ARIZONA HOUSE OF REPRESENTATIVES
Forty-ninth Legislature –Second Regular Session
Minutes of Meeting
House Hearing Room 4 -- 9:00 a.m.
Chairman Barto called the meeting to order at 9:04 a.m. and roll call was taken by the secretary.
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Mr. Ableser |
Mr. Bradley |
Mr. Murphy |
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Mr. Antenori |
Mrs. Goodale |
Mr. Court, Vice-Chairman |
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Mr. Boone |
Mr. Lopes |
Mrs. Barto, Chairman |
None
Committee Action
HB2021 – DPA S/E (8-0-0-1) HB2651 – DP (5-4-0-0)
HB2492 – DP (6-3-0-0) HB2652 – DP (5-2-0-2)
HB2545 – DPA (9-0-0-0) HB2659 – HELD
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CONSIDERATION OF BILLS
HB2659 – division of developmental disabilities – HELD
Chairman Barto announced that HB2659 will be held.
HB2652 – human embryos; treatment – DO PASS
Vice-Chairman Court moved that HB2652 do pass.
Ingrid Garvey, Majority Research Analyst, explained that HB2652 prohibits a person from knowingly or intentionally creating or attempting to create an in vitro human embryo by any means other than fertilization of a human egg by a human sperm (Attachment 1).
Chairman Barto, sponsor, stated that there have been exciting advances in biotechnology in the past few years, but Americans believe that retrieving and using human tissue and genetic material must be coupled with the necessary safeguards to protect the dignity of the human person.
Nikolas Nikas, President, Bioethics Defense Fund, representing self, in support of HB2652, related that this bill is aimed at preventing asexual reproduction of human beings and creation of animal human hybrids. In response to questions, he related that he is an attorney who dedicated the last 20 years of his practice to bioethical law issues.
Vice-Chairman Court announced the names of those who signed up in support of HB2652 but did not speak:
Anthony Baillargeon, representing self
Bryan Ginter, representing self
Jennifer Patentreger, representing self
Diane Hazen, representing self
Ron Johnson, Executive Director, Arizona Catholic Conference
Beth Straley, Administrator, 40 Days for Life Campaign, representing self
James Hallgren, Assistant Prayer Coordinator, 40 Days for Life Campaign, representing self
Vice-Chairman Court announced the names of those who signed up in opposition to HB2652 but did not speak:
Seth Apfel, representing self
Question was called on the motion that HB2652 do pass. The motion carried by a roll call vote of 5-2-0-2 (Attachment 2).
HB2545 – professions; dismissed complaints; records – DO PASS AMENDED
Vice-Chairman Court moved that HB2545 do pass.
Desiree Baumer, Majority Staff Leadership Intern, explained that HB2545 requires health and non-health regulatory boards to exclude dismissed, meritless complaints from a professional’s file (Attachment 3).
Vice-Chairman Court moved that the Barto 11-line amendment to HB2545 dated 2/16/10 (Attachment 4) be adopted.
Ms. Baumer explained that the amendment to HB2545 specifies that the record of the complaint dismissed by a health or non-health profession regulatory board is not available to the public, but it is available to the regulatory board (Attachment 4). It also states that this section does not prohibit a health or non-health profession regulatory board from conducting its authorized duties in a public meeting.
Representative Matt Heinz, sponsor, said the bill states that after any professional board has reviewed and dismissed a complaint, it cannot be accessed by the public. This has been a problem for some colleagues in the hospital where he works. The amendment takes care of issues raised by the boards. In response to a question, he related that advisory letters are already available to the public and will remain so.
Vice-Chairman Court announced the names of those who signed up as neutral on HB2545 but did not speak:
Pat Pritzl, Director, Board of Chiropractic Examiners
Stuart Goodman, Lobbyist, Arizona Medical Board
Vice-Chairman Court announced the names of those who signed up in support of HB2545 but did not speak:
Wayne Anderson, veterinarian, Arizona Veterinary Medical Association
Mike Williams, representing Arizona Dental Hygienists Association
David Landrith, Vice President, Policy & Political Affairs, Arizona Medical Association
Bryan Soller, State Vice President, Arizona State Fraternal Order of Police
James Mann, Arizona Fraternal Order of Police
Don Isaacson, representing Fraternal Order of Police; Aging Services of Arizona
Norman Moore, Attorney, Aging Services of Arizona
Bryan Ginter, representing self
Amanda Weaver, Executive Director, Arizona Osteopathic Medical Association
Janet Elliott, Director, Pharmacy Affairs, Arizona Community Pharmacy Committee
Kevin Earle, Executive Director, Arizona Dental Association
Mr. Lopes surmised that the same goal can be achieved if the medical boards state that the public cannot access the files.
Representative Heinz stated that he cannot speak on behalf of the boards, but the problem at this point is that action has not been taken by every board, so there are dismissed complaints that can be retrieved by the public.
Question was called on the motion that the Barto 11-line amendment to HB2545 dated 2/16/10 (Attachment 4) be adopted. The motion carried.
Vice-Chairman Court moved that HB2545 as amended do pass. The motion carried by a roll call vote of 9-0-0-0 (Attachment 5).
HB2492 – admissibility of expert opinion testimony.. – DO PASS
Vice-Chairman Court moved that HB2492 do pass.
Ingrid Garvey, Majority Research Analyst, explained that HB2492 changes the standard used in civil trials relating to the admissibility of expert testimony from the Frye standard to the Daubert standard (Attachment 6).
Representative Andy Tobin, sponsor, stated that the business community is concerned about the high cost of frivolous malpractice lawsuits, so this bill changes the standard by which the courts admit expert testimony. About 37 other states already adopted this standard and he believes it will eventually help keep insurance premiums down and protect some business expenditures.
In response to questions, Representative Tobin said he does not have figures on the cost of frivolous lawsuits or how much this bill will decrease insurance premiums. He related that his experience as the former Chief Executive Officer of a manufacturing firm is that testimony could be given in cases from non-experts about parts they did not make or understand how the parts fit into an engine system. Premiums continued to rise for product liability to the point that it was not even carried because the cost was so high, which placed the company at great risk. The bill does not take away the ability to file a lawsuit for damages, but it does set a standard so expert testimony is provided by a person who is an expert on the specific product.
In response to Mr. Lopes’ inquiry as to why this is not being done by the Administrative Office of the Courts, Representative Tobin indicated that the courts had an opportunity, over several years, to address and accept the standard in this bill, but did not, so he will allow the courts to see the legislation and determine if a change in rule should be made.
Mr. Lopes submitted that a Rand study in 2002 indicated that one of the results of the Daubert standard is a change in balance between plaintiffs and defendants, in favor of defendants and away from plaintiffs.
Representative Tobin surmised that having the very best expert testimony would be an improvement from the plaintiff’s and defendant’s point of view.
Mr. Antenori stated that he travels a lot for business, and in other states he does not see the number of television commercials aimed at class action lawsuits that he sees in Arizona. He asked if there is a correlation between the level of expert testimony requirements in relationship to ads shopping for class action lawsuits.
Representative Tobin said he did not notice the correlation until Mr. Antenori made the point.
Suzanne Taylor, Senior Vice President of Public Policy, Arizona Chamber of Commerce & Industry; Arizona Manufacturers Council, spoke in favor of HB2492. She testified that this legislation brings Arizona in line with federal courts, as well as courts in 37 other states. Currently, companies operating in Arizona, and especially those with headquarters in Arizona, face higher costs defending lawsuits that would not have merit in other states, which makes Arizona a less competitive business location. This legislation will act as a filter against some of the ungrounded lawsuits and will, hopefully, save businesses time and money. There is a physician shortage in this state, particularly in some rural areas; this bill will be helpful because other states with better tort environments for medical malpractice are not facing physician shortages. It will also help create a fair trial for plaintiffs and defendants.
Lloyd Rabb, Attorney/President, Arizona Trial Lawyers, opposed HB2492. He discussed a handout (Attachment 7) and submitted that Daubert gives judges judicial discretion. Only six states enacted Daubert legislation; the courts in the remaining states took control and adopted Daubert standards. He contended that with the Frye standard there is predictability and an even standard and scientists set that standard. With the Daubert standard and judges using judicial discretion, a substantial amount of cases will be appealed, costing the state a lot more money. He responded to questions concerning his testimony.
Patrick Paul, Attorney, representing self, testified in support of HB2492. He opined that this legislation is not promoting something new or novel, but asks the state to align with all of the federal courts and most of the other states, whether those standards were adopted legislatively or by court order. It is important to emphasize that this is a neutral standard that will be equally applied to both sides so either sides’ experts can be challenged equally. Passage of this bill will improve judicial efficiency, limit the impact on juror resources and place the judge appropriately in the role of gatekeeper to assess whether certain types of expert testimony are appropriate. He said he believes it will result in early resolution of cases.
Vice-Chairman Court announced the names of those who signed up in support of HB2492 but did not speak:
David Landrith, Vice President of Policy & Political Affairs, Arizona Medical Association Raymond Kronenbitter, Registered Nurse, Arizona Nurses Association
Joseph Abate, Counsel, Arizona Osteopathic Medical Association; Pharmaceutical Research & Manufacturers of America
Courtney Gilstrap Levinus, Central Arizona Chamber Coalition
Kathi Beranek, Government Relations Coordinator, Blue Cross Blue Shield of Arizona
Allison Bell, Arizona Chamber of Commerce & Industry
Steve Barclay, Lobbyist, CIGNA HealthCare of Arizona; Mayo Clinic Arizona
Tom Dorn, Lobbyist, East Valley Chambers of Commerce Alliance
Pete Wertheim, Chief Legislative Liaison, IASIS Healthcare - Health Choice Arizona
Farrell Quinlan, State Director, National Federation of Independent Business - Arizona
Amanda Weaver, Executive Director, Arizona Osteopathic Medical Association
Lori Lustig, Tucson Metropolitan Chamber of Commerce
Richard Bitner, Legislative Counsel, Arizona College of Emergency Physicians
Kathleen Pagels, Executive Director, Arizona Health Care Association
Michelle Bolton, Vice President of Public Affairs, Greater Phoenix Chamber of Commerce
Eric Emmert, East Valley Chambers of Commerce Alliance
Teresa Lopez, Government Relations Representative, Salt River Project
Barbara Fanning, Legislative Liaison, Arizona Hospital and Healthcare Association
Mark Boesen, Director, Government Affairs, representing self
Helena Whitney, Director, Government Relations & Legislative Affairs, University Physician's Healthcare
Jason Bezozo, Senior Program Director, Government Relations, Banner Health
Penny Allee Taylor, Specialist/Government Affairs, Southwest Gas Corporation
Spencer Kamps, Deputy Director, Home Builders Association of Central Arizona
Vice-Chairman Court announced the names of those who signed up in opposition to HB2492 but did not speak:
Bryan Ginter, representing self
Seth Apfel, representing self
Paul Ahler, Executive Director, Arizona Prosecuting Attorneys' Council
Janice Goldstein, Arizona Trial Lawyers Association
Marcus Osborn, Manager of Government and Public Affairs, Arizona Manufacturers Council, in favor of HB2492, responded to a question concerning inclusion of Item #5 on page 1, lines 28 through 30, of the bill.
Mr. Antenori conveyed the
positive results of a report by The Perryman Group prepared in
April 2008 at the request of the Texas Legislature after enactment of some tort
reforms, including shifting the standard of evidence to the Daubert
standard.
Question was called on the motion that HB2492 do pass. The motion carried by a roll call vote of 6-3-0-0 (Attachment 8).
HB2651 – human egg providers; protection – DO PASS
Vice-Chairman Court moved that HB2651 do pass.
Gina Kash, Majority Assistant Research Analyst, explained that HB2651 sets forth requirements for human egg donations and prohibits the purchase or sale of human eggs (Attachment 9).
Dr. Jacque Chadwick, Family Physician, Scottsdale, spoke in favor of HB2651. She stated that this bill is primarily about patient safety and addresses informed consent and compensation. The purpose of informed consent is to make sure women understand the scope of issues faced by undergoing this procedure and for better data collection to know what egg donors could have problems with later in life. Advertisements, mostly on college campuses, offer varying amounts of compensation, so she believes some regulation of the industry is needed.
In response to questions, Dr. Chadwick noted that the bill does not eliminate compensation but requires compensation for expenses. She has no problem with $3,000, which is a standard set by a professional organization, but she does have a problem when the amount reaches $5,000 to $100,000. A poor college student will look at this as a way to make money, which is a concern. She advised that from what she has read, college women in their fertile years are targeted.
Dr. Chadwick responded to further questions about the potential for the bill to reduce availability of donor eggs, adoption, advertising by egg donors and infertility treatment.
Chairman Barto stated that she read testimony from a woman who sounds very intelligent and outlined her experience as an egg donor. Some of the issues she mentioned include no follow-up tracking of egg providers, payment seems to be based upon production of the number of eggs, and there is no adjustment in medical protocol; as a result she suffered medical consequences.
Dr. Chadwick stated that she personally has not seen evidence of improper medical treatment, but she is aware of that case. She added that she believes the procedure has been improved over the years and risks have lessened because of the use of medications at different levels and more monitoring. Informed consent is important because the woman would have known and better understood some of the risks.
Dr. Drew Moffitt, Reproductive Endocrinologist/Fertility Specialist, representing self, testified in opposition to HB2651. He stated that the law in the United Kingdom is similar to this bill and the wait for donors is now two years. This procedure is not without risk, but he does not believe it is necessary to codify informed consent in statute since donors already go through three levels of consent with the nurse, physician and an independent mental health specialist. In relation to compensation, he submitted that the bill infers that a college-age female is not capable of making rational choices about what risks to accept when faced with compensation of $2,500 to $3,500, which is the compensation range in Arizona.
Dr. Moffitt responded to questions concerning compensation, the cost to donor egg recipients and monitoring and follow-up of egg donors.
Tina Nelson, Registered Nurse;
President, RESOLVE, Arizona Affiliate, spoke in favor of HB2651. She stated
that she has a wonderful little girl through adoption who has
cerebral palsy, developmental delays and severe learning disabilities. She wanted
a second child and egg donation provided that chance. If individuals donate
eggs only for the money, most drop out after finding out what is involved. She
submitted that the best way not to exploit these women is to leave the process
in the hands of educated specialty physicians and adhere to guidelines already
set by the American Society for Reproductive Medicine.
Vice-Chairman Court announced the names of those who signed up in support of HB2651 but did not speak:
Raymond Kronenbitter, Registered Nurse, Arizona Nurses Association
Bryan Ginter, representing self
Jennifer Patentreger, representing self
Diane Hazen, representing self
Beth Straley, Administrator, 40 Days for Life Campaign, representing self
James Hallgren, Assistant Prayer Coordinator, 40 Days for Life Campaign, representing self Nikolas Nikas, President, Bioethics Defense Fund, representing self
Michael Anderson, artist, representing self
Vice-Chairman Court announced the names of those who signed up in opposition to HB2651 but did not speak:
Dr. Stephanie Mast, representing self
Nathaniel Zoneraich, Physician, Advanced Fertility Care, representing self
Daniel Rychlik, Physician, representing self
Diana Thomas, representing self
Rebecca Shippe, Donor Coordinator, representing self
David Landrith, Vice President of Policy & Political Affairs, Arizona Medical Association
Seth Apfel, representing self
Mark Boesen, Director, Government Affairs, The Apothecary Shops
Question was called on the motion that HB2651 do pass. The motion carried by a roll call vote of 5-4-0-0 (Attachment 10).
HB2021 – technical correction; chiropractic – DO PASS AMENDED S/E
S/E: physician assistant practice act
Vice-Chairman Court moved that HB2021 do pass.
Vice-Chairman Court moved that the Barto 21-page S/E amendment to HB2021 dated 2/15/10 (Attachment 11) be adopted.
Vice-Chairman Court moved that the Barto four-line amendment to the S/E amendment to HB2021 dated 2/16/10 (Attachment 12) be adopted.
Gina Kash, Majority Assistant
Research Analyst, explained that the S/E amendment to HB2021 updates the
Arizona Physician Assistant Practice Act by making numerous changes to existing
statute regarding the Arizona Regulatory Board of Physician Assistants,
supervising physician responsibilities and the licensing, scope of practice and
initiation of practice for
Physician Assistants (PAs) (Attachment 13). The amendment to the S/E amendment
remedies a technical error (Attachment 12).
Richard Bitner, Legislative Counsel, Arizona State Association of Physician Assistants, in favor of the S/E amendment to HB2021, offered to stand by for questions and deferred testimony to Jacqueline Spiegel.
Jacqueline Spiegel, President-Elect,
Arizona State Association of Physician Assistants, spoke in support of
HB2021. She stated that she has been a practicing PA for the past 10 years and
in Arizona for the past four years. She provided background information on PAs
and noted that recent statistics furnished by the two PA programs in Arizona show that slightly under
50 percent of Arizona trained students become licensed PAs in Arizona. In
trying to determine why PAs are vacating the state, it was discovered that many
of the outdated barriers in the statute discourage physicians, hospital
administrators and PAs from working in Arizona, so the time is long overdue to
modernize the PA Practice Act.
Question was called on the motion that the Barto four-line amendment to the S/E amendment to HB2021 dated 2/16/10 (Attachment 12) be adopted. The motion carried.
Vice-Chairman Court moved that the Barto 21-page S/E amendment to HB2021 dated 2/15/10 (Attachment 11) as amended be adopted. The motion carried.
Vice-Chairman Court moved that HB2021 as amended do pass. The motion carried by a roll call vote of 8-0-0-1 (Attachment 14).
Without objection, the meeting adjourned at 11:49 a.m.
_______________________________
Linda Taylor, Committee Secretary
March 4, 2010
(Original minutes, attachments and audio on file in the Chief Clerk’s Office; video archives available at http://www.azleg.gov)
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COMMITTEE ON HEALTH
AND HUMAN SERVICES
2
February 17, 2010
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