Legislature(2001 - 2002)
03/20/2002 01:15 PM House JUD
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 197 - HEALTH CARE SERVICES DIRECTIVES Number 0413 CHAIR ROKEBERG announced that the last order of business would be HOUSE BILL NO. 197, "An Act relating to directives for personal health care services and for medical treatment." [Before the committee was CSHB 197(HES).] Number 0430 MELANIE LESH, Staff to Representative Bill Hudson, Alaska State Legislature, sponsor, speaking on behalf of the sponsor, noted that [the proposed committee substitute (CS) for HB 197, version 22-LS0712\O, Bannister, 2/26/02,] is quite expanded from CSHB 197(HES). She mentioned that [Version O] incorporates [the Uniform Health Care Decisions Act], which is national model language that other states have also adopted. She relayed that there is also a proposed amendment that speaks to concerns raised by the Department of Health & Social Services (DHSS) regarding the emergency medical technicians' protocol for responding to do-not-resuscitate (DNR) orders. Number 0582 REPRESENTATIVE JAMES moved to adopt the proposed committee substitute (CS) for HB 197, version 22-LS0712\O, Bannister, 2/26/02, as a work draft. There being no objection, Version O was before the committee. Number 0600 SIOUX PLUMMER, President, Board of Directors, Foundation for Hospice and Home Care of Juneau Alaska, relayed that during the time she'd worked for Representative Hudson, she'd also chaired the Juneau End of Life Task Force. She said that she, along with other likeminded people, supports HB 197. Because of her interest in issues related to death and dying, she said, it became evident to her that "we could improve existing statute in Alaska for persons who wish to die here." "We could make dying better, if you'll forgive the phrase, but, in fact, dying can be improved if you would accept that language," she added. The fundamental intent of HB 197 is to clear up, improve, and make more readily available to Alaskans this language based on the idea of the "Five Wishes," language which currently exists in the state laws of 35 or more states. MS. PLUMMER reiterated her support of HB 197, and relayed her hope that HB 197 would be reported out of committee after serious consideration. She mentioned that on a personal level, she hadn't been very familiar with death and dying until [she watched] the "Bill Moyers special," which addressed dying in America and which was broadcast on public television a couple of years ago. As a result of that program, here in Juneau as well as across the nation in many cities, local groups formed to learn more about issues of death and dying. She said it was at one such conference that she learned about the Five Wishes, about why the notion of theses wishes is so prevalent throughout the United States, and about why there is a new trend in the country relating to improving issues pertaining death and dying. REPRESENTATIVE JAMES asked what the Five Wishes are. MS. PLUMMER, noting that they were listed in the sponsor statement, said that the wishes include: "The person I want to make care decisions for me when I can't"; "The kind of medical treatment I want or don't want"; "How comfortable I want to be"; "How I want other people to treat me"; and "What I want my loved ones to know." These are wishes that persons who are terminally ill or who know they are going to die soon would want to express to their caregiver, their medical provider, their family, and their loved ones. These Five Wishes are the premise upon which HB 197 is based. MS. PLUMMER relayed that within the last three years, she lost four of her closest family members: her husband, her brother, her mother, and her father. Up until that time, she said, she had never paid attention to what it must be like to die; now, because of her recent personal experiences, she has a real strong feeling about the necessity of having very clear language and clear law that enables people to die the way they would like to. Number 0823 CHAIR ROKEBERG asked Ms. Lesh to comment on the DHSS's concerns and the proposed amendment. MS. LESH said that she has just spoken with almost everyone in the "Comfort One Do-Not-Resuscitate (DNR) program" affected by the proposed amendment as it relates to Version O. She explained that [HB 197] repealed the statutes for the Comfort One DNR program, the Organ Donation program, and the Living Will program and re-enacted them in one new chapter. More importantly, the legislation added the expanded health care directives in which one can write his/her health care wishes succinctly. Ms. Lesh noted that in repealing and reenacting the aforementioned programs, the very important Comfort One DNR program was [inadvertently] left out. Under this program an individual, with a physician's consent, can obtain a bracelet and documentation which specifies that the individual has chosen, with a physician's concurrence, to not have CPR administered. Ms. Lesh said that the intent of [Amendment 1] is to [reenact] the Comfort One DNR program since the sponsor did not wish to impact the DNR protocol already existing in statute. Number 0982 RICHARD BLOCK, Christian Science Committee on Publication for the State of Alaska, testified via teleconference in support of [Version O]. First, it places the four statutes, which are currently in different locations and [are] in conflict with one another, together in harmony. He opined that that is reason enough alone to adopt the bill. Second, the bill grants a great deal of latitude to the person preparing a health care directive document in regard to how that person wishes his/her surrogate to make health care decisions on his/her behalf. Furthermore, it allows persons with religious considerations to express those and to have those protected through the health care directive. Therefore, Mr. Block said, he viewed [Version O] as positive because it returns to individuals the ability to make provisions for their own care. Mr. Block reiterated support for [Version O] and urged its adoption. Mr. Block mentioned that he couldn't comment on the amendment since he hadn't yet seen it. Number 1186 MARK JOHNSON, Chief, Community Health & Emergency Medical Services, Division of Public Health, Department of Health & Social Services (DHSS), announced support of the intent of HB 197. As mentioned earlier, the Comfort One DNR program is already in place for the EMS (Emergency Medical Services) community, and seems to be working. He noted that there had been a discussion with the sponsor [regarding working out that issue]. He informed the committee that EMS providers are trained to restore life whenever possible, but there is no desire to prolong suffering at the end of someone's life. CHAIR ROKEBERG asked if Amendment 1 satisfies [the DHSS's] concerns as relayed in the letter in the committee packet. MR. JOHNSON answered that he believes the sponsor intends to satisfy those concerns, although it still needs to be sorted out a bit. He remarked that it's clear to him that the sponsor shares [the DHSS's] goal. Number 1262 LYN FREEMAN, Executive Director, Alaska Commission on Aging, Division of Senior Services, Department of Administration, testified in support of Version O. She relayed that the commission feels that it's very important and meaningful that this draft incorporates the Uniform Health Care Decisions Act and includes the Five Wishes form. Specifically, the commission is pleased with the thoroughness, completeness, and understanding of the Five Wishes component for the general population. She relayed the importance this kind of direction has for the individual and their family members. Ms. Freeman encouraged the committee to support Version O. Number 1402 MARIE DARLIN, AARP Capitol City Task Force, informed the committee that AARP was one of the organizations that pushed for this legislation to be introduced last year. Ms. Darlin said AARP wants to urge the committee's support. She pointed out that the committee should have a letter from AARP's legislative committee, which supports the bill. The idea of placing all the directives in one location [in statute] is very important. She explained that the AARP really likes the Five Wishes because it opens up the opportunity for families to discuss what an individual's last wishes would be in a situation in which the individual can't make his/her own decisions. Ms. Darlin relayed the belief that discussions regarding amendments will take care of most everything of concern. Number 1462 REPRESENTATIVE COGHILL moved to adopt Amendment 1, 22- LS0712\O.1, Bannister, 3/20/02, which read: Page 7, line 19: Delete "do not resuscitate protocol" Insert "protocol for do not resuscitate orders" Page 10, line 30: Delete "orders not to resuscitate" Insert "do not resuscitate orders" Page 18, following line 29: Insert new paragraphs to read: "(4) "cardiopulmonary resuscitation" means cardiopulmonary resuscitation or a component of cardiopulmonary resuscitation; (5) "do not resuscitate order" means a directive from a licensed physician that emergency cardiopulmonary resuscitation should not be administered to a qualified patient; in this paragraph, (A) "qualified patient" means a patient who has been determined by the attending physician to be in a terminal condition; (B) "terminal condition" means a progressive incurable or irreversible condition that, without the administration of life-sustaining procedures, will, in the opinion of two physicians, when available, who have personally examined the patient, one of whom must be the attending physician, result in death within a relatively short time; in this subparagraph, "life-sustaining procedures" means medical procedures or interventions that, when administered to a qualified patient, will serve only to prolong the dying process; " Renumber the following paragraphs accordingly. Page 19, lines 2 - 3: Delete "do not resuscitate protocol" Insert "protocol for do not resuscitate orders that is" Page 19, line 12: Delete "orders not to resuscitate" Insert "do not resuscitate orders" CHAIR ROKEBERG, noting that there was no objection, stated that Amendment 1 was adopted. CHAIR ROKEBERG announced that public testimony would be held open for HB 197. [HB 197, Version O, as amended, was held over.]
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