HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE May 14, 1999 8:35 a.m. MEMBERS PRESENT Representative Fred Dyson, Co-Chair Representative John Coghill, Co-Chair Representative Jim Whitaker Representative Joe Green Representative Tom Brice MEMBERS ABSENT Representative Carl Morgan Representative Allen Kemplen COMMITTEE CALENDAR SENATE BILL NO. 71 "An Act relating to licensure by the State Medical Board." - MOVED HCS CSSB 71(HES) OUT OF COMMITTEE (* First public hearing) PREVIOUS ACTION BILL: SB 71 SHORT TITLE: PHYSICIAN LICENSURE CHANGES SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES Jrn-Date Jrn-Page Action 2/11/99 227 (S) READ THE FIRST TIME - REFERRAL(S) 2/11/99 227 (S) HES, L&C 4/07/99 (S) HES AT 1:30 PM BUTROVICH 205 4/07/99 (S) MINUTE(HES) 4/12/99 (S) HES AT 1:30 PM BUTROVICH 205 4/12/99 (S) MINUTE(HES) 4/13/99 899 (S) HES RPT CS 4DP 1NR SAME TITLE 4/13/99 899 (S) DP: MILLER, WILKEN, ELTON, PETE KELLY; 4/13/99 899 (S) NR: PEARCE 4/27/99 (S) L&C AT 1:30 PM BELTZ 211 4/27/99 (S) HEARD AND HELD 4/28/99 1149 (S) ZERO FISCAL NOTE (DCED) 4/29/99 (S) L&C AT 1:30 PM BELTZ 211 4/29/99 (S) MOVED CS(L&C) OUT OF COMMITTEE 4/29/99 (S) MINUTE(L&C) 4/30/99 1184 (S) L&C RPT CS 2DP 1NR SAME TITLE 4/30/99 1184 (S) DP: MACKIE, TIM KELLY; NR: DONLEY 4/30/99 1184 (S) PREVIOUS ZERO FN (DCED) 5/03/99 (S) RLS AT 12:45 PM FAHRENKAMP 203 5/03/99 (S) MINUTE(RLS) 5/04/99 1222 (S) RLS TO CAL W/CS & 1 OR 5/4 SAME TITLE 5/04/99 1222 (S) PREVIOUS ZERO FN (DCED) 5/04/99 1225 (S) READ THE SECOND TIME 5/04/99 1225 (S) RLS CS ADOPTED UNAN CONSENT 5/04/99 1225 (S) ADVANCED TO THIRD READING UNAN CONSENT 5/04/99 1225 (S) READ THE THIRD TIME CSSB 71(RLS) 5/04/99 1226 (S) PASSED Y18 N1 E1 5/04/99 1226 (S) MILLER NOTICE OF RECONSIDERATION 5/05/99 1261 (S) HELD ON RECONSIDERATION TO 5/6 5/06/99 1279 (S) RECON TAKEN UP - IN THIRD READING 5/06/99 1279 (S) RETURN TO SECOND FOR AM 1 UNAN CONSENT 5/06/99 1279 (S) AM NO 1 ADOPTED UNAN CONSENT 5/06/99 1280 (S) AUTOMATICALLY IN THIRD READING 5/06/99 1280 (S) PASSED Y16 N- A4 5/06/99 1281 (S) TRANSMITTED TO (H) 5/07/99 1222 (H) READ THE FIRST TIME - REFERRAL(S) 5/07/99 1222 (H) HES, L&C 5/11/99 (H) HES AT 3:00 PM CAPITOL 106 5/11/99 (H) 5/12/99 (H) L&C AT 3:15 PM CAPITOL 17 5/12/99 (H) 5/13/99 (H) HES AT 3:00 PM CAPITOL 106 5/13/99 (H) 5/14/99 (H) HES AT 8:30 AM CAPITOL 106 WITNESS REGISTER SHARON CLARK, Legislative Assistant for Senator Mike Miller Alaska State Legislature Capitol Building, Room 119 Juneau, Alaska 99801 Telephone: (907) 465-3762 POSITION STATEMENT: Presented SB 71. DR. SARAH ISTO, Chair Alaska State Medical Board 1718 Willow Drive Juneau, Alaska 99801 Telephone: (907) 586-8992 POSITION STATEMENT: Testified in support of SB 71. CATHERINE REARDON, Director Division of Occupational Licensing Department of Commerce and Economic Development P.O. Box 110806 Juneau, Alaska 9981 Telephone: (907) 465-2534 POSITION STATEMENT: Testified in support of SB 71. ACTION NARRATIVE TAPE 99-57, SIDE A Number 0001 CO-CHAIRMAN DYSON called the House Health, Education and Social Services Standing Committee meeting to order at 8:35 a.m. Members present at the call to order were Representatives Dyson, Coghill, Green and Brice. Representative Whitaker joined the meeting at 8:42 a.m. SB 71 - PHYSICIAN LICENSURE CHANGES Number 0032 CO-CHAIRMAN DYSON announced the first order of business as Committee Substitute for Senate Bill No. 71(RLS), "An Act relating to licensure by the State Medical Board." Number 0126 SHARON CLARK, Legislative Assistant for Senator Mike Miller, Alaska State Legislature, came forward to present SB 71. Senate Bill 71 is an act relating to licensure by the State Medical Board. This bill was requested for introduction by the Senate Health, Education and Social Services (HES) Committee by the State Medical Board who fully support the bill. This bill resolves licensure problems for the board, updates Alaska statutes in relation to other states and corrects unintended problems within the current law. On behalf of the Alaska State Medical Board, they would like to convey their appreciation to House HES committee members for scheduling this bill, and they would ask their consideration and support of it. MS. CLARK noted that there is a concern with the final version of the bill, and a conceptual amendment will be offered. She indicated that Senator Miller has no problem with it. CO-CHAIRMAN DYSON asked if the State Medical Board was in agreement with the changes. MS. CLARK acknowledged this bill was written specifically on the recommendations of the medical board. Ms. Clark indicated that they have worked closely with the State Medical Board and the Division of Occupational Licensing. It was actually Dr. Martha Cotten and Dr. Sarah Isto who came to Senator Miller and asked him to sponsor this legislation. Number 0399 DR. SARAH ISTO, Chair, Alaska State Medical Board, came forward to testify in support of SB 71. This is basically a housekeeping and update bill for the medical board. The board has been working on this for a long time. They have talked with the Alaska State Medical ASsociation, the Alaska Osteopathic Association, and the Alaska Family Practice Residency and solicited comments from licensees and rural hospital administrators. She said she believes there is broad support for this. DR. ISTO noted that SB 71 helps accelerate renewals of licenses. Some licenses can be renewed only if the board meets, and the board meets quarterly which can be a very awkward situation. This bill will allow the board to consider felony convictions of unclassified and Class A felonies that were not committed during the practice of medicine. She cited an example of someone who had committed murder at home, not during the practice of medicine, and the statute did not allow them to consider that part of his application history. Fortunately his application was deficient in other areas, but that situation alerted them to a problem that could be of great concern to them. DR. ISTO explained that SB 71 requires new applicants who have recently graduated from U.S. and Canadian medical schools to have at least two years of postgraduate training. The vast majority of applicants have three years which is the standard number. There are no one-year rotating internships anymore. People who have only one year have started a three-year program and have stopped prematurely. The board feels that represents an undertraining risk to the public. Other states are going to this same plan, and some states require more than two years. The Alaska board wants to phase it in. Doctors who did a rotating internship in 1980 and have worked in the state of Washington all this time have all kinds of history behind them, and they aren't worried about their competence. It is the new graduate, who quit training early, that they want to address. Number 0575 CO-CHAIRMAN DYSON told Dr. Isto that he had a member of the profession call him a few months ago who was concerned that the board was not doing fingerprint checks to find out if there is a criminal record. He asked her if that is true. Number 0596 DR. ISTO answered that is correct. The board requires extensive documentation from residencies, the National Practitioner Data Bank, hospitals and other boards. In the course of that, theoretically, any criminal activity should come up. If the legislature were interested in that, they should consider nurses aides, nurses, people who work with people at home who may be disabled and maybe consider some kind of broad area. The board has not felt the need of doing fingerprint checks. They investigate so extensively that the chances of a medical applicant having a secret are pretty slim. The same extensive documentation would also apply to foreigners. CO-CHAIRMAN DYSON asked Dr. Isto why they don't do fingerprint checks. Number 0679 DR. ISTO answered that it is not in the statute or regulations. CO-CHAIRMAN DYSON asked her what keeps them from putting it into regulation. Number 0692 DR. ISTO answered there would probably need to be some kind of a statute that would deal with licensing of health care professionals for them to then develop a regulation. CO-CHAIRMAN DYSON asked Dr. Isto if she had seen the amendment. Number 0739 DR. ISTO said it had been described to her. She noted that SB 29 is also working its way through the process, and it contains exactly the language of this amendment, and this amendment will prevent a conflict between the two bills. They support SB 29 as well. CO-CHAIRMAN DYSON asked her if there was some overlap between the two bills. DR. ISTO answered that now both bills delete the requirement for citizenship which is what the board desires. There are qualified people who are legally in this country who could be treating patients, but they aren't citizens. Number 0826 CATHERINE REARDON, Director, Division of Occupational Licensing, Department of Commerce and Economic Development, came forward to testify. She offered their strong support to this legislation and encouraged the committee to pass SB 71 this year if possible. It will help the efficiency which helps all of their customers. REPRESENTATIVE GREEN asked Ms. Reardon if she saw any problem with Amendment 1. MS. REARDON answered it is a good idea. Number 0891 CO-CHAIRMAN COGHILL made a motion to adopt a conceptual amendment that would on page 2, delete lines 12 and 13, which reads: (5) be a citizen of the United States or be lawfully admitted for permanent residence. CO-CHAIRMAN DYSON asked whether there was any objection. There being none, Amendment 1 was adopted. Number 0927 REPRESENTATIVE BRICE made a motion to move HCS CSSB 71, as amended, out of committee with individual recommendations and zero fiscal note. There being no objection, HCS CSSB 71(HES) moved from the House Health, Education and Social Services Standing Committee. ADJOURNMENT Number 0962 There being no further business before the committee, the House Health, Education and Social Services Standing Committee meeting was adjourned at 8:49 a.m.