Legislature(2017 - 2018)CAPITOL 106

04/06/2017 03:00 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Recessed to 4/8/17 at 3:00 PM --
*+ HB 10 CHILD IN NEED OF AID/PROTECTION; DUTIES TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+= HB 25 INSURANCE COVERAGE FOR CONTRACEPTIVES TELECONFERENCED
Scheduled but Not Heard
+= HB 54 TERMINALLY ILL: ENDING LIFE OPTION TELECONFERENCED
Heard & Held
-- Public Testimony --
+= SCR 2 SEXUAL ASSAULT AWARENESS MONTH:APRIL 2017 TELECONFERENCED
Moved SCR 2 Out of Committee
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 6, 2017                                                                                          
                           3:02 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Bryce Edgmon, Vice Chair                                                                                         
Representative Sam Kito                                                                                                         
Representative Geran Tarr                                                                                                       
Representative David Eastman                                                                                                    
Representative Jennifer Johnston                                                                                                
Representative Colleen Sullivan-Leonard                                                                                         
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Matt Claman                                                                                                      
Representative Dan Saddler                                                                                                      
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                              
HOUSE BILL NO. 10                                                                                                               
"An Act  relating to the duties  of the Department of  Health and                                                               
Social  Services; relating  to child-in-need-of-aid  proceedings;                                                               
relating to  child protection; and  amending Rules  6(a), 6(b)(2)                                                               
and  (3),  10(c)(2) and  (3),  10(e)(2),  10.1, 15(f)(2),  17(c),                                                               
17(d)(2), 17.1(b),  17.1(d)(3), 17.2(a), 17.2(e),  17.2(f), 17.3,                                                               
18(c),  and  19.1(c),  Alaska  Child  in Need  of  Aid  Rules  of                                                               
Procedure, and repealing Rules  17.1(a), 17.1(c), and 17.1(d)(2),                                                               
Alaska Child in Need of Aid Rules of Procedure."                                                                                
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE CONCURRENT RESOLUTION NO. 2                                                                                              
Proclaiming April 2017 as Sexual Assault Awareness Month.                                                                       
                                                                                                                                
     - MOVED SCR 2 OUT OF COMMITTEE                                                                                             
                                                                                                                                
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 54                                                                                        
"An  Act  providing  an end-of-life  option  for  terminally  ill                                                               
individuals; and providing for an effective date."                                                                              
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 25                                                                                                               
"An  Act relating  to insurance  coverage for  contraceptives and                                                               
related  services; relating  to medical  assistance coverage  for                                                               
contraceptives  and  related  services;   and  providing  for  an                                                               
effective date."                                                                                                                
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: HB 10                                                                                                                   
SHORT TITLE: CHILD IN NEED OF AID/PROTECTION; DUTIES                                                                            
SPONSOR(s): REPRESENTATIVE(s) WILSON                                                                                            
                                                                                                                                
01/18/17       (H)       PREFILE RELEASED 1/9/17                                                                                
01/18/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/18/17       (H)       HSS, JUD                                                                                               
04/06/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: SCR 2                                                                                                                   
SHORT TITLE: SEXUAL ASSAULT AWARENESS MONTH: APRIL 2017                                                                         
SPONSOR(s): SENATOR(s) MEYER                                                                                                    
                                                                                                                                
02/08/17       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/08/17       (S)       STA, HSS                                                                                               
02/24/17       (S)       STA REFERRAL WAIVED UC                                                                                 
02/27/17       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
02/27/17       (S)       Heard & Held                                                                                           
02/27/17       (S)       MINUTE(HSS)                                                                                            
03/01/17       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/01/17       (S)       Moved  SCR 2 Out of Committee                                                                          
03/01/17       (S)       MINUTE(HSS)                                                                                            
03/03/17       (S)       HSS RPT  5DP                                                                                           
03/03/17       (S)       DP: WILSON, BEGICH, VON IMHOF, GIESSEL,                                                                
                         MICCICHE                                                                                               
03/06/17       (S)       TRANSMITTED TO (H)                                                                                     
03/06/17       (S)       VERSION: SCR  2                                                                                        
03/08/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/08/17       (H)       STA, HSS                                                                                               
03/21/17       (H)       STA AT 5:30 PM GRUENBERG 120                                                                           
03/21/17       (H)       Moved  SCR 2 Out of Committee                                                                          
03/21/17       (H)       MINUTE(STA)                                                                                            
03/24/17       (H)       STA RPT 7DP                                                                                            
03/24/17       (H)       DP: JOHNSON, WOOL, LEDOUX, KNOPP,                                                                      
                         BIRCH, TUCK, KREISS-TOMKINS                                                                            
04/04/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/04/17       (H)       Heard & Held                                                                                           
04/04/17       (H)       MINUTE(HSS)                                                                                            
04/06/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 54                                                                                                                   
SHORT TITLE: TERMINALLY ILL: ENDING LIFE OPTION                                                                                 
SPONSOR(s): REPRESENTATIVE(s) DRUMMOND                                                                                          
                                                                                                                                
01/18/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/18/17       (H)       HSS, JUD                                                                                               
03/14/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/14/17       (H)       <Bill Hearing Canceled>                                                                                
03/27/17       (H)       SPONSOR SUBSTITUTE INTRODUCED                                                                          
03/27/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/27/17       (H)       HSS, JUD                                                                                               
03/28/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/28/17       (H)       Heard & Held                                                                                           
03/28/17       (H)       MINUTE(HSS)                                                                                            
04/06/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
REPRESENTATIVE TAMMIE WILSON                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 10 as the sponsor of the bill.                                                              
                                                                                                                                
CHRISTY LAWTON, Director                                                                                                        
Central Office                                                                                                                  
Office of Children's Services                                                                                                   
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during discussion of HB                                                               
10.                                                                                                                             
                                                                                                                                
CHRISTINE MARASIGAN, Staff                                                                                                      
Senator Kevin Meyer                                                                                                             
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented SCR 2 on behalf of the resolution                                                              
sponsor, Senator Meyer.                                                                                                         
                                                                                                                                
TARA BURNS                                                                                                                      
Community United for Safety And Protection                                                                                      
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of the resolution.                                                                  
                                                                                                                                
REPRESENTATIVE HARRIET DRUMMOND                                                                                                 
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented SSHB 54, as the sponsor of the                                                                 
bill.                                                                                                                           
                                                                                                                                
KRISTIN KRANENDONK, Staff                                                                                                       
Representative Harriet Drummond                                                                                                 
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented SSHB 54, on behalf of the sponsor                                                              
of the bill, Representative Drummond.                                                                                           
                                                                                                                                
KRISTEN HANSON, Chair                                                                                                           
Patients' Rights Action Group                                                                                                   
New York, New York                                                                                                              
POSITION STATEMENT:  Testified for James Hanson during                                                                        
discussion of HB 54.                                                                                                            
                                                                                                                                
WILLIAM HARRINGTON                                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 54.                                                                           
                                                                                                                                
KARMELLE DEILLE                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 54.                                                                        
                                                                                                                                
PAMELA SAMASH, President                                                                                                        
Right to Life                                                                                                                   
Nenana, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in opposition to HB 54.                                                                        
                                                                                                                                
JEANNE ANDERSON, MD                                                                                                             
Katmai College                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 54.                                                                        
                                                                                                                                
MARILYN GOLDEN, Senior Policy Analyst                                                                                           
Disability Rights Education and Defense Fund                                                                                    
Berkeley, California                                                                                                            
POSITION STATEMENT:  Testified in opposition to HB 54.                                                                        
                                                                                                                                
FRANK MCGILVARY                                                                                                                 
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 54.                                                                        
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:02:57 PM                                                                                                                    
                                                                                                                                
CHAIR IVY SPOHNHOLZ  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:02   p.m.                                                               
Representatives  Spohnholz,  Edgmon, Kito,  and  Sullivan-Leonard                                                               
were present  at the  call to  order.   Representatives Johnston,                                                               
Tarr, and Eastman arrived as the meeting was in progress.                                                                       
                                                                                                                                
         HB 10-CHILD IN NEED OF AID/PROTECTION; DUTIES                                                                      
                                                                                                                                
3:05:13 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  first order of business would                                                               
be  HOUSE BILL  NO. 10,  "An Act  relating to  the duties  of the                                                               
Department of  Health and Social Services;  relating to child-in-                                                               
need-of-aid  proceedings;  relating   to  child  protection;  and                                                               
amending  Rules   6(a),  6(b)(2)  and  (3),   10(c)(2)  and  (3),                                                               
10(e)(2), 10.1,  15(f)(2), 17(c), 17(d)(2),  17.1(b), 17.1(d)(3),                                                               
17.2(a),  17.2(e),  17.2(f),  17.3, 18(c),  and  19.1(c),  Alaska                                                               
Child  in Need  of Aid  Rules of  Procedure, and  repealing Rules                                                               
17.1(a), 17.1(c),  and 17.1(d)(2),  Alaska Child  in Need  of Aid                                                               
Rules of Procedure."                                                                                                            
                                                                                                                                
3:05:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   TAMMIE   WILSON,   Alaska   State   Legislature,                                                               
paraphrased  from the  Sponsor  Statement  [Included in  members'                                                               
packets], which read:                                                                                                           
                                                                                                                                
     Inequality  should  not  be tolerated!  Currently,  the                                                                    
     Office   of    Children   Services   (OCS)    has   two                                                                    
     discriminatory   standards   for   Alaska's   children.                                                                    
     Congress passed the Indian Child  Welfare Act (ICWA) in                                                                    
     1978  as   a  response  to   then-prevalent  culturally                                                                    
     insensitive  state government  child welfare  practices                                                                    
     that  negatively  impacted   "Indian  children",  their                                                                    
     families,  and their  tribes. The  ICWA aims  to ensure                                                                    
     that  Indian children  are removed  from their  parents                                                                    
     only after carefully crafted efforts  have been made to                                                                    
     maintain the  Indian family. In 1996,  the Alaska Court                                                                    
     System  received a  major federal  grant  to study  and                                                                    
     improve  the  state's   handling  of  child  protection                                                                    
     cases,  including child  abuse,  neglect, foster  care,                                                                    
     and adoption  litigation. These cases are  called child                                                                    
     in  need  of  aid  cases,   or  CINA.  The  CINA  guide                                                                    
     describes  how these  cases are  handled by  the state,                                                                    
     the roles played by  various individuals, agencies, and                                                                    
     courts. The child's ethnicity changes  the level of the                                                                    
     State's duty. When the child  in custody is Indian, the                                                                    
     State has an affirmative  duty to make "active efforts"                                                                    
     to reunify  the family (ICWA).  When the child  is non-                                                                    
     Indian,  the  State   must  make  "reasonable  efforts"                                                                    
     (CINA). "Active  efforts" is a more  stringent standard                                                                    
     than  "reasonable efforts,"  which  embody duties  that                                                                    
     touch on important rights of  parents. HB 10 raises the                                                                    
     standard so  that all of Alaska's  children are treated                                                                    
     the same.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  WILSON stated  that  one standard  would make  it                                                               
easier  for  the  department,  as  all  staff  would  be  trained                                                               
specifically for this  standard.  She pointed out  that there was                                                               
a  difference  between active  and  reasonable.   Reasonable  was                                                               
determined as the parents need  to follow the guidelines and find                                                               
the  services; whereas,  active required  the case  worker to  be                                                               
more  active  in  the  program.   Whether  in  an  Alaska  Native                                                               
community or  not, most parents  found themselves scared  and not                                                               
knowing  how the  system worked.   She  declared that  a steadier                                                               
means  to find  the necessary  resources to  reunify the  family,                                                               
including counseling and drug rehabilitation, was the purpose.                                                                  
                                                                                                                                
3:08:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   WILSON  paraphrased   the  Sectional   Analysis,                                                               
[included in members' packets], which read as follows:                                                                          
                                                                                                                                
     Section  1. AS  47.05.065  This section  is amended  to                                                                
     ensure  that remedial  and rehabilitative  programs are                                                                    
     offered to  all families  so they have  the opportunity                                                                    
     to  remedy the  parental  conduct or  condition in  the                                                                    
     home that  placed the child  at risk of damage  or harm                                                                    
     and  that the  more stringent  requirement of  "active"                                                                    
     efforts (as opposed to  "reasonable" efforts) are made.                                                                    
     That the child is placed  in a safe, secure, and stable                                                                    
     environment that  is in  the least  restrictive setting                                                                    
     that  most  approximates a  family  home  in which  the                                                                    
     child's needs may be met  and that is within reasonable                                                                    
     proximate to the child's home                                                                                              
                                                                                                                                
     Sec. 2. AS 47.10.011 This  section is amended to ensure                                                                
     that  the  more stringent  standards  are  used by  the                                                                    
     court  when  determining,  by a  preponderance  of  the                                                                    
     evidence, that a child is in need of aid.                                                                                  
                                                                                                                                
     Sec. 3. AS 47.10.011 This  section is amended by adding                                                                
     a new  subsection so  that the  same standards  used to                                                                    
     make  a determination  of physical  damage or  harm are                                                                    
     parallel  to the  more  stringent  standards of  U.S.C.                                                                    
     1901-1963,  as set  forth in  the Indian  Child Welfare                                                                    
     Act of 1978, (ICWA) regardless  of whether the child is                                                                    
     an Indian child.                                                                                                           
                                                                                                                                
     Sec.  4. AS  47.10.013(a)  This section  is amended  to                                                                
     require that the court  substantiate the more stringent                                                                    
     standards   of   "serious"    risk,   as   opposed   to                                                                    
     "substantial"   risk.  It   also  adds   "emotional  or                                                                    
     physical  damage," in  addition to  "harm" to  parallel                                                                    
     ICWA standards.                                                                                                            
                                                                                                                                
     Sec.  5.  AS  47.10.015.  This section  is  amended  to                                                                
     ensure that  the more stringent  standards of  ICWA are                                                                    
     used by the court  when determining, by a preponderance                                                                    
     of the evidence,  that a child was a victim  of harm or                                                                    
     neglect from  the conduct by, or  conditions created by                                                                    
     a parent, guardian or custodian.                                                                                           
                                                                                                                                
     Sec.  6. AS  47.10.030(c)  This section  is amended  to                                                                
     require  the   court  to  make   a  finding   that  the                                                                    
     conditions or surroundings  that prevention of imminent                                                                    
     physical  damage  or harm  to  the  child requires  the                                                                    
     immediate  assumption  of  custody by  the  court,  the                                                                    
     court may order, by endorsement  upon the summons, that                                                                    
     the officer  serving the summons  shall take  the child                                                                    
     into custody and make temporary  placement of the child                                                                    
     that the court directs.                                                                                                    
                                                                                                                                
     Sec.  7. AS  47.10.080(c) AS  47.10.80(1) requires  the                                                                
     department to place the child  in a setting as provided                                                                    
     under AS  47.14.100 or 25  U.S.C. 1915(b)  and requires                                                                    
     active efforts  to find a  permanent placement  for the                                                                    
     child.                                                                                                                     
                                                                                                                                
     Sec.  8. AS  47.10.080(f)  This section  is amended  to                                                                
     require  an  additional  finding  by the  court  as  to                                                                    
     whether the child should be  returned to the custody of                                                                    
     the parent or guardian.                                                                                                    
                                                                                                                                
     Sec. 9.  AS 47.10.080(l)  It requires a  more stringent                                                                
     standard that  when the department is  establishing the                                                                    
     permanent  plan for  the child,  the  court shall  make                                                                    
     appropriate   written   findings,  including   findings                                                                    
     related to whether "returning the  child to the child's                                                                    
     parent  or  guardian is  likely  to  result in  serious                                                                    
     emotional or physical damage to the child".                                                                                
                                                                                                                                
     Sec.  10. AS  47.10.080(p) This  section is  amended to                                                                
     require the  more stringent standards  of ICWA  in that                                                                    
     active efforts  must provide  opportunities for  and to                                                                    
     facilitate  reasonable  visitation   if  the  child  is                                                                    
     removed from the parental home.                                                                                            
                                                                                                                                
     Sec. 11. AS  47.10.080 NEW SUB SECTION  AS 47.10.080 is                                                              
     amended by adding a new  subsection which would require                                                                    
     that  an  order issued  under  this  section not  allow                                                                    
     removal of a  child from the child's  home or continued                                                                    
     placement of the child outside  the child's home unless                                                                    
     there is,  at the time  the order is issued,  clear and                                                                    
     convincing  evidence,  including  the  testimony  of  a                                                                    
     qualified  expert witness  who is  not employed  by the                                                                    
     department, that the child is  likely to suffer serious                                                                    
     emotional or  physical damage if left  with or returned                                                                    
     to the child's parent or guardian.                                                                                         
                                                                                                                                
     Sec. 12. AS 47.10.081(b)  This section has been revised                                                                
     to  require  the  determination  of  whether  continued                                                                    
     custody of the child by  the child's parent or guardian                                                                    
     is likely  to result  in serious emotional  or physical                                                                    
     damage and be included in the disposition report.                                                                          
                                                                                                                                
     Sec.  13.   AS  47.10.086(a)  This  section   has  been                                                                
     repealed  and  reenacted  to  identify  family  support                                                                    
     services;    and    that    remedial    services    and                                                                    
     rehabilitative  programs   may  include   services  and                                                                    
     programs   provided   by   the  community,   or   other                                                                    
     organizations.  It also  requires "active"  measures in                                                                    
     referring and  obtaining support services for  a parent                                                                    
     or  guardian.  The  department's duty  to  make  active                                                                    
     efforts  under this  subsection  includes  the duty  to                                                                    
     assist  the  child's  parent or  guardian  through  the                                                                    
     steps of a  case plan and with  accessing or developing                                                                    
     the resources  necessary to satisfy the  case plan. The                                                                    
     department  shall  tailor  its active  efforts  to  the                                                                    
     facts  and  circumstances  of the  case  and  list  the                                                                    
     efforts.                                                                                                                   
                                                                                                                                
     Sec.  14. AS  47.10.086(b) This  section is  amended to                                                                
     parallel the more stringent standards as in ICWA.                                                                          
                                                                                                                                
     Sec.  15. AS  47.10.086(d) This  section is  amended to                                                                
     parallel the more stringent standards as in ICWA.                                                                          
                                                                                                                                
     Sec.  16. AS  47.10.086(e) This  section is  amended to                                                                
     parallel the more stringent standards as in ICWA.                                                                          
                                                                                                                                
     Sec.  17. AS  47.10.086(f) This  section is  amended to                                                                
     parallel the more stringent standards as in ICWA.                                                                          
                                                                                                                                
     Sec.  18. AS  47.10.088(a) This  section is  amended to                                                                
     parallel the  more stringent standards  as in  ICWA. It                                                                    
     requires  that  evidence  beyond  a  reasonable  doubt,                                                                    
     including the testimony of  a qualified expert witness,                                                                    
     who is  not employed by the  department, that continued                                                                    
     custody  of the  child  by the  parent  or guardian  is                                                                    
     likely  to  result  in serious  physical  or  emotional                                                                    
     damage to the child.                                                                                                       
                                                                                                                                
     Sec. 19.  AS 47.10.088(b)  This section is  amended for                                                                
     house-keeping  purposes   and  to  parallel   the  more                                                                    
     stringent standards as in ICWA.                                                                                            
                                                                                                                                
     Sec.  20. AS  47.10.088(d)  The section  is amended  to                                                                
     read   that   the   department   shall   petition   for                                                                    
     termination of  a parent's rights  to a  child, without                                                                    
     making further  active efforts, when  a child  is under                                                                    
     the jurisdiction  of the court  under AS  47.10.010 and                                                                    
     47.10.011 and  the court  has made  a finding  under AS                                                                    
     47.10.086(b) that  the best interests  of the  child do                                                                    
     not require  further active  efforts by  the department                                                                    
     unless  the  department  had  documented  a  compelling                                                                    
     reason for  determining that the petition  would not be                                                                    
     in the best interest of  the child. A compelling reason                                                                    
     under this  subsection may include  care by  a relative                                                                    
     for the child.                                                                                                             
                                                                                                                                
     Sec.  21. AS  47.10.088(g) This  section is  amended so                                                                
     that the  department must parallel the  ICWA standards.                                                                    
     In filing a petition  to terminate parental rights, the                                                                    
     department  must determine  that  continued custody  of                                                                    
     the  child by  the  child's parents  or guardian  would                                                                    
     likely result in serious emotional or physical damage.                                                                     
                                                                                                                                
     Sec.  22. AS  47.10.142(a) This  section is  amended to                                                                
     parallel the more stringent standards as in ICWA.                                                                          
                                                                                                                                
     Sec.  23. AS  47.10.142(b) This  section is  amended to                                                                
     allow for  the department to take  emergency custody of                                                                    
     a minor from the minor's  parent or guardian only if it                                                                    
     is necessary  to prevent  the imminent  physical damage                                                                    
     or harm to the child.                                                                                                      
                                                                                                                                
     Sec.  24. AS  47.10.142(d) This  section is  amended to                                                                
     parallel the  more stringent standards as  in ICWA. The                                                                    
     court  must determine  that  allowing the  department's                                                                    
     continuing  temporary legal  custody  of  the child  is                                                                    
     based  on the  necessity to  prevent imminent  physical                                                                    
     damage or harm to the child.                                                                                               
                                                                                                                                
3:18:51 PM                                                                                                                    
                                                                                                                                
     Sec.  25. AS  47.10.142(e) This  section is  amended to                                                                
     direct  the court  to also  determine at  the temporary                                                                    
     custody hearing  whether (1) by a  preponderance of the                                                                    
     evidence, removal of the child  is necessary to prevent                                                                    
     imminent physical damage  or harm to the  child, or (2)                                                                    
     by  clear   and  convincing  evidence,   including  the                                                                    
     testimony  of a  qualified  expert witness  who is  not                                                                    
     employed  by the  department,  the  child would  likely                                                                    
     suffer serious physical or emotional  damage if left in                                                                    
     the  child's home.  If the  Court  finds that  probable                                                                    
     cause exists  for believing that  the child is  a child                                                                    
     in need of  aid and that a sufficient  showing has been                                                                    
     made under  either (1)  or (2)  of this  subsection, it                                                                    
     shall order  the child committed to  the department for                                                                    
     temporary  placement outside  the home  of the  child's                                                                    
     parent or  guardian. If the  court finds  that probably                                                                    
     cause  does not  exist  for believing  the  child is  a                                                                    
     child in  need of  aid, but  that a  sufficient showing                                                                    
     has not been made under  (1) or (2) of their subsection                                                                    
     the court shall order the  child to be either committed                                                                    
     to  the  custody  of   the  department  with  temporary                                                                    
     placement to be in the  child's home or returned to the                                                                    
     custody of the child's parent or guardian.                                                                                 
                                                                                                                                
     Sec. 26.  AS 47.10.142(f)  This section is  amended for                                                                
     house-keeping purposes  to parallel the  more stringent                                                                    
     standards  as   in  ICWA.  The  provision,   except  as                                                                    
     provided in  (i) of this section,  limits the temporary                                                                    
     placement under this section to 30 days.                                                                                   
                                                                                                                                
     Sec.  27. AS  47.10.142(h) This  section is  amended to                                                                
     change the  timeline for court review  of the placement                                                                    
     plan  and  actual  placement  of  the  child  under  AS                                                                    
     47.10.080 (I)  to occur within  30 days, as  opposed to                                                                    
     12  months,   after  a  child   is  committed   to  the                                                                    
     department.                                                                                                                
                                                                                                                                
     Sec.  28.  AS  47.10.142  This section  is  amended  by                                                                
     adding  a new  paragraph to  read: The  court may  only                                                                    
     order  a child  committed  to  for temporary  placement                                                                    
     under  (e) and  (f) of  this section  for more  than 30                                                                    
     days if  the court  determines by clear  and convincing                                                                    
     evidence,  including  the   testimony  of  a  qualified                                                                    
     expert witness  who is not employed  by the department,                                                                    
     that  custody of  the child  by the  child's parent  or                                                                    
     guardian  is  likely  to result  in  imminent  physical                                                                    
     damage  or  harm to  the  child  or that  extraordinary                                                                    
     circumstances exist.                                                                                                       
                                                                                                                                
     Sec.  29.  AS  47.10.990  This section  is  amended  by                                                                
     adding  a  new  paragraphs   [sic]  to  define  "active                                                                    
     effort,"  "emotional  damage," and  "remedial  services                                                                    
     and rehabilitative programs".                                                                                              
                                                                                                                                
     Sec.  30.  AS 47.14.100(r)  is  amended  to read:  This                                                                
     section  is  amended  to parallel  the  more  stringent                                                                    
     efforts as in ICWA.                                                                                                        
                                                                                                                                
     Sec.  31. AS  47.17.290(3) This  section is  amended to                                                                
     parallel the more stringent  definition of "child abuse                                                                    
     or neglect".                                                                                                               
                                                                                                                                
     Sec. 32. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT.  Rule  6(a), Alaska  Child  in  Need of  Aid                                                                    
     Rules  of  Procedure;  amends  the  "Emergency  Custody                                                                    
     Without  Court Order"  standards to  parallel the  ICWA                                                                    
     standards.                                                                                                                 
                                                                                                                                
     Sec. 33. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  6(b)(2), Alaska  Child in Need  of Aid                                                                    
     Rules  of  Procedure;  amends the  "Form,  Contents  of                                                                    
     Motion" standards  for removal  of a child  to parallel                                                                    
     the ICWA standards.                                                                                                        
                                                                                                                                
     Sec. 34. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  6(b)(2), Alaska  Child in Need  of Aid                                                                    
     Rules  of Procedure,  is amended  to  read: (3)  Order;                                                                    
     amends the  standards for  emergency orders  of removal                                                                    
     of a child to parallel ICWA standards.                                                                                     
                                                                                                                                
     Sec. 35. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  10(c)(2), Alaska Child in  Need of Aid                                                                    
     Rules of  Procedure; amends  the standards  for removal                                                                    
     of a child to parallel the ICWA standards.                                                                                 
                                                                                                                                
     Sec. 36. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  10(c)(3), Alaska Child in  Need of Aid                                                                    
     Rules of  Procedure; amends  the standards  for removal                                                                    
     of a child to parallel the ICWA standards.                                                                                 
                                                                                                                                
     Sec. 37. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  10(e)(2), Alaska Child in  Need of Aid                                                                    
     Rules  of  Procedure;  amends that  standards  for  the                                                                    
     return of  the child  to the  child's home  to parallel                                                                    
     ICWA standards.                                                                                                            
                                                                                                                                
     Sec. 38. The  uncodified law of the State  of Alaska is                                                                
     amended by adding  a new section to  read: DIRECT COURT                                                                  
     RULE AMENDMENT.  Rule 10.1(a)(1), Alaska Child  in Need                                                                    
     of Aid Rules of  Procedure; amends Findings to parallel                                                                    
     ICWA standards.                                                                                                            
                                                                                                                                
     Sec. 39. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  15(f)(2), Alaska Child in  Need of Aid                                                                    
     Rules  of Procedure;  amends the  inquiry and  findings                                                                    
     required by CINA Rule 10.1 to parallel ICWA standards.                                                                     
                                                                                                                                
     Sec. 40. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT.  Rule 17(c),  Alaska  Child in  Need of  Aid                                                                    
     Rules  of   Procedure;  amends  the   Requirements  for                                                                    
     Disposition to parallel ICWA standards.                                                                                    
                                                                                                                                
     Sec. 41. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  17(d)(2), Alaska Child in  Need of Aid                                                                    
     Rules  of Procedure;  amends  the  standards the  court                                                                    
     uses  to approve  the  removal of  the  child from  the                                                                    
     child's home to parallel ICWA standards.                                                                                   
                                                                                                                                
     Sec. 42. The  uncodified law of the State  of Alaska is                                                                
     amended by adding  a new section to  read: DIRECT COURT                                                                  
     RULE AMENDMENT.  Rule 17.1(b), Alaska Child  in Need of                                                                    
     Aid  Rules of  Procedure, amends  the standard  used by                                                                    
     the court  in determining  if a continuation  of active                                                                    
     efforts is  not in  the best interest  of the  child by                                                                    
     paralleling them to the ICWA standard.                                                                                     
                                                                                                                                
     Sec. 43. The  uncodified law of the State  of Alaska is                                                                
     amended by adding  a new section to  read: DIRECT COURT                                                                  
     RULE AMENDMENT.  Rule 17.1(d)(3), Alaska Child  in Need                                                                    
     of  Aid  Rules of  Procedure;  amends  the standard  to                                                                    
     determine the  Child's Best  Interests to  parallel the                                                                    
     ICWA standard.                                                                                                             
                                                                                                                                
     Sec. 44. The  uncodified law of the State  of Alaska is                                                                
     amended by adding  a new section to  read: DIRECT COURT                                                                  
     RULE AMENDMENT.  Rule 17.2(a), Alaska Child  in Need of                                                                    
     Aid  Rules  of  Procedure;  amends  the  standards  for                                                                    
     Purpose and Timing  of the Hearing for a  child in need                                                                    
     of aid to parallel ICWA standards.                                                                                         
                                                                                                                                
3:28:01 PM                                                                                                                    
                                                                                                                                
     Sec. 45. The  uncodified law of the State  of Alaska is                                                                
     amended by adding  a new section to  read: DIRECT COURT                                                                  
     RULE AMENDMENT.  Rule 17.2(e), Alaska Child  in Need of                                                                    
     Ai d Rules  of Procedure; amends the  standards used by                                                                    
     the court for making  written findings to parallel ICWA                                                                    
     standards.                                                                                                                 
                                                                                                                                
     Sec. 46. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  17.2(f), Alaska  Child in Need  of Aid                                                                    
     Rules of Procedure; amends the  standards used to apply                                                                    
     additional findings to parallel ICWA standards.                                                                            
                                                                                                                                
     Sec. 47. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT.  Rule 17(3),  Alaska  Child in  Need of  Aid                                                                    
     Rules  of Procedure;  amends  the  standard applied  to                                                                    
     petition or  proxy for  adoption or  legal guardianship                                                                    
     of a child under AS 47.10.111                                                                                              
                                                                                                                                
     Sec. 48. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT.  Rule 18(c),  Alaska  Child in  Need of  Aid                                                                    
     Rules  of Procedure;  amends  the  standard applied  to                                                                    
     Burden of Proof to parallel ICWA standards.                                                                                
                                                                                                                                
     Sec. 49. The  uncodified law of the State  of Alaska is                                                                
     amended  by adding  a new  section:  DIRECT COURT  RULE                                                                  
     AMENDMENT. Rule  19.1(c), Alaska  Child in Need  of Aid                                                                    
     Rules  of Procedure;  amends the  standard applied  for                                                                    
     Disposition  Order,  pursuant  to  AS  47.10.100(a)  to                                                                    
     parallel ICWA standards.                                                                                                   
                                                                                                                                
     Sec. 50. The  uncodified law of the State  of Alaska is                                                                
     amended  by  adding  a new  section:  REPEAL  OF  COURT                                                                  
     RULES.  Rule 17.1(a),  17.1(c), and  17.1(d)(2), Alaska                                                                    
     Child in Need of Aid Rules of Procedure, are repealed.                                                                     
                                                                                                                                
     Sec. 51.  AS 47.10.086(c),  47.10.086(g), 47.10.088(e),                                                                  
     47.10.990(11),    47.10.990(21),   47.10.990(27)    and                                                                    
     47.10.990(30) are repealed.                                                                                                
                                                                                                                                
     Sec. 52. The  uncodified law of the State  of Alaska is                                                                  
     amended by  adding a new  section: TWO-THIRDS  VOTE NOT                                                                  
     REQUIRED.  Because   the  provisions  of   Rules  6(a),                                                                    
     6(b)(2)  and (3),  10(c)(2)  and  (3), 10(e)(2),  10.1,                                                                    
     15(f)(2), 17(c),  17(d)(2), 17.1(a),  17.1(b), 17.1(c),                                                                    
     17.1(d)(2)  and (3),  17.2(a), 17.3  and 18(c),  Alaska                                                                    
     Child  in Need  of  Aid Rules  of  Procedure, that  are                                                                    
     affected  by the  provisions of  this Act  were adopted                                                                    
     under   the   Alaska   Supreme   Court's   interpretive                                                                    
     authority   exercised   under    art.   IV,   sec.   1,                                                                    
     Constitution of  the State  of Alaska,  secs. 32  - 45,                                                                    
     48, and 50  of this Act take effect even  if secs. 32 -                                                                    
     45, 47, 48,  and 50 of this Act do  not receive the two                                                                    
     thirds  majority vote  normally applicable  to changing                                                                    
     court  rules under  art. IV,  sec. 15,  Constitution of                                                                    
     the State of Alaska.                                                                                                       
                                                                                                                                
     Sec. 53. The  uncodified law of the State  of Alaska is                                                                  
     amended by  adding a  new section:  APPLICABILITY. This                                                                  
     Act applies to  child-in-need-of-aid petitions filed or                                                                    
     pending on or after the effective date of this Act.                                                                        
                                                                                                                                
     Sec. 54. The  uncodified law of the State  of Alaska is                                                                  
     amended by  adding a  new section:  CONDITIONAL EFFECT.                                                                  
     AS 47.10.080(l), as  amended by sec. 9 of  this Act, AS                                                                    
     47.10.081(b), as  amended by sec.  12 of this  Act, and                                                                    
     AS  47.10.142(d), as  amended by  sec. 24  of this  Act                                                                    
     take effect  only if secs.  9, 12,  and 24 of  this Act                                                                    
     receive  the two  thirds majority  vote  of each  house                                                                    
     required  by  art. IV,  sec.  15,  Constitution of  the                                                                    
     State of Alaska.                                                                                                           
                                                                                                                                
3:37:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSTON  directed  attention  to  the  qualified                                                               
external witness mentioned in Sections  11, 25, and 28, and asked                                                               
how Representative Wilson visualized this working.                                                                              
                                                                                                                                
REPRESENTATIVE  WILSON replied  that this  was currently  done in                                                               
ICWA (Indian  Child Welfare Act  of 1978) cases, and  it depended                                                               
on the  issues with the  parents.  She explained  that, currently                                                               
in non-ICWA cases,  the expert witness could be  the case worker,                                                               
which would change in the proposed legislation.                                                                                 
                                                                                                                                
REPRESENTATIVE JOHNSTON  asked if  there was  a state  or federal                                                               
contract with the expert witness.                                                                                               
                                                                                                                                
REPRESENTATIVE   WILSON  explained   that   currently  this   was                                                               
determined by  the attorneys.   She stated  that the  fiscal note                                                               
reflected  the state  expense for  an expert  witness.   She said                                                               
that parents  could fight  an OCS  determination, hence  the need                                                               
for the expert  witness.  She said this need  for a witness could                                                               
also be necessary for terminations,  as most cases not under ICWA                                                               
utilized the case worker.                                                                                                       
                                                                                                                                
3:39:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO   referenced  the  aforementioned   loss  of                                                               
federal  funding  mentioned  in  the fiscal  notes  [Included  in                                                               
members' packets],  and asked about  the reason for this  loss of                                                               
federal funding.                                                                                                                
                                                                                                                                
REPRESENTATIVE WILSON explained that  some grammatical changes in                                                               
one phrase  were necessary,  as there needed  to be  a connection                                                               
for  child placement,  but not  necessarily for  the child.   She                                                               
declared that she had no  intention to eliminate federal funding.                                                               
She shared  that she  was working with  the Department  of Health                                                               
and  Social  Services  to accomplish  her  goals  without  losing                                                               
federal funding.  She noted  that the phrase indicated for change                                                               
was "contrary to the welfare."                                                                                                  
                                                                                                                                
3:41:54 PM                                                                                                                    
                                                                                                                                
CHRISTY LAWTON,  Director, Central  Office, Office  of Children's                                                               
Services  (OCS),  Department  of   Health  and  Social  Services,                                                               
relayed that the  statement was "contrary to the  welfare for the                                                               
child to stay  in their own home,"  and that a judge  had to make                                                               
that finding  at the  very first order  which indicated  that OCS                                                               
had the authority  to have custody as there were  reasons for OCS                                                               
to  have custody.   It  had to  be associated  to removal  of the                                                               
child from  the home.  She  noted that if that  first finding was                                                               
lost, any  eligible further  funding throughout  the life  of the                                                               
case  would be  lost.    She relayed  that  OCS  had spoken  with                                                               
Representative  Wilson for  ways to  change the  language in  the                                                               
proposed bill,  as it  was necessary to  indicate that  the court                                                               
had ruled it  was unsafe for the  child to be in  their own home.                                                               
She added  that revenue could be  lost if the language  from ICWA                                                               
was  imported  into  the  proposed bill,  as  the  standards  for                                                               
removal  of a  child and  to  keep them  in a  foster home  would                                                               
necessitate  a  judge  acknowledging  that OCS  had  made  active                                                               
efforts  to  prevent  removal,  and  active  efforts  to  promote                                                               
reunification.    She  stated  that this  was  a  very  difficult                                                               
standard to  meet, and,  if the  standard could  not be  met, and                                                               
with the elimination of the  reasonable efforts option, the state                                                               
would have  to support  the cost  of care  from the  general fund                                                               
when the threshold for active efforts had not been met.                                                                         
                                                                                                                                
3:43:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO  referenced the  standards necessary  for the                                                               
termination  of  parental rights,  and  asked  if there  was  the                                                               
ability  within OCS  to perform  an investigation  to meet  these                                                               
standards identified in the proposed legislation.                                                                               
                                                                                                                                
MS. LAWTON  opined that the  language in the proposed  bill would                                                               
not  change what  they  do  when it  was  necessary to  terminate                                                               
parental rights.                                                                                                                
                                                                                                                                
3:44:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  declared that the  proposed bill                                                               
was "an  incredible piece  of legislation."   She  expressed that                                                               
every  child  should  be  treated  the  same,  and  that  it  was                                                               
concerning that the system did not  treat everyone the same.  She                                                               
asked what the catalyst was to make these changes.                                                                              
                                                                                                                                
REPRESENTATIVE  WILSON replied  that two  standards made  it more                                                               
difficult  for  the  entire  system,  including  the  staff,  the                                                               
attorneys, and the  courts.  She declared that,  as the standards                                                               
outside ICWA were  much lower for removing  children, most judges                                                               
had to rule in  favor of removal.  She said that  a change to the                                                               
necessity  of  proof  over  hearsay would  still  allow  OCS  for                                                               
voluntary counseling without taking legal custody.                                                                              
                                                                                                                                
3:46:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO  commented  that,  throughout  the  proposed                                                               
bill,  there had  been a  change from  mental injury,  defined on                                                               
page 21  as including  more than  emotional trauma,  to emotional                                                               
damage.  He asked if this  change would continue to cover as much                                                               
as was previously covered by mental injury.                                                                                     
                                                                                                                                
REPRESENTATIVE WILSON  opined that,  although it would  not cover                                                               
everything  previously  covered,  the  goal  was  to  mirror  for                                                               
consistency.   She explained that  throughout the  proposed bill,                                                               
the child had to be in harm's way, in order to be removed.                                                                      
                                                                                                                                
3:47:49 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ asked if there  were any operational changes with                                                               
this change in language.                                                                                                        
                                                                                                                                
MS. LAWTON explained that emotional  damage was not defined under                                                               
ICWA,  although  it  was specifically  and  narrowly  defined  in                                                               
current  statute.    She  noted  that it  was  necessary  for  an                                                               
observable  impairment, and  that a  qualified expert,  usually a                                                               
mental health expert, needed to  testify to that impairment.  She                                                               
pointed out  that OCS did not  often file for custody  under this                                                               
subsection as  the threshold  was quite high.   She  shared that,                                                               
instead, if it  was believed there was emotional  harm related to                                                               
domestic  violence, OCS  would file  under neglect.   She  opined                                                               
that the proposed  bill would potentially broaden  the ability by                                                               
the  department,  as  it  would  not  be  as  narrow  as  it  was                                                               
currently.                                                                                                                      
                                                                                                                                
3:49:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR offered  her belief  that, although  part of                                                               
the  bill was  to align  with ICWA  standards, she  had questions                                                               
regarding  other changes.   She  directed attention  to page  20,                                                               
line  22,  and  asked  about  the  difficulty  for  meeting  this                                                               
standard.   Citing  her personal  experiences, she  declared that                                                               
this would  be difficult to  substantiate, and asked  if children                                                               
could be  left in harmful  situations if this standard  could not                                                               
be met.                                                                                                                         
                                                                                                                                
REPRESENTATIVE  WILSON  replied  that   this  mirrored  what  was                                                               
currently required  by ICWA, and  she offered her belief  that it                                                               
had not been a problem.                                                                                                         
                                                                                                                                
3:50:58 PM                                                                                                                    
                                                                                                                                
MS.  LAWTON, in  response  to Representative  Tarr, opined  that,                                                               
currently under ICWA,  OCS only needed the witness  if the parent                                                               
did  not agree  and  was contesting  the judicial  determination.                                                               
She said that  a witness who was  not a case worker  could be the                                                               
supervisor or  the regional ICWA  specialist.  She  reported that                                                               
currently  it was  very difficult  to find  expert witnesses  for                                                               
ICWA cases,  specifically, cultural experts.   She stated  that a                                                               
bigger  challenge was  the  limitations placed  on  the court  to                                                               
potentially order the  child into state custody.   She added that                                                               
it could  be time consuming  and costly to find  expert witnesses                                                               
and bring them  to the court.   She opined that it  could leave a                                                               
gap, though  she was not  able to  quantify how often  this would                                                               
occur.                                                                                                                          
                                                                                                                                
3:52:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  acknowledged that  "these situations  can be                                                               
so sticky" and  that it was the desire to  give the parents every                                                               
opportunity.  She relayed that  some of the individuals, however,                                                               
were master manipulators.  She  expressed her concern that having                                                               
a high standard  for imminent danger allowed  for manipulation to                                                               
create  difficulty  in  meeting   that  standard,  while  in  the                                                               
meantime, the children would remain in an unsafe situation.                                                                     
                                                                                                                                
REPRESENTATIVE WILSON  countered that  the damage for  removing a                                                               
child  could be  huge,  and  that nobody  wanted  a  child to  be                                                               
injured.  She relayed that  numerous studies showed that moving a                                                               
child  could  do  more  damage.     She  asked,  "where  is  that                                                               
threshold?"  She pointed to the  proposed bill, and asked to what                                                               
level were  they willing to  go to  make sure that  children were                                                               
removed when in harm's way.   She suggested that it was better to                                                               
add the voluntary actions before removing children.                                                                             
                                                                                                                                
3:55:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO asked if there  were any other impacts as far                                                               
as transition  of cases between  the Indian Child  Welfare system                                                               
and the state system when making those programs similar.                                                                        
                                                                                                                                
MS.  LAWTON replied  that the  proposed bill  would not  have any                                                               
impact  on the  OCS  ability for  transfer  of jurisdiction  from                                                               
state court to tribal court.                                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ spoke  about the  "natural  sticky tension  that                                                               
exists in  our child  welfare system,"  and the  daily challenges                                                               
faced by  OCS for finding the  "sweet spot that protects  as many                                                               
children  as  possible  while maintaining  as  many  families  as                                                               
possible."   She noted that it  was recognized that removal  of a                                                               
child from their family was  an adverse childhood experience, but                                                               
that leaving them where they  were while continuing to experience                                                               
harm was also  an adverse childhood experience.   She offered her                                                               
belief that it  was necessary, as feelings could  be very intense                                                               
and  run very  high,  to take  the  time to  step  back, let  the                                                               
intensity  dissipate, and  approach  the issue  with calm,  cool,                                                               
collected wisdom.   She  acknowledged that  the sponsor  had good                                                               
intention and wanted  to do the best for the  children of Alaska.                                                               
She commended  the work done  by the  staff at OCS,  sharing that                                                               
this  work did  not receive  the  respect that  it deserved,  and                                                               
comparing it  to the  work performed  by firefighters  and police                                                               
officers for everyday intensity.                                                                                                
                                                                                                                                
CHAIR SPOHNHOLZ announced that HB 10 would be held over.                                                                        
                                                                                                                                
        SCR 2-SEXUAL ASSAULT AWARENESS MONTH: APRIL 2017                                                                    
                                                                                                                                
3:59:13 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the next order  of business would                                                               
be SENATE CONCURRENT RESOLUTION NO.  2, Proclaiming April 2017 as                                                               
Sexual Assault Awareness Month.                                                                                                 
                                                                                                                                
4:00:28 PM                                                                                                                    
                                                                                                                                
CHRISTINE  MARASIGAN, Staff,  Senator Kevin  Meyer, Alaska  State                                                               
Legislature,    responded   to    an   earlier    question   from                                                               
Representative Sullivan-Leonard  during the April 4  House Health                                                               
and Social Services Standing Committee  meeting about progress on                                                               
lowering  the  high  rate  of  sexual assault.    She  said  that                                                               
generally there  had been a  decline and she  relayed information                                                               
from  the Intimate  Partner Violence  and Sexual  Violence Alaska                                                               
Victimization  Survey,  which compared  the  results  of 2010  to                                                               
2015.  She  shared that in 2010, 12 in  100 women had experienced                                                               
intimate partner violence  and by 2015, this had dropped  to 8 in                                                               
100  women.   She said  that  during this  same period,  intimate                                                               
partner violence  had decreased  by 32 percent,  a drop  of 6,556                                                               
women, and  sexual violence had  decreased by 33 percent,  a drop                                                               
of  3,072 women.   She  reported that  more than  half the  adult                                                               
women  in  Alaska,  more  than  130,000  women,  had  experienced                                                               
violence  in  their  lifetime, and,  although  these  rates  were                                                               
coming down, Alaska  was still number one in the  U.S. for sexual                                                               
assault and violence.   She stated that it was  hard to attribute                                                               
the decline to  one particular program, but  rather a combination                                                               
of many public awareness campaigns and education.                                                                               
                                                                                                                                
4:03:11 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ opened public testimony.                                                                                        
                                                                                                                                
4:03:44 PM                                                                                                                    
                                                                                                                                
TARA  BURNS,   Community  United   for  Safety   and  Protection,                                                               
explained that  her organization was  for current and  former sex                                                               
workers in  Alaska, sex trafficking  victims, and  allies working                                                               
toward safety and protection for  everyone in Alaska's sex trade.                                                               
She reported  that a recent survey  of Alaska voters did  place a                                                               
high priority on  addressing sexual assault in  the state, noting                                                               
that the  processing of the backlog  of rape kits was  the second                                                               
priority only behind the investigations  for missing and murdered                                                               
sex workers  in Anchorage.  She  added that 93 percent  of voters                                                               
did not  realize that it  was legal  for police officers  to have                                                               
sex with those  they were investigating, with  90 percent wanting                                                               
this to be illegal.  She  shared that more than 70,000 people had                                                               
signed a petition  to make this illegal.  She  stated support for                                                               
HB 112  and SB 73,  noting that  neither bill had  been scheduled                                                               
for  public testimony,  and suggesting  that even  in the  Alaska                                                               
State Legislature  raising more awareness was  necessary to bring                                                               
the law in line with the  priorities of Alaskan voters to address                                                               
sexual assault  in the communities.   She stated support  for the                                                               
proposed resolution.                                                                                                            
                                                                                                                                
4:05:26 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ closed public testimony.                                                                                        
                                                                                                                                
4:05:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EDGMON moved  to report  SCR 2  out of  committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There being no objection,  SCR 2 was moved from the House                                                               
Health and Social Services Standing Committee.                                                                                  
                                                                                                                                
4:06:07 PM                                                                                                                    
                                                                                                                                
The committee took an at ease from 4:06 p.m. to 4:08 p.m.                                                                       
                                                                                                                                
            HB 54-TERMINALLY ILL: ENDING LIFE OPTION                                                                        
                                                                                                                                
4:08:20 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  final order of business would                                                               
be SPONSOR  SUBSTITUTE FOR HOUSE  BILL NO. 54, "An  Act providing                                                               
an  end-of-life  option  for   terminally  ill  individuals;  and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
4:08:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HARRIET   DRUMMOND,  Alaska   State  Legislature,                                                               
stated that  proposed HB 54  was "about patient's rights  and end                                                               
of life care.   It allows patients to have  important end of life                                                               
discussions  with their  own doctors,  doctors they  already know                                                               
and trust.  It allows a  patient to ease their pain and suffering                                                               
and  live and  die  on their  own terms  according  to their  own                                                               
beliefs."                                                                                                                       
                                                                                                                                
4:09:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN  asked how the proposed  bill would ensure                                                               
that patients  will not use  coverage for life  saving treatments                                                               
in  exchange for  the less  expensive option.   He  asked how  to                                                               
guarantee this would not occur.                                                                                                 
                                                                                                                                
4:10:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DRUMMOND  asked where  this had happened,  and she                                                               
directed  attention to  the section  of the  proposed bill  which                                                               
guarded against coercion.  She  said that these patients had been                                                               
dealing with their  illness for a long time,  and were surrounded                                                               
by  people who  cared about  them and  were not  going to  coerce                                                               
them.                                                                                                                           
                                                                                                                                
4:10:59 PM                                                                                                                    
                                                                                                                                
KRISTIN  KRANENDONK,  Staff,   Representative  Harriet  Drummond,                                                               
Alaska State Legislature, said that  there were provisions in the                                                               
bill prohibiting a person from  conditioning the sale of any type                                                               
of insurance.  She asked  for further clarification that this was                                                               
reflecting coercion by insurance  companies to push patients into                                                               
an end of  life act.  She noted that  Section 13.55.240 (page 12,                                                               
line 25)  of the  proposed bill had  language that  an insurance,                                                               
life, or health policy could not be conditioned.                                                                                
                                                                                                                                
4:12:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN suggested that  California and Oregon were                                                               
"going down  that road."  He  said there was a  human tendency to                                                               
prefer a less  expensive option to something that  could be life-                                                               
saving but more  expensive.  He asked about the  changes from the                                                               
original  version  of  the   proposed  bill,  specifically  about                                                               
documentation  and  paperwork.     He  asked  about  the  current                                                               
requirements for written documentation for verification.                                                                        
                                                                                                                                
4:12:45 PM                                                                                                                    
                                                                                                                                
MS.  KRANENDONK explained  that Alaska  currently has  palliative                                                               
care  and hospice  care providers  who work  with terminally  ill                                                               
individuals.   She said there  were several options  for terminal                                                               
patients.   The  section removed  from  the original  bill was  a                                                               
written  form required  to  be on  file.   She  relayed that,  as                                                               
Oregon  had found  this to  redundant,  it was  removed from  the                                                               
proposed bill.   She  noted that Alaska  had advance  health care                                                               
directives,  also known  as living  wills.   She  opined that  an                                                               
advance directive was more appropriate  for healthy patients, and                                                               
that  the state  already  provided a  complete  packet which  was                                                               
available  on  the  Division  of  Public  Health  website.    She                                                               
reported that  an individual had  the right to  give instructions                                                               
about their  own health  care to  the extent  as allowed  by law.                                                               
She  relayed  that Alaska  also  had  Medical Officers  for  Life                                                               
Sustaining  Treatment, which  offered  the  Comfort One  program,                                                               
also under the Division of Public  Health.  She clarified that it                                                               
was a set of medical orders  for the very seriously or terminally                                                               
ill, but  was not an advance  directive and not a  substitute for                                                               
naming a health care agent.   She added that Comfort One patients                                                               
could wear  an identifying  bracelet, which  included information                                                               
regarding  the   diagnosis,  treatment,  end  of   life  options,                                                               
hospice, and palliative  care.  She added  that state regulations                                                               
also  included  a Do  Not  Resuscitate  protocol, a  standardized                                                               
procedure.  She  stated that all patients who  qualified for this                                                               
proposed  legislation  would also  qualify  for  the Comfort  One                                                               
program.   She noted  that a  bill had been  passed in  1998 that                                                               
removed the  duty of a  peace officer  to respond to  an expected                                                               
home death.                                                                                                                     
                                                                                                                                
REPRESENTATIVE   EASTMAN   asked  about   written   documentation                                                               
available to verify that this was  supposed to occur, and was not                                                               
foul play.                                                                                                                      
                                                                                                                                
4:17:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DRUMMOND explained that  a terminal patient had to                                                               
personally  request the  medication  on  two separate  occasions,                                                               
more than 15  days apart, from their primary care  provider.  The                                                               
patient had  to be  determined to be  terminally ill,  and "would                                                               
most likely  be dead within  six months."   She added  that there                                                               
was appropriate paperwork to be filed  at that time, and that the                                                               
patient needed  to be declared  capable of making  this decision,                                                               
and being coerced.  If  the physician determined that the patient                                                               
was  in  a  psychological  state  which could  lead  to  a  wrong                                                               
decision,  the  patient  can  be referred  to  counseling.    She                                                               
reiterated that  there were  a number of  these safeguards.   She                                                               
declared,  if there  was  any actual  wrongdoing,  that would  be                                                               
tantamount  to murder.    She reminded  that  the medication  was                                                               
supposed to be self-administered by the patient.                                                                                
                                                                                                                                
MS. KRANENDONK pointed  out that AS 12.65.007  also required that                                                               
hospice have this  form on file, and she added  that more than 95                                                               
percent of the  patients were in hospice.  She  declared that any                                                               
suspicion  of foul  play  would  result in  a  call  to a  police                                                               
officer.  The proposed bill  only stated that the information was                                                               
not available to the public, but  a police officer was allowed to                                                               
review  the medical  records with  the required  documentation if                                                               
there was suspicion of foul play.                                                                                               
                                                                                                                                
4:20:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EASTMAN  asked  what   the  minimum  standard  of                                                               
appropriate paperwork would be and how it could be verified.                                                                    
                                                                                                                                
MS. KRANENDONK replied  that all the patients  that qualified for                                                               
this option  were treated  by a physician  who had  their patient                                                               
files.   She  noted that  the files  for terminally  ill patients                                                               
included extensive  documentation of everything  since diagnosis.                                                               
She  offered her  belief  that  this was  not  usually the  first                                                               
option.   She explained  that the written  form had  been removed                                                               
from  the  proposed  bill  because the  physician  still  had  to                                                               
document that the patient had orally requested it.                                                                              
                                                                                                                                
4:21:59 PM                                                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ  asked  if  other   states  required  a  written                                                               
documentation,  and why  the  sponsor had  opted  to not  include                                                               
this.                                                                                                                           
                                                                                                                                
MS. KRANENDONK explained that Oregon  had initially included this                                                               
requirement because  of concerns for coercion  or wrongful death,                                                               
but in  the 24 years  since its passage,  there had not  been any                                                               
cases needing the forms.  She  reported that, as more states were                                                               
doing  this  by  ballot  initiative, this  requirement  had  been                                                               
removed as it was determined to  be a redundant step.  She stated                                                               
that Washington  DC was the  only place which required  a coroner                                                               
notification,  as  most  states  had a  program  similar  to  the                                                               
aforementioned Medical Officers for Life Sustaining Treatment.                                                                  
                                                                                                                                
CHAIR  SPOHNHOLZ, reflecting  that 95  percent of  these patients                                                               
were under  the care of  hospice, asked how many  communities had                                                               
hospice available.                                                                                                              
                                                                                                                                
MS. KRANENDONK  clarified that this  was the  percentage reported                                                               
from  Oregon.   She stated  that the  Juneau hospice  facilitated                                                               
care for other SE Alaska communities.                                                                                           
                                                                                                                                
REPRESENTATIVE DRUMMOND  added that  they had not  researched the                                                               
availability of hospice  care throughout Alaska.   She noted that                                                               
a criticism  of the  proposed bill was  that palliative  care was                                                               
available.  She declared that,  if the proposed bill improved the                                                               
availability  and effectiveness  of palliative  care, then  there                                                               
would  be  progress.   She  explained  that  one reason  for  the                                                               
proposed bill was that currently people  had to move to Oregon to                                                               
be able  to take control  of their life.   She stated  that there                                                               
were options  that may need to  be worked into the  proposed bill                                                               
to allow  patients to  fully take  advantage of  the legislation,                                                               
should they feel that need.                                                                                                     
                                                                                                                                
CHAIR SPOHNHOLZ asked about those options.                                                                                      
                                                                                                                                
REPRESENTATIVE  DRUMMOND  noted  that,  as  many  communities  in                                                               
Alaska were inaccessible  by road and that  thousands of patients                                                               
were  not able  to travel  to see  doctors, an  option for  tele-                                                               
health  had been  discussed  to be  used in  lieu  of a  personal                                                               
appearance.                                                                                                                     
                                                                                                                                
4:27:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO  spoke of the  challenge for  getting medical                                                               
care  and the  potential cost  in  Alaska due  to the  geographic                                                               
disparity.  He  asked  if  the   proposed  legislation  would  be                                                               
insurance   eligible,  and,   if   not,  would   this  create   a                                                               
circumstance  where   only  having   enough  money   would  allow                                                               
participation in the program.                                                                                                   
                                                                                                                                
MS. KRANENDONK  said that the  current proposed bill  would allow                                                               
this as an  insurance option, although it was not  required as an                                                               
option.   She expressed  concern that the  program would  only be                                                               
available to people who could  afford to travel for medical care,                                                               
although this was  currently true for a lot of  health care.  She                                                               
declared  the  desire  to  make more  health  care  available  to                                                               
everyone in the state.                                                                                                          
                                                                                                                                
4:29:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO  referenced  the  first  10  years  of  this                                                               
program in  Oregon, reporting  that there  were 541  requests for                                                               
the  medication,  with  341  uses.     He  suggested  that  in  a                                                               
comparison with  the Alaska population  over 10 years,  one might                                                               
expect about 100  requests and 60 uses.  He  pointed out that, as                                                               
people  could have  been moving  to Oregon  from other  places to                                                               
take advantage  of this  program, Alaska  could expect  even less                                                               
request.  He asked about the projected level of usage in Alaska.                                                                
                                                                                                                                
REPRESENTATIVE   DRUMMOND  expressed   her  agreement   with  the                                                               
figures, sharing  her research from Oregon,  which included about                                                               
750 requests  for the medication,  with about 340 usages  over 20                                                               
years.   She  stated that  she  had also  extrapolated for  small                                                               
numbers in  Alaska.  She pointed  out there was enormous  cost to                                                               
travel to Oregon for this  program, especially in the late stages                                                               
of a terminal disease.  She  declared that she wanted to make end                                                               
of life options easier for Alaskans, not harder.                                                                                
                                                                                                                                
MS.  KRANENDONK  said  that the  fiscal  note  reflected  similar                                                               
statistics,  as  it  anticipated  10  -  19  cases  annually  for                                                               
patients requesting the medication.   She pointed out that it was                                                               
necessary to establish  residency in Oregon to  take advantage of                                                               
the program.                                                                                                                    
                                                                                                                                
4:32:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN asked about  the requirement for insurance                                                               
to provide  the service.  He  asked if this would  be optional or                                                               
included in every insurance plan.                                                                                               
                                                                                                                                
MS.  KRANENDONK  replied  that  polls  reflected  that  about  70                                                               
percent of Alaskans  would like this as an option.   She observed                                                               
that she  would personally be  more comfortable with  this option                                                               
in her insurance.                                                                                                               
                                                                                                                                
REPRESENTATIVE EASTMAN asked if an  insurance provider may or may                                                               
not offer,  and whether the  proposed bill  distinguished between                                                               
these options.                                                                                                                  
                                                                                                                                
4:35:00 PM                                                                                                                    
                                                                                                                                
MS. KRANENDONK offered to forward more insurance information.                                                                   
                                                                                                                                
4:35:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  stated that she did  not support                                                               
the  premise  of  the  bill.    She  expressed  her  concern  for                                                               
vulnerable   individuals,  for   those   not   close  to   health                                                               
facilities, and  for the  lack of a  requirement to  have written                                                               
approval for a  procedure.  She directed attention  to the fiscal                                                               
note  from  Legislative  Legal  Services  [Included  in  members'                                                               
packets] which read:                                                                                                            
                                                                                                                                
     The  legislation creates  a defense  to  murder in  the                                                                    
     first  degree,   murder  in  the  second   degree,  and                                                                    
     manslaughter  if  the  person   is  performing  an  act                                                                    
     permitted  by the  legislation. It  also establishes  a                                                                    
     new crime  of abuse  of life  termination process  if a                                                                    
     person  intends to  cause  another  person's death  and                                                                    
     falsely  makes,  completes,  or alters  a  request  for                                                                    
     medication or  destroys a rescission  of a  request for                                                                    
     medication. A person  may also be guilty  of this crime                                                                    
     if  they exert  undue  influence on  another person  to                                                                    
     request  medication  for  the purpose  of  ending  that                                                                    
     person's life.  Abuse of life termination  process is a                                                                    
     class A felony.                                                                                                            
                                                                                                                                
REPRESENTATIVE  DRUMMOND replied  that these  were safeguards  to                                                               
prevent abuse of  the process.  She declared that  the desire for                                                               
the proposed  bill was for the  patient to be fully  cognizant of                                                               
the  choice, of  the options,  and to  be able  to rescind  their                                                               
request at any point during the  process.  She offered her belief                                                               
that this was well covered in  the proposed bill, which was based                                                               
on the  experience from  other states.   She reiterated  that the                                                               
proposed bill had  been simplified because the  required form had                                                               
been  "just collecting  dust in  a file."   She  stated that  the                                                               
medical  community   would  figure  out  what   worked  for  each                                                               
individual practice.   She expressed her certainty  that it would                                                               
be resolved in a way to make  the most sense for both patient and                                                               
doctor records.                                                                                                                 
                                                                                                                                
MS. KRANENDONK said  that all the cases and  the medication would                                                               
be accounted for and tracked.                                                                                                   
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD said that  an oral argument would                                                               
not come into play in a legal proceeding.                                                                                       
                                                                                                                                
4:39:53 PM                                                                                                                    
                                                                                                                                
MS. KRANENDONK  replied that  the establishment  of qualification                                                               
was documented in the bill.                                                                                                     
                                                                                                                                
4:40:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO referred  to a  study for  the Oregon  Death                                                               
with Dignity  Act between  2004 and  2006, which  indicated that,                                                               
although  required   by  law  that  individuals   requesting  the                                                               
medication receive  counseling, 16  percent of  those individuals                                                               
suffered  from  clinical  depression  and were  not  referred  to                                                               
counseling.  He  asked if there were protections  in the proposed                                                               
law that  would ensure accountability  for not making  a referral                                                               
to counseling.                                                                                                                  
                                                                                                                                
MS. KRANENDONK  replied that,  although physicians  were required                                                               
to  refer  individuals for  psychiatric  care  if depression  was                                                               
diagnosed, there was no punishment written into the bill.                                                                       
                                                                                                                                
REPRESENTATIVE KITO expressed his concern  for a 16 percent error                                                               
rate, which could allow individuals,  with treatment, to continue                                                               
through their natural end of life.                                                                                              
                                                                                                                                
4:42:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EASTMAN, in  reference  to a  move  to Oregon  to                                                               
participate in the  program, asked what was to  stop someone from                                                               
doctor shopping  in order to qualify  for the program.   He noted                                                               
that  the letter  of the  law allowed  broad qualification  of an                                                               
individual, and asked how to ensure that this would not happen.                                                                 
                                                                                                                                
4:44:07 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  DRUMMOND  pointed  out  that  the  proposed  bill                                                               
required that two  doctors, not in the same  practice, agree that                                                               
an individual was terminal within the prescribed amount of time.                                                                
                                                                                                                                
MS.  KRANENDONK added  that  diabetes would  not  qualify in  the                                                               
early stages.                                                                                                                   
                                                                                                                                
4:45:38 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ pointed to the  definition of terminal disease on                                                               
page 11, line 17, in the proposed bill, and read:                                                                               
                                                                                                                                
     means an  incurable and  irreversible disease  that has                                                                    
     been   medically  confirmed   and  that   will,  within                                                                    
     reasonable medical judgement,  produce death within six                                                                    
     months;                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ said that HB 54 would be held over.                                                                             
                                                                                                                                
4:46:50 PM                                                                                                                    
                                                                                                                                
KRISTEN HANSON,  Chair, Patients' Rights Action  Group, read from                                                               
a  prepared statement  by her  husband, James  Hansen.   He wrote                                                               
that he was  a marine war veteran,  a husband, and a  father.  He                                                               
did not want  to die, and, as he was  currently unable to travel,                                                               
he could  not make his  statement in person.   He shared  that he                                                               
was  suffering  from aggressive  brain  cancer.   He  shared  his                                                               
background prior  to his cancer.   He noted that he  had the same                                                               
brain cancer  as the  young woman  who had  moved to  Oregon from                                                               
California  in  order to  be  able  to take  her  own  life.   He                                                               
reported  that three  different doctors  had told  him there  was                                                               
nothing he could do about  his cancer, as surgery, radiation, and                                                               
chemo therapy rarely  worked.  He, instead, chose  to do standard                                                               
and experimental treatment.  He  expressed his thanks that he had                                                               
not accepted his initial prognosis,  even as the past three years                                                               
had not  been easy, with  a lot  of physical and  emotional pain,                                                               
countless  seizures, and  days with  the loss  of his  most basic                                                               
abilities, unable to talk, walk, read,  or write.  He shared that                                                               
he had  currently lived  two years and  eight months  longer than                                                               
his original prognosis.   If this legislation  had been available                                                               
at that  time, he could  have chosen  the medication, and  he did                                                               
consider  it.   He declared  that there  was no  going back  on a                                                               
decision to  end life.   He  stated that  he had  fought assisted                                                               
suicide  legislation for  the last  18  months.   He opined  that                                                               
legalized  suicide,  touted  as   death  with  dignity,  had  the                                                               
opposite effect.   He said that many  patients with circumstances                                                               
similar  to his  were offered  lethal  drugs and  were denied  or                                                               
delayed coverage  for the necessary  care.  He  acknowledged that                                                               
he had experienced  depression and had felt that he  was a burden                                                               
to his  family.  He  said it was a  very real danger  when people                                                               
could choose  death over care,  and that suicide became  a social                                                               
norm for people who were terminally  ill.  He said there had been                                                               
an  increase  of  general suicide  rates,  along  with  medically                                                               
assisted rates, in states which  had legalized suicide.  He added                                                               
that, as  he had  also suffered  post traumatic  stress disorder,                                                               
legalization of doctor prescribed  suicide sent the wrong message                                                               
to struggling veterans.  He  declared that mistakes would be made                                                               
and  lives would  be  tragically lost  if  assisted suicide  were                                                               
legalized.    He asked  if  one  person's perception  of  choice,                                                               
influenced by  hopelessness and fear  of being a burden,  put the                                                               
lives of those who want to survive at risk.                                                                                     
                                                                                                                                
4:53:52 PM                                                                                                                    
                                                                                                                                
WILLIAM  HARRINGTON stated  that  medication was  not defined  as                                                               
something  to kill,  but something  to heal.   He  stated that  a                                                               
different word  was necessary in  the proposed bill,  although he                                                               
did  support the  legislation.   He  pointed out  that  it was  a                                                               
sacrilege to  kill yourself.   He suggested  that this  should be                                                               
defined as self-termination, and not as suicide.                                                                                
                                                                                                                                
4:55:45 PM                                                                                                                    
                                                                                                                                
KARMELLE DEILLE  stated that she  was against the  proposed bill,                                                               
and opined  that the law  should always be  on the side  of life.                                                               
She  expressed her  agreement with  earlier  testimony, and  that                                                               
termination  of the  hindrances  would open  the floodgates,  and                                                               
would  keep people  from  respecting boundaries.    She shared  a                                                               
personal experience  with a  friend.  She  suggested that  it was                                                               
necessary to  look at  history instead  of emotion  when deciding                                                               
whether to  change laws.  She  declared that it was  not possible                                                               
to legalize  suicide if  we "felt accountable  to the  creator of                                                               
life."                                                                                                                          
                                                                                                                                
5:00:07 PM                                                                                                                    
                                                                                                                                
PAMELA  SAMASH,  President,  Right   to  Life,  stated  that  the                                                               
proposed  bill was  "a dangerous  bill."   She acknowledged  that                                                               
this was  a sensitive  subject.  She  declared that  the proposed                                                               
bill  was wrong  because "we  don't know  why some  circumstances                                                               
prolong death  but sometimes people  miraculously recover."   She                                                               
suggested to review the history  of euthanasia in other countries                                                               
and communities, which  began as a personal choice  but then slid                                                               
into death  as an  answer.   She asked  what message  the suicide                                                               
laws  would send.   She  stated  her opposition  to the  proposed                                                               
bill.                                                                                                                           
                                                                                                                                
5:02:24 PM                                                                                                                    
                                                                                                                                
JEANNE ANDERSON, MD, Katmai College,  paraphrased from a prepared                                                               
statement [Included in members' packets], which read in part:                                                                   
                                                                                                                                
     My  name  is  Jeanne  E  Anderson,  MD.  I  am  medical                                                                    
     oncologist in  private practice in Anchorage  at Katmai                                                                    
     Oncology  Group, LLC.  Specialists in  Medical Oncology                                                                    
     diagnosis patients with  cancer; counsel them regarding                                                                    
     prognosis  and  treatment  options;  prescribe  medical                                                                    
     (i.e.,   drug)  treatment;   and  provide   supportive,                                                                    
     palliative and end of life  care. I received my medical                                                                    
     degree from  Stanford University  in 1988.  I completed                                                                    
     internal  medicine  specialty  training  in  1991,  and                                                                    
     medical oncology  fellowship training in 1994,  both at                                                                    
     the University of Washington.                                                                                              
                                                                                                                                
     I am strongly against  HB54 for many reasons, including                                                                    
     1)  the   uncertainty  in  determining   an  individual                                                                    
     patient's  prognosis,  2)  improvements  in  palliative                                                                    
     care, and  3) hastening  death is not  the role  of the                                                                    
     physician or the medical system.                                                                                           
                                                                                                                                
     A critical feature of SSHB54  is that the patient has a                                                                    
     "terminal"  disease.  There  is no  definitive  way  to                                                                    
     determine  that a  patient has  less than  6 months  to                                                                    
     live.  Estimates of  survival  are  based on  published                                                                    
     data  and  a  physician's clinical  judgment.  Survival                                                                    
     data come  from studies performed years  earlier, often                                                                    
     using treatment  that is not  the most up to  date, and                                                                    
     is based on narrowly defined patient populations.                                                                          
                                                                                                                                
     Even  well informed  and well-meaning  oncologists make                                                                    
     drastic mistakes in their estimates of prognosis.                                                                          
                                                                                                                                
DR. ANDERSON  expressed her agreement with  the earlier testimony                                                               
in  opposition  of the  proposed  bill.   She  acknowledged  that                                                               
professionals often  made drastic mistakes in  prognosis, and she                                                               
shared three relative stories.                                                                                                  
                                                                                                                                
5:06:03 PM                                                                                                                    
                                                                                                                                
MARILYN   GOLDEN,  Senior   Policy  Analyst,   Disability  Rights                                                               
Education  and  Defense  Fund,   stated  her  opposition  to  the                                                               
proposed bill.   She said that, with  legalized assisted suicide,                                                               
some people's lives would be  ended without their consent through                                                               
mistakes and abuse, as no  safeguards could prevent this outcome.                                                               
She offered  her belief  that the health  care system  was broken                                                               
and  would, instead,  offer legalized  suicide  as "the  cheapest                                                               
treatment"   when  insurers   denied  or   delayed  approval   of                                                               
expensive, life sustaining treatment.   She stated that "assisted                                                               
suicide  was a  recipe  for elder  abuse."   She  said that  mis-                                                               
diagnosis  and  incorrect  prognosis could  analyze  prematurely.                                                               
She reported that  negligent personnel were not  liable for their                                                               
negligent actions.   She  said that  abuse was  not investigated,                                                               
and  she suggested  that the  Oregon  data failed  to show  abuse                                                               
because the system was set up not  to find it.  She declared that                                                               
suicide contagion was  also an issue, with an  increase in Oregon                                                               
after the passage of its assisted suicide legislation.                                                                          
                                                                                                                                
5:10:27 PM                                                                                                                    
                                                                                                                                
FRANK MCGILVARY  said that both he  and his wife were  opposed to                                                               
the proposed legislation, as life was really precious.                                                                          
                                                                                                                                
5:11:49 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ closed public testimony.                                                                                        
                                                                                                                                
[HB 54 was held over.]                                                                                                          
                                                                                                                                
5:12:24 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
The House  Health and Social Services  Standing Committee meeting                                                               
was recessed until Saturday, April 8, at 3 p.m.                                                                                 

Document Name Date/Time Subjects
HB10 Ver D 1.30.17.PDF HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Sponsor Statement 1.30.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB10 Supporting Document - ICWA glossary and flowchart - NICWA 1.30.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB10 Supporting Document -CINA Flowchart - OCS Manual 1.30.17.PDF HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Sectional Analysis.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB025 Summary of Changes ver J 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Proposed Blank CS ver J 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-HB025 Support Emails 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Alaska Pharmacists Association 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter ANDVSA 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter APRN Alliance 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Tanana Chiefs Conference 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
SSHB 54 Supporting Document--Aderhold Letter of Support 4.5.2017.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54 Opposing Document--Dore Secondary Memo in opposition 4.5.2017.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54 Opposing Document--Anderson letter of opposition 4.5.2017.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54 Opposing Document--Dore First Memo in opposition 4.5.2017.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SCR 2 Version A.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR 2 Sponsor Statement A.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR 2 Support Materials Alaska Dispatch News 11.20.2016.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
Supplemental Crime in Alaska Report.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR 2 Support Materials Key Results from the 2015 Alaska Victimization Survey.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR 2 Support Materials CDVSA Annual Report 2015.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR 2 Support Materials ANDVSA 2016 Annual Report.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR2-LEG-SESS-02-27-17 FN.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR 2 Support Materials CDC National Intimate Partner and Sexual Violence Survey.pdf HHSS 4/6/2017 3:00:00 PM
SHSS 2/27/2017 1:30:00 PM
SCR 2
SCR 2 Fiscal Note LAA 3.9.17.pdf HHSS 4/6/2017 3:00:00 PM
HSTA 3/21/2017 5:30:00 PM
SCR 2
HB025 Sectional Analysis ver A 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Opposing Document-Letter NFIB 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Sponsor Statement 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-ADN Commentary 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Cost Savings Study 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Guttmacher Alaska Statistics 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Guttmacher Public Costs from Unintended Pregnancies 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-HB025 Support Emails 2.27.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Kachemak Bay Family Planning Clinic 2.23.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Unintended Pregnancies Study 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 ver A 2.16.17.PDF HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Planned Parenthood Votes Northwest & Hawaii 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Fiscal Note DHSS-Medicaid Services 2.28.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Fiscal Note DHSS-DHCS 2.28.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Fiscal Note DCCED-DIO 2.28.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Opposing Document-America's Health Insurance Plans 2.27.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Dr. Tina Tomsen 2.27.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Support Emails 2.27.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-HB025 Support Emails 3.7.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Anne Green 3.3.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Alaska Nurses Association 3.6.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letters of Support 3.8.2017.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 25
HB025 Opposing Document-Letters of Opposition 3.8.2017.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
SSHB 54 Opposing Document--Letters 3.27.17.pdf HHSS 3/28/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54 Sectional Analysis ver O 3.27.17.pdf HHSS 3/28/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54 Sponsor Statement 3.27.17.pdf HHSS 3/28/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54 Supporting Document--Archbishop Tutu Opinion 3.27.17.pdf HHSS 3/28/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54 Supporting Document--Letters 3.27.17.pdf HHSS 3/28/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB 54.PDF HHSS 3/28/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 54
HB 10 Fiscal Note--DHSS-CSM 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Fiscal Note--DHSS-FCAR 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Fiscal Note--DHSS-CST 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Fiscal Note--DHSS-FCBR 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Fiscal Note--DHSS-FCSN 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Fiscal Note--DHSS-FLSW 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Fiscal Note--DHSS-FP 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
HB 10 Fiscal Note--JUD-ACS 4.5.17.pdf HHSS 4/6/2017 3:00:00 PM
HB 10
SSHB 54 Fiscal Note--DOL-CJL 4.5.2017.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB54 Supporing Document - Additional Letters.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB54 Supporting Document - Saturday Evening Post.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB54 Supporting Document - Skelton Op Ed.pdf HHSS 4/6/2017 3:00:00 PM
HB 54
SSHB54 Supporting Document Research 2007.pdf HHSS 4/6/2017 3:00:00 PM
HB 54