03/05/2007 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES

          SB  62-TASK FORCE ON HEALTH CARE INFECTIONS                                                                       
                                                                                                                              
CHAIR DAVIS announced SB 63  to be under consideration. She added                                                               
that because  of the lack of  a quorum, the committee  would only                                                               
be hearing testimony and would not be moving the bill that day.                                                                 
                                                                                                                                
DOUG LETCH, aide to Senator Gary  Stevens, sponsor of SB 62, said                                                               
that  the bill  would  set  up an  advisory  committee on  public                                                               
reporting  of health-care-associated  infections, which  would be                                                               
managed by the  Department of Health and  Social Services (DHSS).                                                               
The committee  would include a  senator and  representative, nine                                                               
members  appointed  by the  governor,  and  a state  official  in                                                               
charge of epidemiology. The nine  appointed members would include                                                               
physicians, a  representative of the Alaska  Native Tribal Health                                                               
Consortium,  a  representative  of  the  Alaska  chapter  of  the                                                               
Association   of   Professionals    in   Infection   Control,   a                                                               
representative  of the  Alaska State  Hospital  and Nursing  Home                                                               
Association   (ASHNHA),  urban   and  rural   consumers,  and   a                                                               
statistician.                                                                                                                   
                                                                                                                                
He explained  that the committee's  role will  include developing                                                               
recommendations  for   analyzing  and   distributing  information                                                               
related to  preventing hospital infection,  and will  provide its                                                               
recommendations to the  DHSS by 2009. By January of  2011 it will                                                               
provide  the  legislature with  a  report  addressing the  unique                                                               
challenges facing Alaska in regards to the issue.                                                                               
                                                                                                                                
He  added  that  many  states   do  this  sort  of  analysis  and                                                               
reporting.                                                                                                                      
                                                                                                                                
1:38:12 PM                                                                                                                    
                                                                                                                                
JAY BUTLER,  Director of  the Division of  Public Health  for the                                                               
Department  of  Health  and Social  Services  (DHSS),  said  that                                                               
infections in  health care settings  have highlighted a  need for                                                               
public health attention in hospitals.  Much intensive health care                                                               
intervention is  now done on  an out-patient basis,  and patients                                                               
are sent home who may be  sicker than those in the hospital. This                                                               
has led  to a  consumer-driven interest  in public  disclosure of                                                               
hospitals'  infection rates.  As  many as  two million  infection                                                               
cases  are  associated  with health  care  settings  yearly;  the                                                               
mortality rate  is around  90,000 each year.  A number  of states                                                               
require public disclosure of these  rates, but challenges include                                                               
accurate  identification  of  infections;  oftentimes  infections                                                               
don't  develop until  discharge from  the hospital.  In addition,                                                               
public  disclosure  could  act  as   a  disincentive  to  use  of                                                               
hospitals; the more thorough a  hospital is in its reporting, the                                                               
more the hospital appears to be negligent in its care.                                                                          
                                                                                                                                
He added that a special challenge  in Alaska is the small patient                                                               
population, which  means difficulties  in reporting  useful data.                                                               
Also  there is  no evidence  that public  reporting will  improve                                                               
health.  Studies  have  shown that  certain  criteria  should  be                                                               
followed in reporting, including  using established public health                                                               
surveillance  methods, a  multidisciplinary  advisory panel,  and                                                               
appropriate  process and  outcome measures;  he gave  examples of                                                               
processes  and   outcomes  that   should  be  studied.   A  final                                                               
recommendation  would  be  that  the agency  measuring  the  data                                                               
provide  regular   and  confidential  feedback  to   health  care                                                               
providers.                                                                                                                      
                                                                                                                                
1:47:08 PM                                                                                                                    
                                                                                                                                
CHAIR  DAVIS thanked  Mr. Butler  for his  presentation and  said                                                               
that she look forward to forming the task force.                                                                                
                                                                                                                                
SENATOR  COWDERY   related  a   personal  story   about  hospital                                                               
infections.                                                                                                                     
                                                                                                                                
1:49:30 PM                                                                                                                    
                                                                                                                                
SANDRA STARK, representing  herself, said she is  a public member                                                               
of the initial  working group. She said that lives  will be saved                                                               
by  this   legislation,  perhaps  an  indeterminate   number  but                                                               
doubtless  many. Practices  are varied  for preventing  infection                                                               
and  they  do  make  a   great  difference.  Monitoring  hospital                                                               
infection  prevention  through a  pilot  program  will mean  less                                                               
costs and hospitalizations,  the rates of which are  very high in                                                               
Alaska.                                                                                                                         
                                                                                                                                
1:52:12 PM                                                                                                                    
                                                                                                                                
ROSEMARY CRAIG,  representing herself,  said she had  worked with                                                               
Ms.  Stark  on  the  Lower   Kenai  Peninsula  and  it  would  be                                                               
advantageous for the entire state  to have some kind of tracking,                                                               
but that she was concerned  with how larger and smaller hospitals                                                               
would be  compared; she requested that  the committee investigate                                                               
this further.                                                                                                                   
                                                                                                                                
1:53:06 PM                                                                                                                    
                                                                                                                                
JENNIFER  GROGG,  representing  the  Alaska  State  Hospital  and                                                               
Nursing  Home  Association (ASHNHA),  said  that  it supports  an                                                               
advisory  committee  on  hospital infections.  Such  a  committee                                                               
would  be able  to  review  the success  of  states with  similar                                                               
legislation and  advise Alaska. Creating equitable  guidelines is                                                               
difficult,  and  Alaska's  should  be  tailored  to  the  state's                                                               
specific needs;  outpatient facilities should be  included in the                                                               
reporting process.                                                                                                              
                                                                                                                                
1:56:13 PM                                                                                                                    
                                                                                                                                
KIM MYMES-SPINK,  with Professionals  in Epidemiology,  said that                                                               
the group supports the bill and  would be happy to participate on                                                               
the task force.                                                                                                                 
                                                                                                                                
CHAIR  DAVIS closed  public  testimony  for SB  62  and said  the                                                               
committee would hear the bill again at a later date.