Legislature(2005 - 2006)HOUSE FINANCE 519
03/15/2006 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB446 | |
| HB377 | |
| HB312 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 312 | TELECONFERENCED | |
| + | HB 377 | TELECONFERENCED | |
| + | HB 446 | TELECONFERENCED | |
| + | HB 478 | TELECONFERENCED | |
| + | SB 232 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE BILL NO. 312
An Act relating to pregnant women; requiring hospitals,
schools, and alcohol licensees and permit tees to
distribute information about fetal alcohol effects and
fetal alcohol syndrome; relating to the consumption of
alcoholic beverages by and the sale or service of
alcoholic beverages to a pregnant woman; requiring
involuntary commitment of a pregnant woman who has
consumed alcohol; creating a fund for the prevention
and treatment of fetal alcohol syndrome and fetal
alcohol effects; relating to fines and to the taking of
permanent fund dividends for selling or serving
alcoholic beverages to pregnant women; and increasing
taxes on sales of alcoholic beverages to fund treatment
and education related to fetal alcohol syndrome and
fetal alcohol effects.
2:36:40 PM
REPRESENTATIVE BRUCE WEYHRAUCH, SPONSOR, explained that the
legislation came forward to address the serious matter
relating to Fetal Alcohol Spectrum Disorder (FASD). It is
deplorable that Alaska ranks first in the Nation for the
highest number of children born with FASD. The bill has
evolved, being amended in the House HESS Committee. He
added that there is at least one amendment to the version
before the Committee.
2:38:29 PM
JACQUELINE TUPOU, STAFF, REPRESENTATIVE BRUCE WEYHRAUCH,
said the saddest fact is that FASD is 100% preventable.
FASD is the leading cause of mental retardation in the State
of Alaska. She stressed the problem in Alaska is large.
FASD can cause birth defects, retarding brain function,
arrested emotional and physical development, cause poor
behavior, deformed facial features and harming learning and
sleeping patterns.
Ms. Tupou stated that it has been estimated that the State
of Alaska will pay $3.1 million dollars over the lifetime of
each child with FASD. Right now, that cost amounts to
approximately $45 million dollars a year paid by the State.
Every department is affected by the costs associated by
FASD.
Ms. Tupou explained the changes that had been made to the
House HESS version:
· It requires a continuing education component for
doctors and nurses;
· It provides for an educational requirement targeting
schools and hospitals; and
· It institutionalizes continuing education, training
and diagnosis.
The legislation is a small step forward in addressing the
vast problem throughout Alaska.
2:41:48 PM
Representative Weyhrauch pointed out the five zero inter-
departmental notes and the one fiscal impact note by the
Department of Health and Social Services. Ms. Tupou
corrected, there are three fiscal impact notes from the
Department of Health and Social Services.
2:42:43 PM
PUBLIC TESTIMONY
DIANE CASTO, MANAGER, PREVENTION/EARLY INTERVENTION
SERVICES, DIVISION OF BEHAVIORAL HEALTH, DEPARTMENT OF
HEALTH & SOCIAL SERVICES, testified that the Department of
Health and Social Services is in favor of HB 312,
emphasizing that FASD is preventable. She mentioned the
social belief that drinking during pregnancy is acceptable
in certain circumstances. Ms. Casto discussed, drinking
during pregnancy is not okay at any time by anyone. There
are still medical providers that still do tell women that it
is okay to drink in moderation. The reality is that the
part of the brain most impacted by alcohol evolves
throughout the entire pregnancy. There is no safe time to
drink alcohol.
Ms. Casto addressed developmental issues related to FASD.
She termed the bill a building block and shared the history
of progress relating to the issue. She mentioned a survey
about to be disbursed that will provide much needed data.
Training is an important aspect of the service delivery
system. The intent of the legislation is to work with the
systems already in place that are working.
Ms. Casto advised that currently, there are a number of
functioning diagnostic teams. In the past year, a series of
regional summits were held to identify the needs of each
community. HB 312 closely aligns with what people in the
public are recommending.
Ms. Casto urged that prevention issues be addressed. FASD
requires a two-pronged approach:
· Prevention, and
· Early services in place.
2:50:00 PM
Representative Kelly questioned if other states were
treating it as a crime. Ms. Casto replied, a few states
have found that many of the women with serious alcohol
problems are not receiving services. Women, who would ask
for help, stopped seeking services when a penalty was
imposed. A better plan would be intervention, including
services and that pregnant women should have a priority for
substance abuse treatment.
Representative Kelly inquired about forcibly incarcerating
women. Ms. Casto asked further clarification.
Representative Kelly restated his query. Ms. Casto
addressed the involuntary commitment statute; there are a
few states, which have addressed it with some of the same
problems following that method with the women going "under-
ground", not coming forward for services out of fear. In
Alaska, there is an involuntary commitment statute allowing
family members to go through the courts to commit a person.
2:54:57 PM
Representative Holm questioned the Alaska FASD ratio
compared nationally per 1,000 FASD cases. Ms. Casto said
that, unfortunately, Alaska is not one of the few states
that keep good data on it. In a five-state study, Alaska
was significantly higher, 1.6% per 1,000 for full-blown
FASD. 10% have FAS and 85% have a disability related to
prenatal exposure to alcohol.
Representative Holm shared his concern about the extent of
the problem and lack of data and solutions from a public
health standpoint. He warned that choice is involved and
that forced birth control might be a solution.
Ms. Casto corrected assumptions made by Representative Holm
regarding the amount of available data. Alaska has
extensive data and agreed that there is a lot to be done
with it. Contraception is a large part of the solution and
it is included in the current version of the bill.
Additionally, it is important to look at FASD from a public
health standpoint. She thought the Department could not
support mandatory birth control. Representative Holm
clarified that the data he was referring to was statistics
that show a decrease or increase due to the Department's
intervention.
Ms. Casto shared her history in the FASD program and the
results of having a State registry. Data shows that FASD is
not frequently reported. She described the data changes due
to better reporting and that education should result in a
decline of FASD in the birthrate. The Birth Defects
Registry Data only goes through 1998; currently, the State
has increased their ability to diagnose the condition, with
increased education among medical providers, there has been
an increase in reports.
3:04:41 PM
Representative Holm voiced frustration about lack of data
regarding significant reductions in FASD. He asked what the
Legislature could do to help. He suggested mandatory
incarceration.
Ms. Casto emphasized that the Department has done quite a
lot through awareness campaigns. Behavior has changed with
those who do not have a substance abuse problem. Now the
focus is on women who do having a drinking problem. Early
intervention must reach the women who need substance abuse
treatment before they become pregnant.
3:08:06 PM
Vice Chair Stoltze pointed out that the intended beneficiary
of the bill is the unborn child. He wondered if such a law
could actually be enforced on those who have a disregard of
life. Representative Weyhrauch said they had not gotten
into that.
3:10:32 PM
Representative Joule commented that he had sat on the State
Drug and Alcohol Control Board in the 1980's when FAS was
relatively unknown. He commented on the magnitude of the
problem and maintained that education needs to be constant
because change comes slowly. The State needs to be
consistent. The most compelling fact is the cost to the
State every year at $45 million dollars. The proposed
legislation will save the State a lot of money in the long
run.
3:13:53 PM
Co-Chair Meyer acknowledged everyone is passionate about the
concern.
Representative Kerttula addressed the intent of the
registry. Mr. Casto explained that the information would be
carefully guarded and that the names would not be released.
The registry helps track the concerns.
3:15:09 PM
LAURA ROREM, PARENT NAVIGATOR ON THE FETAL ALCOHOL SYNDROME
DIAGNOSTIC (FASD) TEAM, ADVOCATE FOR PERSONS WITH FASD,
JUNEAU, introduced herself and her affiliation.
LARRY ROREM, PASTOR, SHEPPARD OF THE VALLEY LUTHERN CHURCH,
MEMBER OF THE JUNEAU FETAL ALCOHOL SYNDROME DISORDER (FASD)
TEAM, JUNEAU, explained the role of his church in serving
"marginalized" people in the community. Pastor Rorem
interwove his involvement with the church and that of his
two adopted FASD adult children.
Ms. Rorem discussed HB 312. She addressed the lifetime
reality of adopting two children with FASD, with whom State
services claimed were healthy at the time of adoption. She
presented a photo picture book of her adult children.
Pastor Rorem compared his life to a recent fire at their
church; that fire did not show itself on the surface or the
outside of the church, but inside, there was a lot of
damage. Their adult children suffer from severe brain
damage. They have little support systems within the State
of Alaska. He urged something be done to help prevent the
damage occurring for both the person with FASD and their
caretakers. The "garbage dump" for these people is usually
prison. Anything that can be done to prevent the foundation
damage and apply the appropriate repairs is vital.
Ms. Rorem stressed how important passage of HB 312 is as it
addresses the prevention. It provides for education of
professionals. Lifetime costs for FASD are outrageous. She
noted that they call their children the "million dollar
babies" because so much has been spent on their care. Ms.
Rorem stated that they are exhausted by the realities that
await their children. Both of these young people express
anger toward the effects that alcohol has had on their
lives.
3:22:30 PM
Co-Chair Meyer voiced his appreciation for their testimony.
RIC IANNOLINO, JUNEAU FETAL ALCOHOL SYNDROME DISORDER (FASD)
DIAGNOSTIC CLINIC, JUNEAU, read a letter from a child he
cares for with FAS, literally a physical & mental disability
with permanent and irreparable brain damage.
Mr. Iannolino emphasized that approximately 60% of
individuals with FAS will end up in prisons or mental health
facilities. About 50% of Lemon Creek incarcerated people
were prenatally exposed to alcohol and it is estimated that
70% of the children in foster care were exposed. He
mentioned the facial features of some with FAS, which
thth
develop during the 19-24 day of pregnancy. He made the
analogy of the FASD tragedy to that of Hurricane Katrina.
Mr. Iannolino referenced comments made by a physician at the
University of Washington, Dr. Stiscode, who stated that the
costs associated with all alcohol births are very high,
particularly those with the FASD individuals. Those with
secondary disabilities resulting from FASD are dropping out
of school, going to jail, stealing, experience alcoholism
and homelessness. Those individuals actually need more
services than those with full-blown FAS.
Mr. Iannolino provided information on his background working
with Tlinget-Haida tribes of Alaska and the lead agency for
the FAS diagnostic clinic, providing research through an
international agency studying FASD and his involvement with
the U.S. Indian Health Service. Most people do not realize
that the average person that has a child with FAS is 35
years old, white and professional. The associated costs are
huge; 54% of children in custody are estimated to be FAS.
He stressed the seriousness of the concern and the tragedy
involved in the field.
3:29:25 PM
Representative Holm asked if there had been any reduction in
the numbers. Mr. Iannolino responded that the concern is so
huge and unbelievable. The rates are very high compared to
the rest of the country. Canada has many more services in
place and understands that support services are the way to
address the vastness of these concerns. He urged that
treatment and support services be put in place throughout
Alaska.
3:31:01 PM
Representative Holm agreed it is a difficult issue and that
his wife, a schoolteacher, experienced extreme frustration
and sadness in attempting to deal with the heartbreak and
concern. He hoped to find a way to slow-down the process.
3:31:47 PM
Co-Chair Meyer indicated that the amendment in the file
would be held for consideration at a late date.
SUESHANNA FIONA STEWART-CAMPBELL, (TESTIFIED VIA
TELECONFERENCE), FASD ADULT, FAIRBANKS, stated that she is
an adult FAS survivor. She commented on the challenges that
have kept her from functioning fully in the world, stressing
the difficulties accessing services.
Ms. Stewart-Campbell referred to herself as a "cookie
cutter". Life is raw for those with FAS and many are deeply
wounded in their hearts and souls. She stated that because
of her condition, she has not been able to live a rewarding
life; always being either homeless or among the working
poor. She stressed that FASD diagnostic teams could provide
education for the public, support groups because without
diagnosis and support, these people can not discover the
beauty of their own truth and talents. She urged support to
maintain and increase funding.
3:39:10 PM
JEANNE GERHARBT-CYRUF, (TESTIFIED VIA TELECONFERENCE),
PARENTS, KIANA, spoke on behalf of her six children exposed
to prenatal alcohol and now FASD. She addressed the
continual need for services for individuals and families
impacted by FASD. Her children range between six and
eighteen years of age. They have many challenges,
behavioral, social and language and it affects their ability
to function successfully.
Ms. Gerharbt-Cyruf stressed that unless the concerns are
addressed daily, it is difficult to understand the impact on
individuals and their families. These are individuals at
risk. She urged the legislation be adopted and moved from
Committee.
3:43:21 PM
KARA NYQUIST, (TESTIFIED VIA TELECONFERENCE), ATTORNEY,
ALASKA ASSOCIATION FOR HOMES FOR CHILDREN (AAHC), ANCHORAGE,
stated that among the youth their agency serves, as many as
60% suffer from FASD. There is not a diagnosis for all
those youth. The program has never adequately been funded
and consequently, the agency has not been at a point that
they could collect adequate data. Native youth, at this
time, are the only ones being diagnosed. There is no
funding for non-Native youth. The young being served are
the ones coming back from residential treatment programs and
are the ones in the foster care system. Those kids are
having behavioral problems in school and are found
throughout the criminal justice system.
Ms. Nyquist noted AAHC supports the legislation and hopes
that the Legislature will adequately fund treatment
programs. The Legislature keeps complaining that funding
requests from the Department of Health and Social Services
keep increasing; that is because the State is not investing
the necessary dollars early on; instead, treating only the
crisis. A crisis already exists and funds needs to be
invested in diagnosing the data of those youth who already
have fetal alcohol syndrome. She reiterated, current
funding is inadequate and that the real issue is not being
addressed. AAHC supports HB 312 and would like to see it
accompanied with adequate funding so it can be properly
implemented.
3:47:07 PM
MICHAEL BALDWIN, (TESTIFIED VIA TELECONFERENCE), MENTAL
HEALTH THERAPIST, ANCHORAGE, spoke to his involvement with
FASD in his counseling practice and the devastating impact
of alcohol on these families. He spoke to other problem
areas that are tied to the consequences of prenatal alcohol
exposure such as the high suicide & violence rates.
Mr. Baldwin referenced the public health issues of the
legislation. The public health approach changes cultural
beliefs about alcohol and more people need to be educated
regarding these concerns. The system must change; adequate
funding is essential to help educate the populace. There is
research available that upfront dollars reduce long-range
costs associated with FASD. He echoed support for the
legislation.
PATRICIA SENNER, (TESTIFIED VIA TELECONFERENCE), CHAIR,
LEGISLATIVE COMMITTEE FOR THE ALASKA NURSES ASSOCIATION,
ANCHORAGE, advocated for greater funding reserved for
education and training of nurses addressing FASD. She
stressed that many kids are misdiagnosed and women are still
not being educated regarding the dangers of drinking during
pregnancy. Health care providers are not always recognizing
these children.
Ms. Senner recommended that training for nurse practioners
must include midwife direct entry nurse midwives as well.
Prevention is effective and will change the way services are
provided for those kids. Many of the folks currently
getting training are FASD kids themselves and are now having
children of their own.
3:53:37 PM
Ms. Senner mentioned the "secret-drinking mothers", as more
people know that they should not be drinking during
pregnancy.
3:55:19 PM
CHERYL SCOTT, (TESTIFIED VIA TELECONFERENCE), PARENT OF FASD
CHILD, STONE SOUP GROUP, ANCHORAGE, spoke to her child and
his associated FASD disorder. She addressed all the
conditions that occur with the illness. The area of
developmental disabilities is vast. The Stone Soup Group
has been available to provide support for children around
the State with FASD and sharing resource information. It is
families that cannot access in-home support that need
assistance and are in crisis. The challenge is finding
appropriate childcare. She stressed that it is a tragedy
because these children often do not physically look like
they suffer from FAS.
Ms. Scott recommended family camps. The Stone Soup Group
has been researching the issue since 1997 to determine a
strategy to help these children. She emphasized the number
currently living in foster care because their birth families
are in crisis.
HB 312 was HELD in Committee for further consideration.
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