson Representative Hoffman Co-Chair MacLean Representative Martin Vice-Chair Hanley Representative Therriault Representative Brown Representative Parnell Representative Grussendorf Representative Navarre and Representative Foster were not present for the meeting. ALSO PRESENT Representative Gary Davis; Representative Con Bunde; Barry Campbell, Academy of Physician Assistants, Anchorage; Dave Williams, Division of Medical Assistance, Department of Health and Social Services; Lynn Smith, Staff, Representative Cynthia Toohey; Michael Johnson, Staff, Representative Joe Sitton. SUMMARY HB 341 An Act relating to physician assistants; and providing for an effective date. CS HB 341 (HES) was reported out of Committee with a "do pass" recommendation and with zero fiscal notes by the Department of Health and Social Services, the Department of Commerce and Economic Development and the Department of Labor. HB 427 An Act relating to compensation for members of the Local Boundary Commission. HB 427 was reported out of Committee with "no recommendation" and with a fiscal note by the Department of Community and Regional Affairs dated 2/24/94. 1 HB 453 An Act amending the motor fuel tax to establish a different tax levy on residual fuel oil used in and on watercraft; and providing for an effective date. CS HB 453 (FIN) was reported out of Committee with a "do pass" recommendation and with a fiscal note by the Department of Revenue and a zero fiscal note by the Department of Transportation and Public Facilities. HB 506 An Act relating to student loans; to sanctions for defaulting on a student loan, including denial of a state occupational license or disbursement of state money; and providing for an effective date. CS HB 506 (FIN) was reported out of Committee with "no recommendations" and with a fiscal note by the Department of Education. HB 507 An Act relating to licensure by the State Medical Board and temporary permits for certain optometrists. CS HB 507 (FIN) was reported out of Committee with "individual recommendations" and with a fiscal note by the Department of Commerce and Economic Development dated 3/02/94. HOUSE BILL 427 "An Act relating to compensation for members of the Local Boundary Commission." Co-Chair Larson MOVED to report HB 427 out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. HB 427 was reported out of Committee with "no recommendations" and with a fiscal note by the Department of Community and Regional Affairs dated 2/24/94. HOUSE BILL 506 "An Act relating to student loans; to sanctions for defaulting on a student loan, including denial of a state occupational license or disbursement of state money; and providing for an effective date." Representative Brown MOVED to adopt Amendment #1. [Copy on file]. 2 REPRESENTATIVE CON BUNDE commented that Amendment #1 addresses concerns regarding limiting administrative costs to three percent. He noted that he supported the amendment. There being NO OBJECTION to adopting Amendment #1, it was adopted. Representative Brown MOVED TO RESCIND previous action on Amendment #2. There being NO OBJECTION, the action was rescinded. DAN AUSTIN, STAFF, REPRESENTATIVE KAY BROWN, explained that the new Amendment #2 would clarify that action may be taken no sooner than sixty days after the commission has notified the borrower of a default status on the loan. Representative Brown MOVED to adopt the new Amendment #2. There being NO OBJECTION, it was adopted. Representative Parnell MOVED to report CS HB 506 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. CS HB 506 (FIN) was reported out of Committee with a "no recommendation" and with a fiscal note by the Department of Education. HOUSE BILL 341 "An Act relating to physician assistants; and providing for an effective date." MICHAEL JOHNSON, STAFF, REPRESENTATIVE JOE SITTON, stated that HB 341 would amend several current statutes relating to health care providers giving Alaskans greater access to quality health care and placing physician assistants on equal footing to those providers with similar levels of training. He added that HB 341 would amend the statutes governing workers' compensation and private insurance companies to account for physicians assistants' (P.A.'s) emergence as health care providers and insure that those companies would not have trouble receiving payment from those entities. The legislation also would add physician assistants to the statute that prohibits private insurance companies from refusing to pay one health care provider if another qualified practitioner could offer the same procedure or level of care. 3 Mr. Johnson pointed out that Representative Sitton does not support the fiscal note as provided by the Department of Health and Social Services and consequently has provided an alternative note. DAVE WILLIAMS, DIVISION OF MEDICAL ASSISTANCE, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, explained that in Alaska, physicians assistants have not been paid directly for services rendered. He pointed out that there are a number of reasons why the legislation will cost the Department a large amount of money, adding that the legislation would provide seventeen new access points for services in Alaska. Thus far this year, $1.8 million dollars has been paid by the Department for rural health clinics enrolled as IHS providers. Mr. Johnson explained that the Department assumes that a certain number of physician assistants will enroll and that there will be a number of new patients contributing to the cost of the program. He indicated that the assumption would not include any cost shifting or accounting for cost shifting and felt the fiscal note should reflect that information. BARRY CAMPBELL, PRESIDENT, ALASKA ACADEMY OF PHYSICIAN ASSISTANTS, ANCHORAGE, remarked that a physician assistant (P.A.'s) requires two to four years training. Some programs require prior medical background. Mr. Campbell noted support of Representative Sitton's fiscal note. Mr. Williams advised that the legislation would provide for P.A.'s in both rural and urban areas and added that the Department had provided their fiscal note based upon that information and the Governor's proposed budget. Discussion followed among Committee members regarding the fiscal note and the impact to the Department of Health and Social Services. Representative Hanley MOVED to adopt Amendment #1 which would rearrange services payable by the Department of Health and Social Services and would place physician assistant services in the first category. Representative Brown OBJECTED. A roll call vote was taken on the MOTION. IN FAVOR: Hanley. OPPOSED: Hoffman, Martin, Parnell, Brown, Grussendorf, MacLean, Larson. 4 Representatives Navarre and Foster were not present for the vote. The MOTION FAILED (1-7). Representative Hanley MOVED to report CS HB 341 (HES) out of Committee with individual recommendations and with a zero fiscal note by the Department of Health and Social Services. There being NO OBJECTION, it was so ordered. CS HB 341 (HES) was reported out of Committee with a "do pass" recommendation and with zero fiscal notes by the Department of Health and Social Services, the Department of Commerce and Economic Development and the Department of Labor. HOUSE BILL 453 "An Act amending the motor fuel tax to establish a different tax levy on residual fuel oil used in and on watercraft; and providing for an effective date." REPRESENTATIVE GARY DAVIS stated that HB 453 would attempt to create an equal playing field between Alaska's residual fuel oil industry and their counterparts in the Lower 48 and Canada. He added that residual fuel oil is the residue from crude oil after the light oils, gasoline, naphtha, kerosine, and mid-distillates are extracted in the refining process. The only applications for residual fuel oil in Alaska are asphalt, cruise ship fuel and reinjection into the pipeline. Representative Parnell MOVED work draft #8-LS1357\X, Chenoweth, 3/28/94, as the version before the Committee. There being NO OBJECTION, the work draft was adopted. Co-Chair MacLean MOVED to report CS HB 453 (FIN) out of Committee with individual recommendations and with accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS HB 453 (FIN) was reported out of Committee with a "do pass" recommendation and with a fiscal note by the Department of Revenue and a zero fiscal note by the Department of Transportation and Public Facilities. HOUSE BILL 507 "An Act relating to licensure by the State Medical Board and temporary permits for certain optometrists." (Tape Change, HFC 94-116, Side 1). 5 LYNN SMITH, STAFF, REPRESENTATIVE CYNTHIA TOOHEY, advised that HB 507 was introduced by the House HESS Committee by the request of the State Medical Board and the Alaska Optometric Association and would address concerns of the board that interviewing applicants for licensure be in person. The provision would decrease costs for applicants who wish to practice medicine in Alaska. Representative Brown MOVED to adopt Amendment #1 requiring an interview and allowing that interview to be by telephone. There being NO OBJECTION, it was adopted. Co-Chair MacLean MOVED to report CS HB 507 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. CS HB 507 (FIN) was reported out of Committee with "individual recommendations" and with the fiscal note by the Department of Commerce and Economic Development dated 3/02/94. ADJOURNMENT The meeting adjourned at 6:30 P.M. HOUSE FINANCE COMMITTEE April 8, 1994 5:30 P.M. TAPE HFC 94 - 115, Side 2, #000 - end. TAPE HFC 94 - 116, Side 1, #000 - #112. CALL TO ORDER Co-Chair Larson called the House Finance Committee meeting to order at 5:30 P.M. PRESENT Co-Chair Larson Representative Hoffman Co-Chair MacLean Representative Martin Vice-Chair Hanley Representative Therriault Representative Brown Representative Parnell Representative Grussendorf Representative Navarre and Representative Foster were not present for the meeting. 6 ALSO PRESENT Representative Gary Davis; Representative Con Bunde; Barry Campbell, Academy of Physician Assistants, Anchorage; Dave Williams, Division of Medical Assistance, Department of Health and Social Services; Lynn Smith, Staff, Representative Cynthia Toohey; Michael Johnson, Staff, Representative Joe Sitton. SUMMARY HB 341 An Act relating to physician assistants; and providing for an effective date. CS HB 341 (HES) was reported out of Committee with a "do pass" recommendation and with zero fiscal notes by the Department of Health and Social Services, the Department of Commerce and Economic Development and the Department of Labor. HB 427 An Act relating to compensation for members of the Local Boundary Commission. HB 427 was reported out of Committee with "no recommendation" and with a fiscal note by the Department of Community and Regional Affairs dated 2/24/94. HB 453 An Act amending the motor fuel tax to establish a different tax levy on residual fuel oil used in and on watercraft; and providing for an effective date. CS HB 453 (FIN) was reported out of Committee with a "do pass" recommendation and with a fiscal note by the Department of Revenue and a zero fiscal note by the Department of Transportation and Public Facilities. HB 506 An Act relating to student loans; to sanctions for defaulting on a student loan, including denial of a state occupational license or disbursement of state money; and providing for an effective date. CS HB 506 (FIN) was reported out of Committee with "no recommendations" and with a fiscal note by the Department of Education. HB 507 An Act relating to licensure by the State Medical Board and temporary permits for certain optometrists. 7 CS HB 507 (FIN) was reported out of Committee with "individual recommendations" and with a fiscal note by the Department of Commerce and Economic Development dated 3/02/94. HOUSE BILL 427 "An Act relating to compensation for members of the Local Boundary Commission." Co-Chair Larson MOVED to report HB 427 out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. HB 427 was reported out of Committee with "no recommendations" and with a fiscal note by the Department of Community and Regional Affairs dated 2/24/94. HOUSE BILL 506 "An Act relating to student loans; to sanctions for defaulting on a student loan, including denial of a state occupational license or disbursement of state money; and providing for an effective date." Representative Brown MOVED to adopt Amendment #1. [Copy on file]. REPRESENTATIVE CON BUNDE commented that Amendment #1 addresses concerns regarding limiting administrative costs to three percent. He noted that he supported the amendment. There being NO OBJECTION to adopting Amendment #1, it was adopted. Representative Brown MOVED TO RESCIND previous action on Amendment #2. There being NO OBJECTION, the action was rescinded. DAN AUSTIN, STAFF, REPRESENTATIVE KAY BROWN, explained that the new Amendment #2 would clarify that action may be taken no sooner than sixty days after the commission has notified the borrower of a default status on the loan. Representative Brown MOVED to adopt the new Amendment #2. There being NO OBJECTION, it was adopted. Representative Parnell MOVED to report CS HB 506 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was 8 so ordered. CS HB 506 (FIN) was reported out of Committee with a "no recommendation" and with a fiscal note by the Department of Education. HOUSE BILL 341 "An Act relating to physician assistants; and providing for an effective date." MICHAEL JOHNSON, STAFF, REPRESENTATIVE JOE SITTON, stated that HB 341 would amend several current statutes relating to health care providers giving Alaskans greater access to quality health care and placing physician assistants on equal footing to those providers with similar levels of training. He added that HB 341 would amend the statutes governing workers' compensation and private insurance companies to account for physicians assistants' (P.A.'s) emergence as health care providers and insure that those companies would not have trouble receiving payment from those entities. The legislation also would add physician assistants to the statute that prohibits private insurance companies from refusing to pay one health care provider if another qualified practitioner could offer the same procedure or level of care. Mr. Johnson pointed out that Representative Sitton does not support the fiscal note as provided by the Department of Health and Social Services and consequently has provided an alternative note. DAVE WILLIAMS, DIVISION OF MEDICAL ASSISTANCE, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, explained that in Alaska, physicians assistants have not been paid directly for services rendered. He pointed out that there are a number of reasons why the legislation will cost the Department a large amount of money, adding that the legislation would provide seventeen new access points for services in Alaska. Thus far this year, $1.8 million dollars has been paid by the Department for rural health clinics enrolled as IHS providers. Mr. Johnson explained that the Department assumes that a certain number of physician assistants will enroll and that there will be a number of new patients contributing to the cost of the program. He indicated that the assumption would not include any cost shifting or accounting for cost shifting and felt the fiscal note should reflect that information. 9 BARRY CAMPBELL, PRESIDENT, ALASKA ACADEMY OF PHYSICIAN ASSISTANTS, ANCHORAGE, remarked that a physician assistant (P.A.'s) requires two to four years training. Some programs require prior medical background. Mr. Campbell noted support of Representative Sitton's fiscal note. Mr. Williams advised that the legislation would provide for P.A.'s in both rural and urban areas and added that the Department had provided their fiscal note based upon that information and the Governor's proposed budget. Discussion followed among Committee members regarding the fiscal note and the impact to the Department of Health and Social Services. Representative Hanley MOVED to adopt Amendment #1 which would rearrange services payable by the Department of Health and Social Services and would place physician assistant services in the first category. Representative Brown OBJECTED. A roll call vote was taken on the MOTION. IN FAVOR: Hanley. OPPOSED: Hoffman, Martin, Parnell, Brown, Grussendorf, MacLean, Larson. Representatives Navarre and Foster were not present for the vote. The MOTION FAILED (1-7). Representative Hanley MOVED to report CS HB 341 (HES) out of Committee with individual recommendations and with a zero fiscal note by the Department of Health and Social Services. There being NO OBJECTION, it was so ordered. CS HB 341 (HES) was reported out of Committee with a "do pass" recommendation and with zero fiscal notes by the Department of Health and Social Services, the Department of Commerce and Economic Development and the Department of Labor. HOUSE BILL 453 "An Act amending the motor fuel tax to establish a different tax levy on residual fuel oil used in and on watercraft; and providing for an effective date." REPRESENTATIVE GARY DAVIS stated that HB 453 would attempt to create an equal playing field between Alaska's residual 10 fuel oil industry and their counterparts in the Lower 48 and Canada. He added that residual fuel oil is the residue from crude oil after the light oils, gasoline, naphtha, kerosine, and mid-distillates are extracted in the refining process. The only applications for residual fuel oil in Alaska are asphalt, cruise ship fuel and reinjection into the pipeline. Representative Parnell MOVED work draft #8-LS1357\X, Chenoweth, 3/28/94, as the version before the Committee. There being NO OBJECTION, the work draft was adopted. Co-Chair MacLean MOVED to report CS HB 453 (FIN) out of Committee with individual recommendations and with accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS HB 453 (FIN) was reported out of Committee with a "do pass" recommendation and with a fiscal note by the Department of Revenue and a zero fiscal note by the Department of Transportation and Public Facilities. HOUSE BILL 507 "An Act relating to licensure by the State Medical Board and temporary permits for certain optometrists." (Tape Change, HFC 94-116, Side 1). LYNN SMITH, STAFF, REPRESENTATIVE CYNTHIA TOOHEY, advised that HB 507 was introduced by the House HESS Committee by the request of the State Medical Board and the Alaska Optometric Association and would address concerns of the board that interviewing applicants for licensure be in person. The provision would decrease costs for applicants who wish to practice medicine in Alaska. Representative Brown MOVED to adopt Amendment #1 requiring an interview and allowing that interview to be by telephone. There being NO OBJECTION, it was adopted. Co-Chair MacLean MOVED to report CS HB 507 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. CS HB 507 (FIN) was reported out of Committee with "individual recommendations" and with the fiscal note by the Department of Commerce and Economic Development dated 3/02/94. ADJOURNMENT 11 The meeting adjourned at 6:30 P.M. 12