Legislature(2017 - 2018)CAPITOL 106
04/06/2017 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB10 | |
| SCR2 | |
| HB54 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 10 | TELECONFERENCED | |
| += | HB 25 | TELECONFERENCED | |
| += | HB 54 | TELECONFERENCED | |
| += | SCR 2 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 54-TERMINALLY ILL: ENDING LIFE OPTION
4:08:20 PM
CHAIR SPOHNHOLZ announced that the final order of business would
be SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 54, "An Act providing
an end-of-life option for terminally ill individuals; and
providing for an effective date."
4:08:57 PM
REPRESENTATIVE HARRIET DRUMMOND, Alaska State Legislature,
stated that proposed HB 54 was "about patient's rights and end
of life care. It allows patients to have important end of life
discussions with their own doctors, doctors they already know
and trust. It allows a patient to ease their pain and suffering
and live and die on their own terms according to their own
beliefs."
4:09:35 PM
REPRESENTATIVE EASTMAN asked how the proposed bill would ensure
that patients will not use coverage for life saving treatments
in exchange for the less expensive option. He asked how to
guarantee this would not occur.
4:10:21 PM
REPRESENTATIVE DRUMMOND asked where this had happened, and she
directed attention to the section of the proposed bill which
guarded against coercion. She said that these patients had been
dealing with their illness for a long time, and were surrounded
by people who cared about them and were not going to coerce
them.
4:10:59 PM
KRISTIN KRANENDONK, Staff, Representative Harriet Drummond,
Alaska State Legislature, said that there were provisions in the
bill prohibiting a person from conditioning the sale of any type
of insurance. She asked for further clarification that this was
reflecting coercion by insurance companies to push patients into
an end of life act. She noted that Section 13.55.240 (page 12,
line 25) of the proposed bill had language that an insurance,
life, or health policy could not be conditioned.
4:12:00 PM
REPRESENTATIVE EASTMAN suggested that California and Oregon were
"going down that road." He said there was a human tendency to
prefer a less expensive option to something that could be life-
saving but more expensive. He asked about the changes from the
original version of the proposed bill, specifically about
documentation and paperwork. He asked about the current
requirements for written documentation for verification.
4:12:45 PM
MS. KRANENDONK explained that Alaska currently has palliative
care and hospice care providers who work with terminally ill
individuals. She said there were several options for terminal
patients. The section removed from the original bill was a
written form required to be on file. She relayed that, as
Oregon had found this to redundant, it was removed from the
proposed bill. She noted that Alaska had advance health care
directives, also known as living wills. She opined that an
advance directive was more appropriate for healthy patients, and
that the state already provided a complete packet which was
available on the Division of Public Health website. She
reported that an individual had the right to give instructions
about their own health care to the extent as allowed by law.
She relayed that Alaska also had Medical Officers for Life
Sustaining Treatment, which offered the Comfort One program,
also under the Division of Public Health. She clarified that it
was a set of medical orders for the very seriously or terminally
ill, but was not an advance directive and not a substitute for
naming a health care agent. She added that Comfort One patients
could wear an identifying bracelet, which included information
regarding the diagnosis, treatment, end of life options,
hospice, and palliative care. She added that state regulations
also included a Do Not Resuscitate protocol, a standardized
procedure. She stated that all patients who qualified for this
proposed legislation would also qualify for the Comfort One
program. She noted that a bill had been passed in 1998 that
removed the duty of a peace officer to respond to an expected
home death.
REPRESENTATIVE EASTMAN asked about written documentation
available to verify that this was supposed to occur, and was not
foul play.
4:17:24 PM
REPRESENTATIVE DRUMMOND explained that a terminal patient had to
personally request the medication on two separate occasions,
more than 15 days apart, from their primary care provider. The
patient had to be determined to be terminally ill, and "would
most likely be dead within six months." She added that there
was appropriate paperwork to be filed at that time, and that the
patient needed to be declared capable of making this decision,
and being coerced. If the physician determined that the patient
was in a psychological state which could lead to a wrong
decision, the patient can be referred to counseling. She
reiterated that there were a number of these safeguards. She
declared, if there was any actual wrongdoing, that would be
tantamount to murder. She reminded that the medication was
supposed to be self-administered by the patient.
MS. KRANENDONK pointed out that AS 12.65.007 also required that
hospice have this form on file, and she added that more than 95
percent of the patients were in hospice. She declared that any
suspicion of foul play would result in a call to a police
officer. The proposed bill only stated that the information was
not available to the public, but a police officer was allowed to
review the medical records with the required documentation if
there was suspicion of foul play.
4:20:09 PM
REPRESENTATIVE EASTMAN asked what the minimum standard of
appropriate paperwork would be and how it could be verified.
MS. KRANENDONK replied that all the patients that qualified for
this option were treated by a physician who had their patient
files. She noted that the files for terminally ill patients
included extensive documentation of everything since diagnosis.
She offered her belief that this was not usually the first
option. She explained that the written form had been removed
from the proposed bill because the physician still had to
document that the patient had orally requested it.
4:21:59 PM
CHAIR SPOHNHOLZ asked if other states required a written
documentation, and why the sponsor had opted to not include
this.
MS. KRANENDONK explained that Oregon had initially included this
requirement because of concerns for coercion or wrongful death,
but in the 24 years since its passage, there had not been any
cases needing the forms. She reported that, as more states were
doing this by ballot initiative, this requirement had been
removed as it was determined to be a redundant step. She stated
that Washington DC was the only place which required a coroner
notification, as most states had a program similar to the
aforementioned Medical Officers for Life Sustaining Treatment.
CHAIR SPOHNHOLZ, reflecting that 95 percent of these patients
were under the care of hospice, asked how many communities had
hospice available.
MS. KRANENDONK clarified that this was the percentage reported
from Oregon. She stated that the Juneau hospice facilitated
care for other SE Alaska communities.
REPRESENTATIVE DRUMMOND added that they had not researched the
availability of hospice care throughout Alaska. She noted that
a criticism of the proposed bill was that palliative care was
available. She declared that, if the proposed bill improved the
availability and effectiveness of palliative care, then there
would be progress. She explained that one reason for the
proposed bill was that currently people had to move to Oregon to
be able to take control of their life. She stated that there
were options that may need to be worked into the proposed bill
to allow patients to fully take advantage of the legislation,
should they feel that need.
CHAIR SPOHNHOLZ asked about those options.
REPRESENTATIVE DRUMMOND noted that, as many communities in
Alaska were inaccessible by road and that thousands of patients
were not able to travel to see doctors, an option for tele-
health had been discussed to be used in lieu of a personal
appearance.
4:27:37 PM
REPRESENTATIVE KITO spoke of the challenge for getting medical
care and the potential cost in Alaska due to the geographic
disparity. He asked if the proposed legislation would be
insurance eligible, and, if not, would this create a
circumstance where only having enough money would allow
participation in the program.
MS. KRANENDONK said that the current proposed bill would allow
this as an insurance option, although it was not required as an
option. She expressed concern that the program would only be
available to people who could afford to travel for medical care,
although this was currently true for a lot of health care. She
declared the desire to make more health care available to
everyone in the state.
4:29:19 PM
REPRESENTATIVE KITO referenced the first 10 years of this
program in Oregon, reporting that there were 541 requests for
the medication, with 341 uses. He suggested that in a
comparison with the Alaska population over 10 years, one might
expect about 100 requests and 60 uses. He pointed out that, as
people could have been moving to Oregon from other places to
take advantage of this program, Alaska could expect even less
request. He asked about the projected level of usage in Alaska.
REPRESENTATIVE DRUMMOND expressed her agreement with the
figures, sharing her research from Oregon, which included about
750 requests for the medication, with about 340 usages over 20
years. She stated that she had also extrapolated for small
numbers in Alaska. She pointed out there was enormous cost to
travel to Oregon for this program, especially in the late stages
of a terminal disease. She declared that she wanted to make end
of life options easier for Alaskans, not harder.
MS. KRANENDONK said that the fiscal note reflected similar
statistics, as it anticipated 10 - 19 cases annually for
patients requesting the medication. She pointed out that it was
necessary to establish residency in Oregon to take advantage of
the program.
4:32:30 PM
REPRESENTATIVE EASTMAN asked about the requirement for insurance
to provide the service. He asked if this would be optional or
included in every insurance plan.
MS. KRANENDONK replied that polls reflected that about 70
percent of Alaskans would like this as an option. She observed
that she would personally be more comfortable with this option
in her insurance.
REPRESENTATIVE EASTMAN asked if an insurance provider may or may
not offer, and whether the proposed bill distinguished between
these options.
4:35:00 PM
MS. KRANENDONK offered to forward more insurance information.
4:35:39 PM
REPRESENTATIVE SULLIVAN-LEONARD stated that she did not support
the premise of the bill. She expressed her concern for
vulnerable individuals, for those not close to health
facilities, and for the lack of a requirement to have written
approval for a procedure. She directed attention to the fiscal
note from Legislative Legal Services [Included in members'
packets] which read:
The legislation creates a defense to murder in the
first degree, murder in the second degree, and
manslaughter if the person is performing an act
permitted by the legislation. It also establishes a
new crime of abuse of life termination process if a
person intends to cause another person's death and
falsely makes, completes, or alters a request for
medication or destroys a rescission of a request for
medication. A person may also be guilty of this crime
if they exert undue influence on another person to
request medication for the purpose of ending that
person's life. Abuse of life termination process is a
class A felony.
REPRESENTATIVE DRUMMOND replied that these were safeguards to
prevent abuse of the process. She declared that the desire for
the proposed bill was for the patient to be fully cognizant of
the choice, of the options, and to be able to rescind their
request at any point during the process. She offered her belief
that this was well covered in the proposed bill, which was based
on the experience from other states. She reiterated that the
proposed bill had been simplified because the required form had
been "just collecting dust in a file." She stated that the
medical community would figure out what worked for each
individual practice. She expressed her certainty that it would
be resolved in a way to make the most sense for both patient and
doctor records.
MS. KRANENDONK said that all the cases and the medication would
be accounted for and tracked.
REPRESENTATIVE SULLIVAN-LEONARD said that an oral argument would
not come into play in a legal proceeding.
4:39:53 PM
MS. KRANENDONK replied that the establishment of qualification
was documented in the bill.
4:40:23 PM
REPRESENTATIVE KITO referred to a study for the Oregon Death
with Dignity Act between 2004 and 2006, which indicated that,
although required by law that individuals requesting the
medication receive counseling, 16 percent of those individuals
suffered from clinical depression and were not referred to
counseling. He asked if there were protections in the proposed
law that would ensure accountability for not making a referral
to counseling.
MS. KRANENDONK replied that, although physicians were required
to refer individuals for psychiatric care if depression was
diagnosed, there was no punishment written into the bill.
REPRESENTATIVE KITO expressed his concern for a 16 percent error
rate, which could allow individuals, with treatment, to continue
through their natural end of life.
4:42:15 PM
REPRESENTATIVE EASTMAN, in reference to a move to Oregon to
participate in the program, asked what was to stop someone from
doctor shopping in order to qualify for the program. He noted
that the letter of the law allowed broad qualification of an
individual, and asked how to ensure that this would not happen.
4:44:07 PM
REPRESENTATIVE DRUMMOND pointed out that the proposed bill
required that two doctors, not in the same practice, agree that
an individual was terminal within the prescribed amount of time.
MS. KRANENDONK added that diabetes would not qualify in the
early stages.
4:45:38 PM
CHAIR SPOHNHOLZ pointed to the definition of terminal disease on
page 11, line 17, in the proposed bill, and read:
means an incurable and irreversible disease that has
been medically confirmed and that will, within
reasonable medical judgement, produce death within six
months;
CHAIR SPOHNHOLZ said that HB 54 would be held over.
4:46:50 PM
KRISTEN HANSON, Chair, Patients' Rights Action Group, read from
a prepared statement by her husband, James Hansen. He wrote
that he was a marine war veteran, a husband, and a father. He
did not want to die, and, as he was currently unable to travel,
he could not make his statement in person. He shared that he
was suffering from aggressive brain cancer. He shared his
background prior to his cancer. He noted that he had the same
brain cancer as the young woman who had moved to Oregon from
California in order to be able to take her own life. He
reported that three different doctors had told him there was
nothing he could do about his cancer, as surgery, radiation, and
chemo therapy rarely worked. He, instead, chose to do standard
and experimental treatment. He expressed his thanks that he had
not accepted his initial prognosis, even as the past three years
had not been easy, with a lot of physical and emotional pain,
countless seizures, and days with the loss of his most basic
abilities, unable to talk, walk, read, or write. He shared that
he had currently lived two years and eight months longer than
his original prognosis. If this legislation had been available
at that time, he could have chosen the medication, and he did
consider it. He declared that there was no going back on a
decision to end life. He stated that he had fought assisted
suicide legislation for the last 18 months. He opined that
legalized suicide, touted as death with dignity, had the
opposite effect. He said that many patients with circumstances
similar to his were offered lethal drugs and were denied or
delayed coverage for the necessary care. He acknowledged that
he had experienced depression and had felt that he was a burden
to his family. He said it was a very real danger when people
could choose death over care, and that suicide became a social
norm for people who were terminally ill. He said there had been
an increase of general suicide rates, along with medically
assisted rates, in states which had legalized suicide. He added
that, as he had also suffered post traumatic stress disorder,
legalization of doctor prescribed suicide sent the wrong message
to struggling veterans. He declared that mistakes would be made
and lives would be tragically lost if assisted suicide were
legalized. He asked if one person's perception of choice,
influenced by hopelessness and fear of being a burden, put the
lives of those who want to survive at risk.
4:53:52 PM
WILLIAM HARRINGTON stated that medication was not defined as
something to kill, but something to heal. He stated that a
different word was necessary in the proposed bill, although he
did support the legislation. He pointed out that it was a
sacrilege to kill yourself. He suggested that this should be
defined as self-termination, and not as suicide.
4:55:45 PM
KARMELLE DEILLE stated that she was against the proposed bill,
and opined that the law should always be on the side of life.
She expressed her agreement with earlier testimony, and that
termination of the hindrances would open the floodgates, and
would keep people from respecting boundaries. She shared a
personal experience with a friend. She suggested that it was
necessary to look at history instead of emotion when deciding
whether to change laws. She declared that it was not possible
to legalize suicide if we "felt accountable to the creator of
life."
5:00:07 PM
PAMELA SAMASH, President, Right to Life, stated that the
proposed bill was "a dangerous bill." She acknowledged that
this was a sensitive subject. She declared that the proposed
bill was wrong because "we don't know why some circumstances
prolong death but sometimes people miraculously recover." She
suggested to review the history of euthanasia in other countries
and communities, which began as a personal choice but then slid
into death as an answer. She asked what message the suicide
laws would send. She stated her opposition to the proposed
bill.
5:02:24 PM
JEANNE ANDERSON, MD, Katmai College, paraphrased from a prepared
statement [Included in members' packets], which read in part:
My name is Jeanne E Anderson, MD. I am medical
oncologist in private practice in Anchorage at Katmai
Oncology Group, LLC. Specialists in Medical Oncology
diagnosis patients with cancer; counsel them regarding
prognosis and treatment options; prescribe medical
(i.e., drug) treatment; and provide supportive,
palliative and end of life care. I received my medical
degree from Stanford University in 1988. I completed
internal medicine specialty training in 1991, and
medical oncology fellowship training in 1994, both at
the University of Washington.
I am strongly against HB54 for many reasons, including
1) the uncertainty in determining an individual
patient's prognosis, 2) improvements in palliative
care, and 3) hastening death is not the role of the
physician or the medical system.
A critical feature of SSHB54 is that the patient has a
"terminal" disease. There is no definitive way to
determine that a patient has less than 6 months to
live. Estimates of survival are based on published
data and a physician's clinical judgment. Survival
data come from studies performed years earlier, often
using treatment that is not the most up to date, and
is based on narrowly defined patient populations.
Even well informed and well-meaning oncologists make
drastic mistakes in their estimates of prognosis.
DR. ANDERSON expressed her agreement with the earlier testimony
in opposition of the proposed bill. She acknowledged that
professionals often made drastic mistakes in prognosis, and she
shared three relative stories.
5:06:03 PM
MARILYN GOLDEN, Senior Policy Analyst, Disability Rights
Education and Defense Fund, stated her opposition to the
proposed bill. She said that, with legalized assisted suicide,
some people's lives would be ended without their consent through
mistakes and abuse, as no safeguards could prevent this outcome.
She offered her belief that the health care system was broken
and would, instead, offer legalized suicide as "the cheapest
treatment" when insurers denied or delayed approval of
expensive, life sustaining treatment. She stated that "assisted
suicide was a recipe for elder abuse." She said that mis-
diagnosis and incorrect prognosis could analyze prematurely.
She reported that negligent personnel were not liable for their
negligent actions. She said that abuse was not investigated,
and she suggested that the Oregon data failed to show abuse
because the system was set up not to find it. She declared that
suicide contagion was also an issue, with an increase in Oregon
after the passage of its assisted suicide legislation.
5:10:27 PM
FRANK MCGILVARY said that both he and his wife were opposed to
the proposed legislation, as life was really precious.
5:11:49 PM
CHAIR SPOHNHOLZ closed public testimony.
[HB 54 was held over.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB10 Ver D 1.30.17.PDF |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Sponsor Statement 1.30.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB10 Supporting Document - ICWA glossary and flowchart - NICWA 1.30.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB10 Supporting Document -CINA Flowchart - OCS Manual 1.30.17.PDF |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Sectional Analysis.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB025 Summary of Changes ver J 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Proposed Blank CS ver J 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-HB025 Support Emails 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Alaska Pharmacists Association 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter ANDVSA 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter APRN Alliance 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Tanana Chiefs Conference 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| SSHB 54 Supporting Document--Aderhold Letter of Support 4.5.2017.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Opposing Document--Dore Secondary Memo in opposition 4.5.2017.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Opposing Document--Anderson letter of opposition 4.5.2017.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Opposing Document--Dore First Memo in opposition 4.5.2017.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SCR 2 Version A.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR 2 Sponsor Statement A.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR 2 Support Materials Alaska Dispatch News 11.20.2016.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| Supplemental Crime in Alaska Report.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR 2 Support Materials Key Results from the 2015 Alaska Victimization Survey.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR 2 Support Materials CDVSA Annual Report 2015.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR 2 Support Materials ANDVSA 2016 Annual Report.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR2-LEG-SESS-02-27-17 FN.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR 2 Support Materials CDC National Intimate Partner and Sexual Violence Survey.pdf |
HHSS 4/6/2017 3:00:00 PM SHSS 2/27/2017 1:30:00 PM |
SCR 2 |
| SCR 2 Fiscal Note LAA 3.9.17.pdf |
HHSS 4/6/2017 3:00:00 PM HSTA 3/21/2017 5:30:00 PM |
SCR 2 |
| HB025 Sectional Analysis ver A 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Opposing Document-Letter NFIB 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Sponsor Statement 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-ADN Commentary 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Cost Savings Study 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Guttmacher Alaska Statistics 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Guttmacher Public Costs from Unintended Pregnancies 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-HB025 Support Emails 2.27.17.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Kachemak Bay Family Planning Clinic 2.23.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Unintended Pregnancies Study 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 ver A 2.16.17.PDF |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Planned Parenthood Votes Northwest & Hawaii 2.16.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Fiscal Note DHSS-Medicaid Services 2.28.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Fiscal Note DHSS-DHCS 2.28.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Fiscal Note DCCED-DIO 2.28.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Opposing Document-America's Health Insurance Plans 2.27.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Dr. Tina Tomsen 2.27.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Support Emails 2.27.17.pdf |
HHSS 2/28/2017 3:00:00 PM HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-HB025 Support Emails 3.7.17.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Anne Green 3.3.17.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letter Alaska Nurses Association 3.6.17.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 25 |
| HB025 Supporting Document-Letters of Support 3.8.2017.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 25 |
| HB025 Opposing Document-Letters of Opposition 3.8.2017.pdf |
HHSS 3/9/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM HHSS 4/11/2017 3:00:00 PM |
HB 25 |
| SSHB 54 Opposing Document--Letters 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Sectional Analysis ver O 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Sponsor Statement 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Supporting Document--Archbishop Tutu Opinion 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Supporting Document--Letters 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54.PDF |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| HB 10 Fiscal Note--DHSS-CSM 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Fiscal Note--DHSS-FCAR 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Fiscal Note--DHSS-CST 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Fiscal Note--DHSS-FCBR 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Fiscal Note--DHSS-FCSN 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Fiscal Note--DHSS-FLSW 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Fiscal Note--DHSS-FP 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| HB 10 Fiscal Note--JUD-ACS 4.5.17.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 10 |
| SSHB 54 Fiscal Note--DOL-CJL 4.5.2017.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB54 Supporing Document - Additional Letters.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB54 Supporting Document - Saturday Evening Post.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB54 Supporting Document - Skelton Op Ed.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB54 Supporting Document Research 2007.pdf |
HHSS 4/6/2017 3:00:00 PM |
HB 54 |