NORTH DAKOTA LEGISLATIVE COUNCIL
Minutes of the COMMERCE COMMITTEE

Thursday, September 26, 2002
Roughrider Room, State Capitol
Bismarck, North Dakota

Senator John M. Andrist, Chairman, called the meeting to order at 9:00 a.m.

Chairman Andrist called on committee counsel to present a bill draft [30183.0100] regarding regulation of podiatrists by the State Board of Medical Examiners. Committee counsel said under the bill draft, the law creates the Board of Podiatric Medicine and regulating podiatrists would be repealed and licensure of podiatrists would be performed by the State Board of Medical Examiners. She said the State Board of Medical Examiners would adopt rules relating to licensure of podiatrists. Membership of the State Board of Medical Examiners, she said, would change to include a podiatrist member who would have limited participation. Under the bill draft, she said, any outstanding receivables, obligations, and funds of the Board of Podiatric Medicine would be transferred to the State Board of Medical Examiners and the license fees paid by podiatrists would be used to retire any of the Board of Podiatric Medicine's outstanding balance of any obligations transferred to the State Board of Medical Examiners.

In response to a question from Senator Andrist, committee counsel said existing laws and rules relating to the licensure of podiatrists would cease being effective as of the effective date of the bill.

In response to a question from Representative Winrich, committee counsel said it would be possible to add some type of transition language relating to licensure of podiatrists to ensure there is no gap in licensure requirements.

Chairman Andrist called on Dr. Cherian Mathew, President, Board of Podiatric Medicine, for comments regarding the committee bill draft regarding licensure of podiatrists. Dr. Mathew said the Board of Podiatric Medicine recognizes there have been problems in the past and is actively addressing these problems. He said there has been a significant change in board membership and abolishing the Board of Podiatric Medicine is premature.

Dr. Mathew said the financial problems of the Board of Podiatric Medicine are being resolved and the disciplined podiatrist is responsible for repayment to the board.

In response to a question from Senator Andrist, Dr.Mathew said under the committee bill draft there would be inadequate board representation by podiatrists. Additionally, he said, he anticipates there would be scope of practice issues for podiatrists as well as transition problems resulting from abolishment of the Board of Podiatric Medicine.

In response to a question from Senator Wardner, Dr. Mathew said problems relating to the past disciplinary actions taken by the board have been addressed by the current board.

In response to a question from Representative Froseth, Dr. Mathew said although it is possible the financial liability of podiatrists may decrease under the State Board of Medical Examiners, the drawback would be lack of representation on the State Board of Medical Examiners. He said the current podiatrist licensure fee is $500. He said he is hopeful this fee will decrease once the board meets its current financial obligations.

In response to a question from Representative Galvin, Dr. Mathew said one reason for maintaining separate boards for physicians and podiatrists is that a podiatrist undergoes training different from a physician.

Chairman Andrist called on Ms. Kelly Schmidt, layperson, Board of Podiatric Medicine, for comments regarding the committee bill draft. Ms. Schmidt said she believes the Board of Podiatric Medicine is moving in the right direction and asks that the committee allow the board to get back on its feet. She said she distinguishes physicians from podiatrists and this justifies keeping separate boards.

In response to a question from Representative Berg, Ms. Schmidt said she agrees the board took appropriate action in disciplining its member and the board has been responsible in paying debts it incurred. She said although 2001 legislation gave the Board of Podiatric Medicine the authority to borrow money to meet its debts, the board has not borrowed money. However, she said, she is not aware of an easy answer to the question of how to spread risk for disciplinary actions for the small boards.

In response to a question from Senator Wardner regarding the feasibility of the risk management fund charging a surcharge that would be kept as a separate fund to help small boards, Ms. Zschomler said with appropriate legislative changes she does not know of a reason her office would be prevented from taking this action.

Chairman Andrist said although it appears the committee is not interested in taking action at this time, Senator Wardner may wish to pursue this on his own.

Senator Wardner said he would pursue the idea of creating a separate fund in the risk management fund.

Chairman Andrist called on Mr. Gary Thune, legal counsel, Board of Podiatric Medicine, for comments regarding the committee's study of occupational and professional licensing boards of less than 100 licensees. Mr. Thune said if the Board of Podiatric Medicine is faced with a large debt in the future, a fund such as that discussed by Senator Wardner would be helpful as well as the 2001 Legislative Assembly enacted legislation that allows the board to suspend the license of a podiatrist until the podiatrist pays the board for disciplinary action costs and that allows the board to borrow money from the Bank of North Dakota.

Mr. Thune said the committee would be sending the wrong message to occupational and professional licensing boards if it abolished the Board of Podiatric Medicine. In effect, he said, the committee would be retaliating against the board for doing its job.

Senator Andrist said the committee is not retaliating against the Board of Podiatric Medicine for doing its job, but it is instead looking at the feasibility and desirability of consolidating small occupational and professional boards.

Chairman Andrist called on Dr. Brian Gale, podiatrist, Bismarck, for comments regarding the study of occupational and professional licensing boards that license fewer than 100 licensees. Dr. Gale said he is in support of the current Board of Podiatric Medicine. On the current board, he said, only one board member remains from the board that took disciplinary action against him.

Dr. Gale said small boards are inherently vulnerable to large disciplinary debts and to the problems associated with lack of turnover of board members. He said he supports combining administrative functions of occupational and professional boards in an attempt to lessen possible turf protection by occupational and professional boards.

Chairman Andrist called on Mr. John Olson, State Board of Medical Examiners, for comments regarding the committee's bill draft on licensure of podiatrists. Mr. Olson said he opposes the bill draft. He said there are curriculum, licensure, and disciplinary issues that would arise with consolidation of the Board of Podiatric Medicine and the State Board of Medical Examiners.

Mr. Olson said increasing the size of the State Board of Medical Examiners is expensive and he foresees problems with limiting the activities of the podiatry member to podiatry matters addressed by the State Board of Medical Examiners.

In response to a question from Representative Dosch, Dr.Mathew said the Board of Podiatric Medicine pays the risk management fund $750 per year. He said because the Board of Podiatric Medicine does not have any employees, the budget of the board is essentially the cost of running the board.

In response to a question from Representative Dosch, Ms.Zschomler said small boards have full coverage under the risk management fund regardless of the amount of contribution. She said it was an administrative decision to exempt the smallest boards from paying into the fund.

Representative Dosch said if small boards do not have the necessary funds to pay into the risk management fund, perhaps the small boards should not exist.

Ms. Zschomler said the risk management fund pays for defenses of money damage claims and because small boards have less exposure to liability, they pay less to the fund.

Ms. Schmidt said that although the Board of Podiatric Medicine has paid into the risk management fund, the risk management fund has not provided the board with any defense during the board's litigation.