Legislature(1993 - 1994)
02/24/1994 03:00 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
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+ teleconferenced
= bill was previously heard/scheduled
HB 320 - PUBLIC SCHOOL HEALTH AND SAFETY EDUCATION Number 327 REP. CYNTHIA TOOHEY, Prime Sponsor oh HB 320, stated that she wanted to propose a committee substitute (CS) for HB 320. REP. VEZEY made a motion to adopt the CS for HB 320. CHAIR BUNDE, hearing no objections, said the CS for HB 320 was so moved. Number 353 REP. TOOHEY said she has become increasingly concerned and alarmed about the health of Alaska's youth. She proceeded to list statistics that indicate that as compared to youths nationwide, rates of abuse of addictive substances and problems with public health are far greater for Alaskan youths. She said 70% of Alaskan students in grades 10 through 12 reported using alcohol at some time; and %62 of youths have tried cigarettes compared to 38% nationally. As much as 25% of all deaths in Alaska are drug related. She indicated an increasing rate of suicide among Natives and white youths under 18 years of age. Alaska has the second highest pregnancy rate for 15-19 year old youths, and the mean age of first intercourse for males is 13.2 and for females it is 14.0. REP. TOOHEY further stated that 204 Alaskans have been confirmed as having AIDS, and 489 Alaskans have been diagnosed HIV positive. She maintained that 25% of those with AIDS contracted it in their teens. Teens and women are the fastest growing group of individuals who are contracting AIDS. Rep. Toohey asserted that if healthier lifestyles are not promoted for Alaskan youths, health care costs will continue to escalate. She compared the situation to that of Africa, where all that is left of some villages are children who themselves are infected with HIV/AIDS. She stated that the CS for HB 320 would expand the list of recommended topics to be taught and would establish health education curriculum advisory committees at the district level to advise the district school boards about the health curriculum at their schools. She said the bill would mandate the teaching of age appropriate HIV/AIDS with an emphasis on appropriate behavior. For parents who do not want their children to participate in the program, there is an opt-out section. Number 514 CHAIR BUNDE noted that there were approximately 20 people who wanted to testify and asked that individual testimony be limited to two to three minutes. CHAIR BUNDE asked if the fiscal note was relative to the CS for HB 320. REP. TOOHEY said the original fiscal note was approximately $500,000 and felt it was not economically feasible. She said the new proposal indicates a fiscal note for approximately $38,000. CHAIR BUNDE indicated that the fiscal note for the CS was in the bill packets. Number 572 DEBORAH ERICKSON, Chief of Community Health, Division of Public Health, Department of Health and Social Services, testified in Juneau in support of the CS for HB 320. She emphasized that behavior and lifestyle account for the large percentage of death and injury among youths, and that behaviors established during childhood are related to leading causes of major health problems and death later on in life. She said approximately 26% of Alaskans diagnosed with AIDS are age 22 to 29 and probably contracted the HIV virus in adolescence. She said of those Alaskans diagnosed with AIDS, 85% of those cases are a direct result of unsafe sex and I.V. drug use. She stated that comprehensive health education is an effective way of changing behaviors and attitudes. She said the DOE is supportive of the concept of comprehensive health education, but she would have to defer to the DOE to make a position statement. Number 647 REP. G. DAVIS asked what degree of AIDS education was being taught throughout the various school districts. MS. ERICKSON deferred to Cheryl Kilgore on teleconference. Number 652 CHERYL KILGORE, Public Health Specialist, Division of Epidemiology, Department of Health and Social Services, spoke via teleconference from Fairbanks. She deferred to Helen Mehrkens. HELEN MEHRKENS, Health Promotion Specialist, Division of Education Program Support, Department of Education, testified via teleconference from Anchorage. She stated that the data pertaining to AIDS education in schools was not particularly accurate. She indicated a study was soon to be underway that would answer the question. Number 677 CHAIR BUNDE acknowledged that Anchorage, Fairbanks, Kodiak, and Sitka were on teleconference. REP. NICHOLIA asked Ms. Erickson if she supported the CS for HB 320. MS. ERICKSON stated that DHSS is supportive of the concept and the DOE is the lead agency for the administration in terms of voicing the administration's position on the legislation. REP. NICHOLIA asked if DHSS had a position on the proposal. MS. ERICKSON said the DOE is responsible for submitting the position paper for Governor Hickel's administration. REP. TOOHEY explained that the reason the DHSS is mute on the point is because the department is not comfortable with the mandate. Number 723 REP. G. DAVIS said if a mandate is in statute, DHSS would have no choice but to abide. CHAIR BUNDE noted that Ms. Erickson stated that 85% of all the AIDS cases in Alaska are "self-inflicted or is preventable." MS. ERICKSON agreed and said it was more directly related to personal behaviors. CHAIR BUNDE clarified and said it was personal responsibility. REP. TOOHEY clarified and said woman do not get tested for HIV because they are often the innocent victim, pointing out that there may have only been a single encounter with an HIV infected partner. She said it would be ten years before the women are identified within the population as having AIDS. CHAIR BUNDE explained that he should have said "preventable." Number 753 MS. WALKER, Executive Director, Alaska Native Health Board, testified in Juneau in support of the CS for HB 320. She stressed that there should be emphasis on the prevention of adolescent health problems and the promotion of healthy lifestyles. She asserted that there needs to be a change in the method in which health care is promoted and delivered. She felt that no one sector could accomplish the task alone. She urged the collaboration of families, health providers, legislators, public agencies, and schools. She felt the CS for HB 320 was a great beginning and said the ANHB supported it and the companion bill, SB 314. She said there should be a strong and direct link between health and safety programs and schools. She related to the committee that by the age of 16 more than 50% of Alaskan youths have had sex and that three Alaskan teenagers per day give birth. She said health promotion and disease prevention would decrease the budget and change the way the state spends money. Number 842 CHAIR BUNDE asked for further testimony. Number 845 ETTA LARSEN, Peer Educator, King Cove, Alaska, testified in Juneau in support of the CS for HB 320. She said she attended a youth symposium last year for AIDS prevention that was sponsored by the ANHB. She said 30 youths from around the state were trained as peer educators to teach about HIV/AIDS within their communities. She felt the training worked well and that she has helped youths to understand the critical importance of prevention and health care. CHAIR BUNDE asked for further testimony. Number 887 RITA DESOUZA, Executive Director, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. She referred to Rep. Toohey's statement that there are 489 people in the state with HIV, and noted that less than 10% of the population of Alaska has been tested. She suggested to Chair Bunde that perhaps the phrase "self-inflicted" is an inappropriate choice of words, as she felt the real problem is that young people do not perceive themselves at risk. She stated in 1992 a 43% increase was reported in Alaska Natives for the HIV/AIDS virus. She addressed the mandate specified in the CS for HB 320. She asserted that the state mandates the use of seatbelts and the prohibition of drinking and driving to avoid harm and death to Alaskans. She said some people choose to balk when it comes to mandating a bill that will provide every young person with the knowledge to avoid becoming infected with HIV. She stated that it is the state's moral responsibility to ensure that every young person knows how to protect themselves. MS. DESOUZA stated that most of the concern is being placed on the $40,000 fiscal note. She asked what the cost would be in human suffering, death, devastation of families, and the medical costs that would be shared by all if the state does not mandate the proposed legislation. She maintained that it costs an average of $119,000 for lifetime medical costs for AIDS treatment for one individual. She said the program would pay for itself thousands of times over. She then posed the question: How many more young Alaskans will have to suffer and die before something is done? She urged immediate action. Number 992 CHAIR BUNDE said most every high school aged youth knows that unsafe sex is dangerous, but they continue to practice unsafe sex, regardless. He said he still felt it is a personal decision that causes the infection. Number 000 MICHAEL PIERCE, Administrative Assistant, Alaskans Living with HIV (ALHIV), testified in Juneau in support of the CS for HB 320. He stated that he had a letter from the President of the Alaska State Medical Association that endorses the CS for HB 320. He read an excerpt of the letter that expressed the need for preventative medicine comprehensive health care and strongly urged that emphasis be put on the education of youths in regards to HIV/AIDS. Mr. Pierce brought to the attention of the committee the Open Hearts Project that ALHIV initiated. The program will sponsor Ginny White's visit to Alaska. He said Ginny White was the mother of Ryan White, her son who contracted AIDS through a factor transfusion to treat hemophilia. Ryan died at age 19 of AIDS. He said Ms. White now travels the United States as an AIDS educator teaching parents and children about HIV/AIDS. He further stated that the project mailed cut-out hearts across the state and has received approximately 600 in return that will be used along with thousands more to decorate the Senate Finance Committee when she addresses the legislature March 24, 1994. He said the hearts would be a visual sign of support. Mr. Pierce stated that 96% of Alaskans favor HIV/AIDS education. He further stated that in 1992 a study showed that only 52% of the parents polled said their children were receiving AIDS education. Number 071 BRYCE MORRISON, Peer Educator, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. He stated that as part of the training for being a peer educator, those being trained were introduced to a person with full blown AIDS. He said it was a very "convincing" experience. He said the gentlemen was in constant physical pain and had to take at least 16 different medications. He said he never wants to see his friends subjected to the disease. CHAIR BUNDE mentioned that, much like himself when he was young, youths think they are immortal. He asked if the message was getting through to Bryce Morrison's peers. BRYCE MORRISON replied yes. Number 096 DANIELLE KUAANA, Peer Educator, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. She stated that teens and women are the fastest growing demographic for the contraction of AIDS. She said some of her girlfriends are at high risk because of their behavior, and that was a motivating factor for her becoming a peer educator. She does not want to see anyone suffer. CHAIR BUNDE referred to the growing abstinence movement in the U.S. He asked Danielle Kuaana if abstinence was becoming a goal of youths her age. DANIELLE KUAANA said in order for people to abstain they must be taught why and how. REP. TOOHEY stated that the proposal stresses abstinence and the teaching of skills of how to abstain. Number 129 DELISA CULPEPPER, Representative, Alaska Health Education Consortium, testified via teleconference from Anchorage on the CS for HB 320. She stated she had concerns regarding mandates for health education, but thanked Rep. Toohey for bringing the issue of adolescent health problems to everyone's attention. She expressed concerns for having a mandate for only one area and also the lack of specificity regarding age related curriculums, and who would decide the curriculum. She further questioned the amount of the fiscal note and what it supports. She felt there needed to be more specificity for the bill to be passed and implemented effectively. She said a concern was that there are many other health issues that need to be addressed in schools and hoped that the proposal would not edge out those issues. Ms. Culpepper said she supported the concepts, but felt there needed to be clearer guidelines. Number 179 REP. TOOHEY said the language was intended to be broad to allow school districts to decide what the parents, teachers, and administrators want to teach their students. She said the legislation would be mandated by the school district and that each district will come up with their own plan. CHAIR BUNDE suggested that Ms. Culpepper express her concerns in writing to Rep. Toohey. Number 201 CHAIR BUNDE asked if there was further testimony from Anchorage. There was none. TAPE 94-29, SIDE A Number 000 CHAIR BUNDE asked for further testimony. Number 010 ALYSON CAMPBELL, Peer Educator, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. She stated that the more she attended meetings pertaining to HIV/AIDS education, the more she realized that she would not risk her life just for the pleasure of it, and she would wait to become sexually active after she marries. She felt that what she was teaching her peers was having an impact. CHAIR BUNDE stated that sex may be great, but it isn't any worth dying for. Number 077 ZEFFREY THROWELL, Peer Educator, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. He stated that the reason he was addressing the committee was because a lot of his friends are dying and they don't know it yet, because the HIV epidemic is spreading. He said the legislation was the only plan at this time that could effectively stop the spread of AIDS. He reiterated that it would cost $40,000 to educate thousands of youths for the prevention of the spread of AIDS, as opposed to the $119,000 it costs to "string along" the life of a person suffering with full blown AIDS. Number 130 LORRI WILSON, Peer Educator, Alaskans LIving with HIV, testified in Juneau in support of the CS for HB 320. She felt that her teachings are having successful results for the peers she is reaching, but the legislation should be passed so that everyone would be educated to prevent the spread of AIDS. She felt many lives will be saved. Number 163 ALEXIS ROBERTS, Peer Educator, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. She stated that she is thirteen years old and that she has friends 13 and 14 years old that are sexually active. She said those individuals do not know the consequences of their actions. She related the expressions of regret on her friends faces when she informed them of the realities of HIV/AIDS being a sexually transmitted disease. She said if the legislation does not pass, the disease will spread faster than the education will. CHAIR BUNDE stated that the bad news is that there are 13 year old "babies" trying to make babies, and the good news is that Alexis Roberts is trying to prevent it from happening. Number 200 JANELLE BILLINGSLEA, Peer Educator, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. She stated HIV/AIDS is a young person's disease, too. She said she couldn't describe the pain and agony that those who are infected suffer. She indicated that her teacher signed her up to take the training to be a peer educator because her teacher doesn't know enough about AIDS. She said if her teacher doesn't know enough, "then we're lost." CHAIR BUNDE referred to the high teenage pregnancy rate and asked Janelle Billingslea, if the sexual transmission of AIDS can be prevented, could there be considerable prevention of unwanted pregnancies? JANELLE BILLINGSLEA replied yes. Number 250 MICHAEL COLE, Peer Educator, Alaskans Living with HIV, testified in Juneau in support of the CS for HB 320. He stated that he had previously thought he knew a lot about AIDS until he attended the training for peer educators. He said he has been doing presentations at school and helping to educate his friends. He said his friends need the education because many are not willing to remain abstinent. He said the education is not in the schools and that the students desperately need it. He said many of his friends ask him who in the school has AIDS. He tells them that everyone in the school who is sexually active is a potential AIDS victim. CHAIR BUNDE asked if Michael Cole's friends listen to him or is it "uncool to be an educator?" MICHAEL COLE said "it's very cool" to be a peer educator. Number 345 VINCE BARRY, Director, Division of Education Program Support, Department of Education, testified in Juneau on the CS for HB 320. He stated that the legislation would require each school district to establish a health education advisory committee. He said the DOE does support the requirement for the establishment of a health education curriculum advisory committee for the districts. He said the advisory committee would ensure that the district receives the best advice from local health experts, parents, and other community members. He maintained that the DOE recognizes the importance of a structured health curriculum and agrees that students need to be instructed in HIV prevention and other important health risks. However, he expressed concerns regarding the content of the curriculum, the age appropriateness of the curriculum, and the level of emphasis on the content. He asserted that these issues would be best decided by the local school boards in consultation with parents, local health providers, and community members. He further stated that because of the aforementioned reasons, the DOE continues to oppose the imposition of state level curriculum mandates. Number 412 REP. KOTT asked Mr. Barry if he was in a position to address the fiscal note. MR. BARRY said if he's not, Helen Mehrkens could answer. REP. KOTT asked what the $38,000 under the contractual line was for. MR. BARRY answered that it was for training. He said the compliance issue is not factored into the fiscal note. REP. KOTT asked if the bill calls for the increase of at least one person in the DOE. REP. TOOHEY indicated that page 2, behind the fiscal note, would provide an explanation. Number 467 REP. KOTT said, "I see the contractual arrangement on page 2, but I'm just curious as to how the department plans on increasing one person.. .and that has been, in fact, addressed in the fiscal ramifications, but still..." MR. BARRY said the fiscal note assumes the districts would pick up all the training costs for their staff. He commented that a limited survey among seven of the largest districts estimates the total training costs to be $262,000 for K-12. He also said it would cost an additional $54,600 to send a local trainer to an academy. He asked Helen Mehrkens if the figures were correct. Number 495 HELEN MEHRKENS agreed with the numbers. MR. BARRY asked Ms. Mehrkens about the addition of one person to the DOE. MS. MEHRKENS stated that the fiscal note for the CS for HB 320 does not include any additional personnel. Subsequently, she said, there would be no plans for providing compliance monitoring. She then indicated that federal grants could fund the training of educators for the promotion of HIV prevention in school programs. Number 521 REP. KOTT asked if the education specialist indicated on page 3 of the CS was funded by the federal government. REP. TOOHEY stated that line 18, page 3, indicates that the position of education specialist is already established in statute. CHAIR BUNDE asked for further public testimony. Number 567 DEBORAH SMITH, Executive Director, Alaska Mental Health Board, testified in Juneau in support of the CS for HB 320. She stated that the board supported the fact that mental health education is a part of the proposal, although, she said, the board would prefer suggested curriculums, not mandated curriculums. Number 578 KATHY FARIS, President, Alaska School Nurses Association, testified in Juneau in support of the CS for HB 320. She stated that many students come to her during school hours with concerns about being pregnant or having venereal diseases, but rarely do they approach her asking if they need to be tested for AIDS. She said there is a lack of concern from youth today. She suggested that any bill that helps youths with life skills is worth any amount of money. Number 605 REP. G. DAVIS asked Ms. Faris how much AIDS education is being taught in the schools. MS. FARIS said in the Mat-Su Borough there is a health curriculum with mandated personal safety and life skills that addresses AIDS and abstinence. She said at certain grade levels the teaching is minimal. She felt the issue should be addressed on a continuing basis, year to year. CHAIR BUNDE said there is AIDS education at the kindergarten level in the Anchorage school district, but it is very nonspecific. Number 656 REP. TOOHEY asked Rocky Plotnick how many schools have an AIDS education curriculum. Number 675 ROCKY PLOTNICK, HIV Education Specialist, Division of Education Program Support, Department of Education, answered questions in Juneau on the CS for HB 320. She said there is not a concrete number because there are so many different ideas of what HIV prevention/health education is. Number 760 CHAIR BUNDE said when he was 13 years old he could not be held by gunpoint to listen to a group of adults discuss sexually transmitted diseases. He also asked Ms. DeSouza to thank the students who testified. REP. G. DAVIS related that he was a tutor at one time and occasionally AIDS education was part of his work. He felt the materials he used were very good. He said there is always the possibility of teachers out there who don't care and their attitude will be reflected in how they teach an AIDS education curriculum. Number 818 CHAIR BUNDE asked Ms. Plotnick how she addresses those people who believe that AIDS education curriculums promote sexual activity. MS. PLOTNICK answered that her response is that the number one way to prevent the spread of HIV is sexual abstinence; and in fact, there is more emphasis in programs to postpone sexual involvement. She maintained that it is easier to encourage people to postpone sexual activity than to get them to stop once they are already active. Number 841 CHAIR BUNDE asserted that the earlier a person becomes sexually active, they are more likely to have multiple partners. He also said children of single parent homes tend to be sexually active at earlier ages. MS. DESOUZA said the World Health Organization has done 19 studies in six different countries, including the United States, addressing the question of whether or not teaching about HIV/AIDS education increases earlier sexual activity or increases sexual activity at all. She said none of the studies showed that there was an increase in either and that most studies showed a decrease in sexual activity as a result of education. She said it is a myth to believe that education will increase sexual activity. Number 881 MS. PLOTNICK said her education program is age appropriate and that she teaches people not to be fearful. CHAIR BUNDE asked Rep. Toohey if her legislation encourages peer counselling. REP. TOOHEY said the provision encourages students against using peer pressure negatively. Number 900 CHAIR BUNDE said obviously a 13 year old will listen to another 13 year old before listening to an adult. REP. TOOHEY added that the language is broad so the districts can decide for themselves. CHAIR BUNDE suggested that the language be more specific pertaining to peer counselling. Number 942 MARVIN FARIS, Health Educator, Palmer High School, testified in Juneau in support of the CS for HB 320. He stated that there is a concern among educators in general that they are not properly trained and therefore not capable of providing the informational services necessary. CHAIR BUNDE closed public testimony and asked the pleasure of the committee. REP. G. DAVIS said he would like more time to study the bill as he was uncomfortable with the mandate section and the lack of specifics as to how a district is going to disseminate information and the grade level appropriateness. CHAIR BUNDE suggested that a subcommittee be formed. He further suggested that Rep. Toohey include specific language in the bill regarding peer education. Chair Bunde asked for Representatives Toohey and Gary Davis to form a subcommittee and said it was his intention to bring the bill up again at the earliest convenience of the committee. He then indicated that CSHB 320 would be held over. Seeing no further business before the committee, CHAIR BUNDE ADJOURNED the meeting at 5:00 p.m.
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