Legislature(1997 - 1998)

04/16/1997 08:04 AM CRA

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
 HCR 6 - ALCOHOL-RELATED BIRTH DEFECTS AWARENESS                               
 Number 035                                                                    
 CHAIRMAN IVAN indicated that the committee would consider HCR 6,              
 "Relating to Alcohol-Related Birth Defects Awareness Week."                   
 Number 065                                                                    
 KATTARYNA BENNETT, Researcher for Representative Irene Nicholia,              
 came forward to testify on HCR 6.  This resolution requests that              
 the governor proclaim both the weeks of Mother's Day and Father's             
 Day as Alcohol Related Birth Defects Awareness Week.  Alaska ranks            
 number one for babies born each year with alcohol related birth               
 defects.  Leaders of the state should be deeply troubled with this            
 tragic problem, which has reached a crisis level in Alaska, as well           
 as across the nation.  Alcohol can interfere with normal                      
 development of the fetus.  Aside from obvious physical deformities            
 such as facial abnormalities and small body size, alcohol can also            
 damage a baby's brain causing mental and psychological problems               
 that last a life time.  The affects of alcohol on the baby's                  
 nervous system may include brain damage, mental retardation, poor             
 coordination and severe learning disabilities.                                
 MS. BENNETT stated that fetal alcohol syndrome is the number one              
 cause of mental retardation in the Western world and is one of the            
 three leading causes of birth defects.  A child who is born with              
 alcohol related birth defects will have this disability throughout            
 their entire life.  These disabilities are 100 percent preventable.           
 Sadly, in Alaska, up to 10 percent of all pregnant women still                
 consume alcohol through the third trimester of their pregnancy.               
 MS. BENNETT noted that Alaska has come a long way in the last few             
 years to bring about public awareness of alcohol related birth                
 defects but still many women don't understand that there's no safe            
 amount of alcohol consumption at any time during their pregnancy.             
 When a woman who is pregnant drinks alcohol it goes directly from             
 the stomach into the blood stream.  The alcohol crosses the blood             
 stream through the placenta and enters directly into the baby's               
 blood stream.  This problem does not just pertain to the frequent             
 or heavy drinker.  A woman who drinks occasionally can also produce           
 a baby with alcohol related birth defects.                                    
 MS. BENNETT continued that education and public awareness about               
 Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE) and other           
 alcohol related birth defects is critical because these syndromes             
 are 100 percent preventable.  A woman who abstains from drinking              
 alcohol during her pregnancy has no risk of having an FAS or FAE              
 baby.  Every year that Alaska fails to prevent Fetal Alcohol                  
 Syndrome in the state they produce approximately 30 more babies who           
 will grow up disabled for life.  In 1988, it was estimated that the           
 life time cost per Alaska FAS births was $1.4 million per baby not            
 including the cost of welfare, the justice system or other                    
 miscellaneous social costs.  Education and awareness are key to               
 preventing FAS and FAE.  She urged the committee's support.                   
 Number 345                                                                    
 CHAIRMAN IVAN asked about the figures which the department may have           
 gathered in relation to this problem.                                         
 Number 390                                                                    
 LOREN JONES, Director, Division of Alcoholism and Drug Abuse,                 
 Department of Health and Social Services, came forward to testify             
 on HCR 6.  Several years ago the Center for Disease Control, the              
 Indian Health Service and Department of Health and Social Services            
 conducted a joint surveillance project to try and identify, as best           
 as possible, what the prevalence rate for Alaska was.  The                    
 published reports reflect a rate of 2.5 FAS births per 1,000 live             
 births over a 10 year period.  Due to constraints on data, what was           
 marked in medical records and a few other variables, this rate was            
 reflected in the Native Alaskan community only.  The project could            
 not establish scientifically a rate for non-Natives due to the lack           
 of date kept in private pediatric offices and hospitals.                      
 CHAIRMAN IVAN assumed that for this type of awareness program they            
 work with the Native Corporations and their respective clinics.               
 Number 499                                                                    
 MR. JONES responded that the activities their division tries to               
 engage is two fold.  One, through the Alaska Council and other                
 prevention grantees, they try to get quality public information               
 disseminated through radio, television and print ads.  Secondly, in           
 connection with RuRal Cap and their Head Start program, they work             
 with all of the Head Start programs throughout rural and urban                
 Alaska.  RuRal Cap has taken on the role of providing the public              
 information to the Regional Health Corporations and their Fetal               
 Alcohol Syndrome coordinators.  In light of "compacting" within the           
 Native Indian Health Service, the staff at this organization                  
 responsible for FAS tasks are no longer at the Native Indian Health           
 Service.  This function has been designated back to the twelve                
 corporations.  RuRal Cap has taken on this role and the division              
 works with them to coordinate this effort.  He outlined what some             
 of these efforts were.                                                        
 REPRESENTATIVE DYSON understood there were no good protocols for              
 diagnosing Alcohol Related Neurological Defects (ARND) or what used           
 to be called FAE.                                                             
 Number 627                                                                    
 MR. JONES responded that they've been struggling with this problem            
 as the research gets better.  The diagnostic schemes they had                 
 before just weren't as good.  Just recently, the Institute of                 
 Medicine, published a book which addresses the difficulty of                  
 diagnosing what they used to call Fetal Alcohol Effects.  This                
 field has been divided into two areas.  One is alcohol related                
 neuro-developmental disabilities which is a behavioral diagnosis.             
 Secondly, there are birth defects when a child may have one or more           
 of the symptoms of FAS but not the whole configuration.  If there             
 are physical abnormalities this is called something else.  He noted           
 on-going efforts to help with better means of diagnosis.                      
 REPRESENTATIVE REGGIE JOULE asked if it took a doctor with a                  
 special background to diagnose these syndromes.  He also noted a              
 hesitancy to diagnose such problems in order to avoid "labeling."             
 Number 750                                                                    
 MR. JONES responded that significant training is needed to diagnose           
 these conditions.  In the Public Heath and Indian Health Service              
 clinic they brought a pediatric dysmorphologist from Seattle and              
 this person did train some people in the clinic, but not many                 
 pediatricians in private practice in urban Alaska have had this               
 training.  He believed that some people were afraid to label as               
 Representative Joule noted.  Doctors don't often ask about the                
 alcohol behavior of a pregnant woman, which isn't reflected in the            
 clinical records.  One of the disadvantages found during the Center           
 for Disease Control project was that the Indian Health Service had            
 taken this issue very seriously and as such their medical                     
 documentation was much better.  Once they saw a child or teenager             
 it was easier for them to go back into the medical records and                
 produce enough of a history to get a better diagnosis.  Once a                
 child is past the age of seven or eight it is very hard to make               
 this diagnosis.                                                               
 REPRESENTATIVE JOULE mentioned his past experience on a board and             
 at that time there was a study done in the Northwest Arctic area.             
 It was thought that potentially as many as 25 percent of the                  
 children observed might fall into one of these two categories and             
 asked if Mr. Jones was still hearing this type of percentage.                 
 Number 897                                                                    
 MR. JONES responded that they were still hearing this.  It is hard            
 for them to agree or disagree with a number based on their                    
 inability to get good and timely diagnoses.  There are children who           
 are having significant problems whose parental history would lead             
 someone to believe that alcohol was consumed during pregnancy, but            
 whether the behaviors observed and the inability of a child to                
 respond to normal types of discipline or behavior relate back to              
 this original possibility are difficult to determine.                         
 REPRESENTATIVE JOULE said it was interesting to hear, that in                 
 addition to a female contributing to this problem through                     
 consumption, a father at the time of conception might also                    
 contribute to this problem.                                                   
 Number 996                                                                    
 CHAIRMAN IVAN noted that no reference was made in this resolution             
 to other drugs contributing to FAE.                                           
 MS. BENNETT responded that in this resolution, they wished to                 
 specifically address alcohol related birth defects.  There are many           
 birth defects that can be attributed to other drug usage during               
 pregnancy, but they wished to focus on alcohol related birth                  
 Number 1055                                                                   
 ANNE SCHULTZ, Research Analyst, Advisory Board on Alcoholism and              
 Drug Abuse, came forward to testify on HCR 6.  She read a portion             
 of a letter addressed to the state Advisory Board on Alcoholism and           
 Drug Abuse.  This letter applauded their efforts to address the               
 problem of alcohol related birth defects.  HCR 6 reminds all of               
 them that this problem is greater in our state than any other and             
 Alaska must redouble their efforts to ensure that their newest                
 citizens are not starting their lives looking forward to poor                 
 mental and physical health with little opportunity.                           
 REPRESENTATIVE OGAN stated that he had some dear friends who                  
 adopted two children, a brother and a sister, who suffer from Fetal           
 Alcohol Syndrome.  He's a first hand witness to the affects of this           
 problem and offered if there was anything they could do to help               
 they would.  He added that this resolution was an applaudable goal.           
 He summed up that this was a senseless way to impair young people's           
 lives.  He certainly supported this resolution.                               
 Number 1163                                                                   
 REPRESENTATIVE DYSON moved and asked unanimous consent to move HCR
 6 from committee with individual recommendations and accompanying             
 zero fiscal notes.  Hearing no objection, HCR 6 was moved of the              
 House Community and Regional Affairs Committee.                               

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