Legislature(2005 - 2006)CAPITOL 106

04/05/2005 03:00 PM HEALTH, EDUCATION & SOCIAL SERVICES


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03:06:46 PM Start
03:08:00 PM HB14
03:31:47 PM HB214
04:03:43 PM HB13
04:32:06 PM Professional Teaching Practices Commission
04:33:28 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Recessed to a call of the Chair --
+ Confirmation Hearing: Professional TELECONFERENCED
Teaching Practices Comm.
HB 214 ANATOMICAL GIFTS
Moved CSHB 214(HES) Out of Committee
Bills Previously Heard/Scheduled
= HB 14 DISCLOSURES BY FOSTER PARENTS
Moved CSHB 14(HES) Out of Committee
= HB 13 SCHOOL CONSTRUCTION BOND REIMBURSEMENT
Heard & Held
HB 214-ANATOMICAL GIFTS                                                                                                       
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL NO. 214, "An Act  relating to anatomical gifts and the                                                               
anatomical gift donor registry program."                                                                                        
                                                                                                                                
3:31:47 PM                                                                                                                    
                                                                                                                                
VANESSA TONDINI,  Staff to  Representative McGuire,  Alaska State                                                               
Legislature,   reminded  the   committee  that   last  year   the                                                               
legislature  passed the  anatomical  gifts  registry bill,  which                                                               
created  an   official  organ  donor  registry   program  at  the                                                               
Department of Motor Vehicles.   Through the program, she related,                                                               
an organ donor's wishes are kept  on record in a central database                                                               
and are transferred  to Life Alaska Donor Services,  which is the                                                               
state's organ  and tissue  donor program.   She pointed  out that                                                               
Life Alaska  matches the donor's  gift to a  potential recipient.                                                               
She  added  that  HB  214  makes  simple,  technical  changes  to                                                               
existing law,  furthers the intent  of the  original legislation,                                                               
and continues  to move the  donor registry forward in  the state.                                                               
Furthermore,  HB  214  works  to make  the  donor  registry  more                                                               
inclusive  and  offers  expanded  definitions  that  clarify  the                                                               
agencies  responsible  for  donation   within  the  state.    She                                                               
explained  that  it allows  for  increased  notification for  the                                                               
people  who are  trained to  do the  actual recovery  procedures,                                                               
allows  for  greater  donation  potential,  and  clears  up  some                                                               
inconsistencies between federal regulation and state law.                                                                       
                                                                                                                                
CHAIR WILSON inquired  as to the differences  between federal and                                                               
state laws.                                                                                                                     
                                                                                                                                
MS. TONDINI  stated that  the bill that  was submitted  last year                                                               
was done so  with the intent that the donor  registry be operated                                                               
from  within the  state  and not  controlled  by an  out-of-state                                                               
agency and  one of  the changes  is to allow  access to  both in-                                                               
state and out-of-state procurement  organizations.  She explained                                                               
that  procurement  organization  is   in  AS  "13.52.90"  and  AS                                                               
13.52.390 is defined  as the organization designated  by the U.S.                                                               
Department  of Health  and Human  Services.   She  said that  the                                                               
definition of "technician"  is being changed, as  it is currently                                                               
too restrictive  [in HB  214] and  not in line  with the  laws of                                                               
other states.   She explained  that the FDA defines  a technician                                                               
under  "21CFR12.71.170"  by  requiring establishments  to  employ                                                               
sufficient  personnel with  the necessary  education, experience,                                                               
and training to insure competent performance.  She noted that AS                                                                
13.52.200(e) only  addresses notification to the  hospital and HB
214  will expand  notification by  allowing  for law  enforcement                                                               
officers to contact a procurement organization directly.                                                                        
                                                                                                                                
3:37:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCGUIRE asked Bruce  Zalneraitus to elaborate on a                                                               
section of  HB 214 where  42CFR482.45 was  contradicted regarding                                                               
the notification requirements.                                                                                                  
                                                                                                                                
BRUCE  ZALNERAITUS, Executive  Director, Life  Alaska, said  that                                                               
there  is  a  national  requirement  to  notify  the  procurement                                                               
organization  when there  has been  a  death, including  imminent                                                               
deaths for  the purpose of  potential organ donation from  a body                                                               
with a  beating heart.   He explained that the  "determination of                                                               
suitability" is not  the responsibility of the  hospital and that                                                               
the    procurement    organization     would    make    necessary                                                               
determinations.                                                                                                                 
                                                                                                                                
3:39:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARDNER  related  her  understanding  that  organ                                                               
procurement  organizations are  federally  defined  and thus  the                                                               
term  "organ" is  being deleted  in  order to  take the  [state's                                                               
program] out of the federal organ procurement organization.                                                                     
                                                                                                                                
MR.  ZALNERAITUS  said   that  in  this  case   it  broadens  the                                                               
definition to include, an organization  like Life Alaska, with an                                                               
organ procurement organization that is based out of state.                                                                      
                                                                                                                                
REPRESENTATIVE   GARDNER  clarified   that  Life   Alaska  is   a                                                               
procurement organization.   She inquired  as to why  Alaska needs                                                               
its  own  procurement  organization when  there  are  functioning                                                               
regional [procurement] organizations around the country.                                                                        
                                                                                                                                
3:40:48 PM                                                                                                                    
                                                                                                                                
MR.  ZALNERAITUS  explained that,  in  Alaska,  most donation  is                                                               
tissue donation.   He related,  "by having such an  exclusion, to                                                               
an organization  that does not  represent tissue donation  out of                                                               
state,  we feel  that would  be misrepresenting  all donation  in                                                               
Alaska of which organ and tissue are inclusive."                                                                                
                                                                                                                                
REPRESENTATIVE GARDNER stated that the  benefit to Alaska is that                                                               
the tissue donation registry is in Alaska.                                                                                      
                                                                                                                                
MR. ZALNERAITUS clarified  that it would be  a donation registry,                                                               
it is not distinct between organ and tissue.                                                                                    
                                                                                                                                
3:41:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCGUIRE said  that last year she  worked hard with                                                               
the  Division  of Motor  Vehicles  to  get  an organ  and  tissue                                                               
donation registry in  Alaska.  As the bill that  had been created                                                               
to create  this registry moved  through the  legislative process,                                                               
the  people  controlling  the regional  organ  donation  programs                                                               
offered  amendments  at  the  last  minute,  she  related.    She                                                               
mentioned   Life  Center   Northwest,   a  regional   procurement                                                               
organization,  which  demanded  that Alaska's  organ  and  tissue                                                               
donation registry would have to go  through it for approval.  She                                                               
explained  that  Life  Center   Northwest  continued  to  request                                                               
changes as the development of the registry occurred.  She said:                                                                 
                                                                                                                                
     Right now,  we are  working with Senator  Murkowski and                                                                    
     Senator  Stevens to  actually get  a separate  category                                                                    
     for Alaska, but  for right now, what this  bill does is                                                                    
     it allows us  to continue on in the  efforts that we've                                                                    
     done.   We've increased  our organ and  tissue donation                                                                    
     rates,  up  in  the  80th percentile,  we've  had  some                                                                    
     phenomenal  work going  forward and  I don't  want that                                                                    
     work to  be threatened ....   The intent all  along was                                                                    
     that Life  Alaska, our only  organ and  tissue donation                                                                    
     center,  would be  the group  that would  go ahead  and                                                                    
     make the decisions  and help work with  our Division of                                                                    
     Motor Vehicles  ....  Again, Alaskans'  expectation was                                                                    
     that you  use the  resources of  our Division  of Motor                                                                    
     Vehicles  to  work  toward  an  Alaskan  registry  that                                                                    
     benefits  Alaskans  and  is controlled  and  maintained                                                                    
     here, not  somebody in Seattle,  Washington, and  so it                                                                    
     is an issue that hits very close to home.                                                                                  
                                                                                                                                
3:45:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARDNER pointed  out that  a team  comes up  from                                                               
Washington  to  harvest organs  in  Alaska.   Furthermore,  organ                                                               
transplants are not performed in  Alaska.  Since people in Alaska                                                               
are not able to have organ  transplants in Alaska, it makes sense                                                               
to have the registry located where services occur, she opined.                                                                  
                                                                                                                                
3:46:18 PM                                                                                                                    
                                                                                                                                
MR. ZALNERAITUS clarified that the  services are provided in both                                                               
places.  Furthermore, many tissue transplants occur in Alaska.                                                                  
                                                                                                                                
3:46:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARDNER asked  if the  information on  [Alaska's]                                                               
organ  donation registry  is available  to the  organ procurement                                                               
organization.                                                                                                                   
                                                                                                                                
MR. ZALNERAITUS  replied yes, adding that  [the organ procurement                                                               
organization] has  full access to  the registry to look  up names                                                               
of potential donors.                                                                                                            
                                                                                                                                
3:47:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA  expressed  concern  with  regard  to  the                                                               
notion of  the cost  being borne by  Alaskan taxpayers,  and then                                                               
inquired as  to what  kinds of taxes  Alaskan taxpayers  would be                                                               
required to pay [related to this legislation].                                                                                  
                                                                                                                                
REPRESENTATIVE  MCGUIRE reminded  that the  state of  Alaska does                                                               
not have  a personal income tax,  but that all of  the businesses                                                               
in Alaska pay an income tax.                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA interjected  that the  businesses wouldn't                                                               
be paying the taxes on this.                                                                                                    
                                                                                                                                
REPRESENTATIVE MCGUIRE   clarified,  "We are allowing  a division                                                               
of our government that we fund  out of our general fund, which is                                                               
in  part  a  product  of  those  taxes  that  Alaskans  that  own                                                               
businesses, that  own oil companies,  that own  small businesses,                                                               
that pay into licensure and so on."                                                                                             
                                                                                                                                
REPRESENTATIVE CISSNA  opined that it's really  dangerous to talk                                                               
about "Alaskan taxpayers" that way.                                                                                             
                                                                                                                                
3:48:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCGUIRE said:                                                                                                    
                                                                                                                                
     Anytime  we make  a  commitment  to utilize  government                                                                    
     entities,  government   resources,  it  is   my  humble                                                                    
     opinion  ...  that  when we  commit  to  utilizing  our                                                                    
     resources  in   this  state,   to  help   put  together                                                                    
     registries, to  help whatever the  project is,  that we                                                                    
     are  committing  Alaskan resources  to  do  that.   The                                                                    
     Division of Motor Vehicles is  funded in large part ...                                                                    
     by the  fees that  we pay to  get our  driver's license                                                                    
     ....   My point is  that when  I put this  bill through                                                                    
     ...  I  made  the  pitch that  I  thought  the  overall                                                                    
     benefit to  Alaska and to  Alaskans that  could receive                                                                    
     and donate organ  and tissue was a good thing  ....  My                                                                    
     intent in  the bill was  never that the  registry would                                                                    
     be housed  outside of Alaska in  Alaskan's control ....                                                                    
     This legislation,  right now,  is technical in  that it                                                                    
     corrects parts  of the  bill that I  meant to  be there                                                                    
     and in some cases didn't mean to be there ....  I was                                                                      
     trying to articulate the places where I feel I failed                                                                      
     to carry out my intent.                                                                                                    
                                                                                                                                
3:51:40 PM                                                                                                                    
                                                                                                                                
CHAIR  WILSON  asked  Mr. Zalneraitus  to  inform  the  committee                                                               
regarding the importance of an Alaska-based registry.                                                                           
                                                                                                                                
3:51:52 PM                                                                                                                    
                                                                                                                                
MR.  ZALNERAITUS  said  that  there are  both  organ  and  tissue                                                               
donations in Alaska, and Life  Alaska's registry was designed for                                                               
Alaskans to be represented within  the state and had about 65,000                                                               
people on it.   The intent of adopting the  Alaska donor registry                                                               
with the  Division of Motor  Vehicles was that  registering would                                                               
be easier, he  related.  He pointed out that  the intent was also                                                               
that the registry  remain in Alaska and that the  control and the                                                               
operation of the registry stay within  the state in order to take                                                               
advantage of  future opportunities including using  the permanent                                                               
fund for donor registration.                                                                                                    
                                                                                                                                
CHAIR WILSON pointed  out that in Alaska,  accidents often happen                                                               
in remote  locations and thus  it would  be an extra  expense for                                                               
the [registry]  in Seattle to  come to Alaska versus  Life Alaska                                                               
doing it, which she estimated it could the majority of the time.                                                                
                                                                                                                                
3:53:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER applauded the  efforts of encouraging more                                                               
people to  donate organs and tissue.   However, she said  she was                                                               
puzzled  by the  cost involved  with an  Alaskan registry  as the                                                               
donated items are  not only used in Alaska, but  are available to                                                               
the entire  region.  Similarly, Alaskans  can receive transplants                                                               
from other  regions as well.   She expressed concern  with regard                                                               
to  the  expense of  establishing  a  registry when  one  already                                                               
exists.    Representative Gardner  agreed  that  people could  be                                                               
encouraged  to register  through the  DMV or  the permanent  fund                                                               
application  form,  but  they could  register  with  the  Western                                                               
states' registry for no additional cost.                                                                                        
                                                                                                                                
MR. ZALNERAITUS  stated that [Life  Alaska] would bear  that cost                                                               
as they would be responsible to maintain the other registry.                                                                    
                                                                                                                                
REPRESENTATIVE  GARDNER inquired  as to  where the  funding comes                                                               
from to do registry maintenance.                                                                                                
                                                                                                                                
MR.  ZALNERAITUS   said  that  Life  Alaska   funds  support  the                                                               
maintenance   of  the   registry.     In   further  response   to                                                               
Representative  Gardner,  Mr.  Zalneraitus  explained  that  Life                                                               
Alaska  would  be responsible  for  the  Alaskan portion  of  the                                                               
registry  in  Alaska  because  Life  Alaska  would  benefit  from                                                               
knowing who  is on the registry.   Therefore, there is  a fee for                                                               
Life Alaska to access the registry.  He said:                                                                                   
                                                                                                                                
     We are  operating in Alaska,  and if you're  an Alaskan                                                                    
     and let's say an example,  that registry is located out                                                                    
     of state,  that registry  costs money  to build  and to                                                                    
     maintain and  to continue to operate  ... those [costs]                                                                    
     are borne by the users of the registry.                                                                                    
                                                                                                                                
     We  are  authorized to  access  the  registry, not  the                                                                    
     public  ...  for the  purpose  of  determining who's  a                                                                    
     donor ...  and part of  the actual statute is  that "it                                                                    
     shall  only  be used  for  the  purpose of  determining                                                                    
     whether somebody is a donor."                                                                                              
                                                                                                                                
3:56:48 PM                                                                                                                    
                                                                                                                                
CHAIR  WILSON asked  if other  states pay  to access  the Seattle                                                               
area [registry].                                                                                                                
                                                                                                                                
MR. ZALNERAITUS  stated that he  does not know what  other states                                                               
pay.                                                                                                                            
                                                                                                                                
REPRESENTATIVE  GARDNER posed  a  situation in  which her  organs                                                               
were  available for  harvesting  and the  hospital contacted  the                                                               
organ procurement organization.  In  such a case, would that cost                                                               
Life Alaska anything, she asked.                                                                                                
                                                                                                                                
MR.  ZALNERAITUS said  that  the  costs involved  in  this are  a                                                               
result of accessing  and maintaining the registry.   He explained                                                               
that Life Alaska is bearing the cost of the registry, as of now.                                                                
                                                                                                                                
REPRESENTATIVE GARDNER  inquired as to  why a second  registry is                                                               
necessary when Alaska can't harvest or transplant organs here.                                                                  
                                                                                                                                
CHAIR WILSON  clarified that very  little of the  harvesting that                                                               
is done in Alaska is organs, it is mostly tissue.                                                                               
                                                                                                                                
REPRESENTATIVE  GARDNER   surmised  then  that  this   is  really                                                               
targeting the harvesting of tissue.                                                                                             
                                                                                                                                
REPRESENTATIVE MCGUIRE said:                                                                                                    
                                                                                                                                
     Life  Alaska, through  their donations,  does pay  ....                                                                    
     We have initiated in this  state what's called "donated                                                                    
     dollar" ... when you go  to sign up to hopefully become                                                                    
     an organ  and tissue donor  in Alaska ... the  DMV asks                                                                    
     you, "would you like to  donate a dollar to Life Alaska                                                                    
     to  help support  organ and  tissue donation  efforts?"                                                                    
     ... it's mainly getting the word out ....                                                                                  
                                                                                                                                
4:00:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCGUIRE  opined that  she didn't intend  to create                                                               
more  work for  law enforcement  by  requiring them  to send  the                                                               
notification,  which  resulted  in  a fiscal  note  for  postage,                                                               
related  supplies,  etcetera.    Therefore, she  moved  that  the                                                               
committee   adopt   Amendment   1,  which   would   remove   that                                                               
notification  requirement and  thereby  eliminate  a fiscal  note                                                               
from HB 214.  There being no objection, Amendment 1 was adopted.                                                                
                                                                                                                                
REPRESENTATIVE MCGUIRE  moved to adopt [Conceptual]  Amendment 2,                                                               
as follows:                                                                                                                     
                                                                                                                                
     Page 2, line 25:                                                                                                           
          Delete "and a procurement organization"                                                                               
                                                                                                                                
There being no objection, [Conceptual] Amendment 2 was adopted.                                                                 
                                                                                                                                
REPRESENTATIVE ANDERSON moved  to report HB 214,  as amended, out                                                               
of  committee with  individual recommendations  and the  attached                                                               
zero fiscal  note.  There  being no objection, CSHB  214(HES) was                                                               
reported  from the  House Health,  Education and  Social Services                                                               
Standing Committee.                                                                                                             
                                                                                                                                

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