Legislature(2005 - 2006)CAPITOL 106
03/31/2005 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB225 | |
| HB53 | |
| HB111 | |
| HB220 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 225 | TELECONFERENCED | |
| += | HB 53 | TELECONFERENCED | |
| *+ | HB 111 | TELECONFERENCED | |
| *+ | HB 220 | TELECONFERENCED | |
| *+ | HB 14 | TELECONFERENCED | |
HB 220-MENTAL HEALTH PATIENT RIGHTS:STAFF GENDER CHAIR WILSON announced that the next order of business would be HOUSE BILL NO. 220, "An Act relating to mental health patient rights and to a hospital's duty to provide choice of the sex of staff providing intimate care to a mental health patient." 4:24:30 PM REPRESENTATIVE SEATON moved to adopt the proposed committee substitute (CS) for HB 220, labeled 24-LS0667\Y, Mischel, 3/31/05, as the working draft. There being no objection, Version Y was before the committee. 4:25:11 PM REPRESENTATIVE LES GARA, Alaska State Legislature, sponsor, said, "House Bill 220 is about the basic rights of our most vulnerable patients to be treated with dignity." He explained that the bill would require that mental health patients have the opportunity to choose the gender of the person who bathes, dresses, or otherwise cares for them in an intimate way. He presented examples of particular instances in which female patients have expressed discomfort in being cared for by a male staff member. He pointed out that there are news articles regarding this issue in the committee packets. REPRESENTATIVE GARA said that a number of mental health advocacy groups have read the bill. In fact, the National Association for the Mentally Ill has said, "The right to choose a same-sex care provider while in a vulnerable mental state should be a state mandated right." He continued: The Mental Health Consumer Web supports the bill. The Law Project for Psychiatric Rights [and] the Disability Law Center support the bill. And the bill essentially parallels a policy that has been adopted at a facility in Maine, the Bangor Mental Health Facility; they have a provision like this. A number of concerns have been raised by some of the facilities in the state. We've satisfied I believe about 98 percent of the concerns. [Alaska Psychiatric Institute (API)] still has some concerns about the bill that, frankly, you'll either support the bill or you'll support API's position that we shouldn't have a bill like this, and we can't get past API's concerns. We've tried to make the bill flexible so it doesn't require that any facility hire any additional staff. If a ... female patient asks for a female provider and no female provider is available, that just has to be documented on the chart. We've tried to put as little burden as possible on professional staff so if a female patient ... wants a female staff member to bathe that person, the female staff member doesn't have to be of a particular license or particular profession; it's up to the facility. REPRESENTATIVE GARA continued: If [the facility] can't provide a provider of the appropriate gender, then all they have to do is get a licensed staff member of the other gender to do the bathing; just so you have a licensed staff member there in that case. But then even ... if there's no staff member that's available to satisfy the concerns of the patient, ... then all you have to do is say in the chart, "We had no female staff members available that day." ... So you don't have to hire anybody additionally; you just have to put it in the chart as to why you couldn't comply. One of the mental health facilities raised the concern that sometimes you have a mental health patient who would inappropriately ask for a particular gender of provider, maybe somebody with a sexually aggressive condition or something like that, and so we've put in the bill that if it would be inappropriate for the patient's treatment to let them choose what gender person treats them then that's fine too; then you don't have to comply with the provisions of the bill. REPRESENTATIVE GARA continued: [In Version Y] we made about six changes to address the concerns that came in. ... We don't want this bill to apply to small facilities because small facilities don't have enough staff, frankly, to let people choose the gender of who treat them. So it only applies to facilities where you have 10 or more staff members on duty providing mental health care, and still they have an out even then if they don't have enough women or enough men available on a particular day. REPRESENTATIVE GARA said that the original intention of the bill was to require that the provider be the same gender as the patient, but it was changed to allow the patient to decide. However, he noted that if the committee preferred, he would be willing to allow a conceptual amendment to return the bill to its original state, requiring the provider to be the same gender as the patient. He commented, "I think we've satisfied the concerns of every mental health facility that's contacted us except for API." 4:32:35 PM REPRESENTATIVE MCGUIRE remarked that she thinks this is a great bill and she applauds the efforts involved. She said that she prefers to leave the bill as is. She inquired as to why the bill only applies to patients 18 years of age or older. REPRESENTATIVE GARA noted that Alaska law says that parents get to make medical care choices for people under 18 years of age. He said that the original version applied to all patients, and provided that the parent would have the right to make the request for anyone under 18. He commented: One of the facilities in Anchorage made an interesting point; they stated that there is sometimes a link between a child who has mental health problems and parents who have mental health problems. And [the facility] saw a problem with allowing a parent with a mental health problem to make a choice like that for a child with a mental health problem. I don't know what to think about that concern. The majority of mental health patients are adults, and I suppose it's a policy call for the committee. We were somewhat sympathetic to the concerns of the folks at [North Star Behavioral Health System] in Anchorage about the difficulty of dealing with the concerns from a parent for a child who's in a facility. We could go either way; I suppose we prefer the CS the way it is right now. CHAIR WILSON pointed out that a spokesperson from North Star Behavioral Health System was on the teleconference. 4:36:06 PM PATRICK HIGGINS, North Star Behavioral Health System, began by relating that the current version of HB 220 does address the organization's issues. He explained that his agency serves children ages 3-17, and many of them have disorders involving sexual contact issues. He said that the agency attempts to take a great deal of care with these issues and thus have policies dealing with the same-gender issue. REPRESENTATIVE MCGUIRE commented: What we're dealing with here then is probably a drafting issue and a legal issue, because ... [it] sounds like there aren't any problems accommodating the basic policy that's contained in the bill, but rather because of an issue of capacity, not having achieved the age of majority that then you would have to provide for that parent to have that choice, and that's where the problem comes about. REPRESENTATIVE MCGUIRE suggested that perhaps intent language could be included in the bill. 4:38:47 PM CHAIR WILSON stated that sometimes [the gender of the care provider] is part of the treatment plan. She said that there are instances of children who "like to act out in front of somebody of the opposite sex." REPRESENTATIVE SEATON noted that many times children are in the custody of the state, and he questioned how the state would deal with these issues. 4:40:24 PM REPRESENTATIVE ANDERSON commented, "I give great deference and credence to the opinions of like associations.... I also give great deference to Providence Hospital because of its size and probably impact in the bill affecting it more than any other facility. ... Have they talked to [Representative Gara]?" REPRESENTATIVE GARA replied that he had been in contact with a number of facilities and "we were able to satisfy ... what we considered to be the valid concerns of many of the facilities." He offered his belief that every member [excluding API] of the Nursing Home Association either has no concerns, hasn't stated concerns, or thinks the bill is okay. He noted, "The bill doesn't require that you ask the patient what gender of a provider they would like. It would only be if they bring it up; they have the right to request it." He said that if the patient is a child in the custody of the state, the original bill would have allowed the state to decide. He further commented: Sometimes people are being treated for sexually inappropriate conduct, and so the bill provides that if it would not be in the best interests of the patient's treatment ... to allow the patient to make that choice, ... then the bill just doesn't apply; we're not going to give people the right to undermine their own treatment. REPRESENTATIVE ANDERSON remarked that he would be interested in any studies suggesting that male to male or female to female staff care would reduce abuse, "unless your intent here is just for the comfort of the patient." He then stated that the bill concerns him as a possible "haven for lawsuits." Lastly, he commented, "[It is intriguing], if you're looking at mental capacity, and in this case very diminished, I'm intrigued at how they can have the capacity to choose gender." REPRESENTATIVE GARA replied that if a patient is so incapacitated that he/she needs to have a guardian, then the guardian would make the request. But, he noted, "If you're not so incapacitated, you just have mental health problems, but you don't have a guardian, then you have the right to make the request." Regarding Representative Anderson's question about possible studies, Representative Gara answered that he doesn't think there are any such studies. He reiterated that this bill is dealing with "a comfort issue, a privacy issue, it's a dignity issue." Regarding liabilities, Representative Gara responded that the bill doesn't provide for penalties or any specific cause of action or damages. He again explained that if a facility is unable to provide the requested gender of the care provider, the facility only needs to document this. 4:46:35 PM CHAIR WILSON commented that nurses and care providers are very aware of the importance of documentation. 4:47:05 PM REPRESENTATIVE CISSNA commented that some children have become inappropriately sexualized by manipulative adults, and therefore it's best to leave the power in the hands of the parent and the therapist to develop the best plan for a child under 18 years of age. Having worked as a mental health therapist, she stated that when the state has custody of a child, the state usually listens to the advice of the professionals. 4:49:39 PM REPRESENTATIVE SEATON pointed out that subsection (c) is putting a new duty on the facilities, and he asked if the sponsor had spoken with the facilities about the bill's requirement that a notice be posted in the patient rooms. He commented that if a notice was posted in every room it would probably cause more casual requests rather than requests in order to remedy genuine problems. REPRESENTATIVE GARA said that no one has raised a question about posting the notice. He said: This is almost a catch-22; if you don't post the notice you'll have some patients who are too timid to request to be treated appropriately, and the notice would ... let them know they have a right to be treated appropriately. On the other hand, if you do post the notice, you might have more people request them than is necessary. 4:52:48 PM REPRESENTATIVE ANDERSON asked if Mr. Higgins supported the bill. MR. HIGGINS said that North Star's issues and concerns have been addressed by the sponsor. HOLLY GLAESER, Director, Behavioral Health Unit, Fairbanks Memorial Hospital, testified that this issue should be an organizational issue and not a legislation issue. KARL SANFORD, Chief Nursing Officer and Associate Administrator, Fairbanks Memorial Hospital, testified in opposition to HB 220. He stated his belief that this is an unnecessary bill. He said: Currently all hospitals of any size in the state, I believe, are accredited by the Joint Commission for Hospitals nationally. Accrediting bodies such as the [Joint Commission for Hospitals], the state itself, as well as the mental health board, are oversight bodies which really are intended to prevent issues that Representative Gara, I believe, has introduced this bill to address. Those bodies frequently and on a regular basis ensure that facilities abide by patient rights, policies within the facilities. ... I have an overall concern about legislating response to patient complaints; I think it's a bad policy to follow. ... This bill overrides my nursing judgment as a professional nurse. I'm offended by this because it is my job as a nurse to make an appropriate assessment of the patient upon admission into a facility and to make sure that that patient's issues are dealt with appropriately. I believe I have the capability, as do every other registered nurse in the state that takes care of mental health patients. CHAIR WILSON asked Mr. Sanford if the bill would prevent him from conducting any services that he now gives. MR. SANFORD replied that it would not. 4:56:01 PM DORRANCE COLLINS stated: I support the passing of the committee substitute for HB 220. I also ask that the committee read the seven support letters submitted. House Bill 220 is based on a Bangor, Maine policy which uses words like "must" and "will." It's a strong policy and very clear. House Bill 220 is also very strong. In a perfect world we could just send everybody involved an e-mail or a letter and tell them to handle it. ... It is not a perfect world; everyone has an axe to grind. Laws, regulations, and guidelines are necessary on this issue. House Bill 220 is fair to the psychiatric patients, many of which have been sexually abused, not always by the opposite gender, which is why gender choice for intimate care is very important. House Bill 220 is fair to the institutions; it gives them an out. On page 2 of the bill it says the institutions only have to make a good faith effort, then document in the patient's records why gender choice was not provided. That is a huge loophole for any contingency for the institutions. Defeating this bill is only a matter of convenience to the mental institutions. What the last hundred years has taught us is the institutions will fight for convenience. It is much more to the patient; it is about not being degraded or humiliated, and maintaining some control over your life and your body. It is important and it is doable. We ask that HB 220 be passed. 4:58:21 PM FAITH MYERS testified in support of the committee substitute for HB 220. She stated that she is a former psychiatric patient. She said: Over the last four years I have testified on the issue of psychiatric patients not having the right to gender-choice for hands-on intimate care. I have traveled to Fairbanks, Juneau, and in Anchorage. I have testified in front of all relevant boards and committees. House Bill 220 is a patients' rights bill; it is necessary. A high percentage of the psychiatric patients in Alaska's mental hospitals have been sexually abused as children or adults; it is difficult to know which gender abused them, which is why it is important to let the patient choose the gender of the staff they feel most safe and comfortable with. This is why gender choice of staff is more preferable than same-sex of staff in legislative wording of the bill. There is an out for the institutions: on page 2, line 2, of HB 220 it states the institutions must only make a reasonable and good faith effort. On line 4 it simply says that the institution document in the patient's record the reason why they couldn't provide the requested gender. That gives the institution an out for any contingency. Some of the seven support letters submitted in favor of a bill have been written by people who either had the experience of being in an Alaskan psychiatric institution or have had family members in an Alaskan psychiatric institution. House Bill 220 is based on a Bangor, Maine policy and has proven that it is doable. I support CSHB 220 and ask that it be passed. 5:00:32 PM RON ADLER, CEO, Alaska Psychiatric Institute (API), Division of Behavioral Health, Department of Health and Social Services, testified in opposition to HB 220. He said: We believe this is a policy issue and want the opportunity to address these issues in policy rather than legislation, especially since there's only one situation that we're aware of that raises a concern over this issue in the entire system of care. We have no reports of this whatsoever.... MR. ADLER continued: I'm seeing this bill as the API bill, not a patients' rights bill. ... Some of the negotiations that have already occurred really exempt every other hospital in the State of Alaska but API, so it really is the API bill. Let me tell you why I think that's inappropriate. ... On [July 1, 2003], API requested from the [Assistant Commissioner of the Division of Finance and Management Service, Department of Health and Social Services] Janet Clarke [to find] funding to create a consumer and family specialist position with a specified program. This was granted and with this new program at API, on a daily basis we have a consumer and family specialist that surveys all of our guests at the hospital to assure that appropriate and quality treatment services happen. Results of these daily surveys are tabulated each month and reviewed by the API governing board. On [July 1, 2003] there was no incentive for us to do this; we did it because it was the right thing to do. On [October 1, 2004], API established a gender- sensitivity policy which already provides a person receiving services at the hospital everything that's being requested. We have gone to the point of training all of our staff on this competency that's all recorded in personnel documents. On [October 1, 2004] there was no legislative incentive or mandate for us to do this; we did it because we listened to input and feedback at our various meetings in the community and we did it because it was the right thing to do. ... This issue came before the Alaska Mental Health Board's legislative committee who refused to support legislative intent on this issue. Rather, the board decided to assert its influence by making recommendations to [Bill Hogan, Director, Division of Behavioral Health], and specifically requests [Bartlett Hospital] and Fairbanks Memorial Hospital to comport to the same standards as API. The department supports this position: allowing the division to make reasonable changes to advance health care in policy rather than legislation. ... MR. ADLER continued: This legislation is framed within the context of patients' rights. API provides an office for the Disability Law Center in the hospital; what other hospital in Alaska makes such a provision to ensure excellence in patients' rights? One of the other changes that happened here is, ... if there is no unlicensed individual on staff, you're allowing the hospital or institution to redirect a licensed person from another unit - this is a problem with [registered nurses (RN)]; we have a recruitment and retention issue with RNs not only at API but statewide. We know from an operating perspective when you ask an RN to step outside their prescribed duties and tasks for the evening and go do another task, medication error rates go up. And actually that is one of the number one issues ... all hospitals face in our regularly scheduled joint commission site reviews. We've looked every month at our medication error rates; we're keeping them very low at API, but we know the more extraneous demands we make on RNs, the more difficulty we have in managing this. ... The Mental Health Board has asked us to make some language changes in our existing policy so that it will exactly mirror the policy of Bangor Mental Institute. We agreed to do that. So our basic position is that this is unnecessary at this time. CHAIR WILSON asked Mr. Adler if this bill would prevent API from conducting the services that it now gives. MR. ADLER replied that it would not. 5:06:34 PM REPRESENTATIVE ANDERSON said that he had some concerns and they coincided with Dr. Adler's. He remarked that the witnesses' comments that patients are being degraded and humiliated "rubbed me wrong because it suggests that when it's a male to male or female to female there's degrading and humiliation." He asked Mr. Adler to respond to this, and commented, "I assume the current system is working fine other than the, again, comfort level of some mentally disabled folks." MR. ADLER replied: This brings up a very sensitive point. I just really dislike talking about acute psychiatric and behavioral disorders in public because it's just a terrible disorder that people have. And what is degrading and erodes dignity and respect for the person receiving services is when they have to do something that they are forced to do on an involuntary basis. Yet that is the reality that we're faced with. People frequently are admitted to API not of choice, but on a legal basis and frequently we have to do things to stabilize people. And while we make every attempt in the world to do that in a respectful and dignified way, there are times we have to prevent people from hurting themselves or others and that requires us to make certain accommodations in terms of these issues. REPRESENTATIVE ANDERSON said that some say the theme of this bill is about "comfort level." He asked if most of the patients in API are there because they have been sexually abused. MR. ADLER answered that this is an emerging concern on a nationwide level. He said: We believe in this field that we are finding evidence of trauma more and more often, and we believe that we have to do a reasonable trauma screen and evaluation to make sure we don't help people relive past traumas. ... Whether that's a child watching a violent family interaction, which is a traumatic experience, or somebody being sexually abused, or somebody being witness to a friend's suicide, we know that this has an impact, and we know that if we don't deal with this in an appropriate way, especially in an acute in- patient setting that ... we're not doing what's best for the individual. REPRESENTATIVE MCGUIRE commented that if it is already the policy at API to do all that is necessary for the patients' comfort, then she fails to understand why Mr. Adler opposes the bill. She said, "All the bill does is put into place statutorily the policy that ... you have in place at API." 5:11:36 PM MR. ADLER said that API makes that accommodation currently, while the bill exempts all the other hospitals within Alaska. He said, "Why legislate something that's happening?" CHAIR WILSON asked if Mr. Adler was saying that no other hospitals have a staff of over 10 people. MR. ADLER replied, "On any given shift, if you were to take a survey of the other hospitals today, that's correct." 5:13:13 PM REPRESENTATIVE SEATON said: That doesn't mean that if you don't have 10 [staff members on duty] you shouldn't do it." He stated that he is a little concerned that page 1, subsection (b), and said, "If somebody's incapacitated, then we put in an immediate burden that it has to be the same-sex ... nurse, and I'm wondering why we're doing that. ... We don't have a request, but all of the sudden we're putting this blanket duty on if somebody's incapacitated; now we're presuming that there is this request that it's going to be the same-sex person and it seems to me that possibly even if you have 10 staff members on duty, that could be a burden. 5:14:32 PM REPRESENTATIVE GARA said that according to the bill, if a person is incapacitated and there isn't same-gender staff available, then the exceptions would apply; it just has to be written in the chart. He agreed that the bill would be creating a presumption in the cases where a person is incapacitated. 5:16:17 PM RICHARD RAINERY, Executive Director, Alaska Mental Health Board, said that the board supports the intent of the legislation however, "we felt the most direct approach was to ask the Division of Behavioral Health and [API] to institute policy changes that reflect these concerns." He noted that there are some differences between the board's policy and the policy followed in Bangor, Maine; the board would ask that the hospital honor the patient choice of gender. The committee took an at-ease from 5:18:12 PM to 5:18:25 PM. 5:18:37 PM REPRESENTATIVE SEATON asked Mr. Rainery if removal of subsection (b) from the bill would influence the board one way or another. MR. RAINERY replied, "I don't believe so, no." He pointed out that the majority of the members of the Mental Health Board are consumers of mental health services or their families. 5:20:00 PM CHAIR WILSON said, "So basically what you're telling us is that because this has come up, the Mental Health Board itself has decided to put a policy in place that would take care of this concern." MR. RAINERY responded, "We have formerly requested of the Division of Behavior Health and [API] that they revise the appropriate policies to reflect the intent of what this bill asks for, yes. And we intend to work with them to make sure that those revisions do that." 5:20:50 PM ROD BETIT, President, Alaska State Hospital Nursing Home Association (ASHNHA), testified in opposition to HB 220. He said: We don't support the bill, and not because of what the sponsors are attempting to do, but because of the scope of what the bill would set in motion and a solution for a problem that really has only been one incident, to our knowledge, and that it would go beyond what's necessary to address the concerns. We think that the professional practice expectations of the medical staff that are working with these patients, each facility's commitment to meet those kinds of intimate care expectations when someone requests them and policies that they have in place to do that have been affective. To their knowledge there's been no surveys or reviews by licensing organizations to indicate there's any failure in those policies. And that would be the best place for us to put our trust in terms of what needs to happen next to fix the one incident that occurred. And so, we would agree with the Mental Health Board on that. MR. BETIT applauded Representative Gara's efforts and said that at this point this bill would not impact all five members of the ASHNHA with mental health units, but would primarily affect API and occasionally Providence Hospital as well. 5:22:52 PM CHAIR WILSON asked that the director of the Division of Behavioral Health come forward, and she asked him how be felt about the bill. BILL HOGAN, Director, Division of Behavioral Health, Department of Health and Social Services, commended the bill's sponsors because "we think what is being considered in the bill is very important to the people that we serve." However, he continued: We feel as though we can accommodate the concerns that are being raised through policy changes at [API]. In fact, we have ... over the last year and a half or more, tried to change policy based on consumer concerns to ensure that clients or patients do have ... gender choice when there's intimate care involved. We also recognize the concerns expressed by the Mental Health Board.... We have every intention of working with the Mental Health Board with the [API] governing body to implement those policy changes as well. ... Our feeling is that we can make the changes that need to occur through policy and through practice standards, and not through legislation. CHAIR WILSON said, "If you're going to do that, ... what is the objection of having it in statute?" MR. HOGAN responded, "Perhaps it's philosophical. We feel as though we can do what needs to be done without statutory change, and if there was a need for statutory change, I believe I would be up here supporting [it]." 5:25:16 PM REPRESENTATIVE MCGUIRE responded to Mr. Hogan: I might trust you now and the people who are in the position of policymaking right now, and five years from now I may not. And I think that's one of the most important things about considering statutory changes versus allowing your policies to govern. If the issue is important enough, we put it in the law books, and that way it's there for all time to come. And if a future legislature decides for policy reasons to remove that, then the debate will occur in a public setting; the public will be aware of it, and there will be an opportunity for folks to testify. The concern about making these really important decisions on a policy level is, oftentimes, many people don't even know that they're taking place; they don't know the policy is in place, they don't know the policy is being changed. So there isn't that opportunity for people to weigh in on it. And so, with all due respect, I think that's why it is appropriately placed in Alaska state law. REPRESENTATIVE SEATON said that he is uncomfortable with parts of the bill. He moved to adopt Conceptual Amendment 1, as follows: Page 1, lines 11-14 Delete subsection (b) REPRESENTATIVE SEATON stated that the requirement in subsection (b) could be quite burdensome [to the treatment center]. REPRESENTATIVE ANDERSON objected for discussion purposes. He asked if Representative Seaton would object to the addition of a friendly amendment to the conceptual amendment, or if perhaps he should make his own amendment to change line 10 on page 1 to read, "is the opposite sex." CHAIR WILSON recommended that Representative Anderson make a separate amendment to address this concern. REPRESENTATIVE ANDERSON removed his objection. REPRESENTATIVE MCGUIRE asked for clarification of the definition of "incapacitated," and wondered what percentage of the population in a mental hospital would be considered incapacitated. She commented that her only concern is that [the deletion of the word "incapacitated"] would gut the bill. REPRESENTATIVE SEATON replied that he didn't think it would gut the bill. He explained: If you're saying that anybody in a mental institution is incapacitated, what we're really saying is there's an automatic no-request; everybody in the institution must be treated as if they did make a request. ... What I'm trying to do is get it so if anybody makes a request, or their guardian or whoever [makes a request], then that request would be honored through [subsection (a)], but that we would get rid of the automaticity of ... if somebody's incapacitated. REPRESENTATIVE MCGUIRE responded, "So then it would speak to nothing on incapacity; there would be no policy." 5:30:21 PM REPRESENTATIVE GARA said: I think that's right. ... By taking out [subsection (b)] you now make the law say, "If you're 18 or older, you get to make the choice." And I think it's implied that if you're 18 or older and can't make the choice and you have a personal representative, then the personal representative can make the request. You might want to make clear that [the bill is referring to] a person 18 or older or their personal representative, just to make that clear, but I think that would be implied. So I think you could take out [subsection (b)] and you would still protect people or their personal representatives who want to make the request. [There being no objection, Conceptual Amendment 1 was adopted.] 5:31:32 PM REPRESENTATIVE SEATON moved to adopt Conceptual Amendment 2, as follows: Page 2, line 3, after "place" Delete "in patient rooms" REPRESENTATIVE ANDERSON objected for discussion purposes. REPRESENTATIVE SEATON explained, "This is a lot of signage going up around; all we need is notification in the hospital." REPRESENTATIVE ANDERSON removed his objection. [There being no objection, Conceptual Amendment 2 was adopted.] REPRESENTATIVE MCGUIRE moved to report the committee substitute for HB 220, labeled 24-LS0667\Y, Mischel, 3/31/05, as amended, out of committee with individual recommendations and the accompanying fiscal notes. REPRESENTATIVE ANDERSON objected for discussion purposes. He recounted that many of the treatment centers that testified are opposed to the bill, which is of concern for him. He removed his objection. CHAIR WILSON stated her concern [that the treatment centers are opposed to the bill]. There being no objection, CSHB 220(HES) was reported from the House Health, Education and Social Services Standing Committee.
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