Legislature(2011 - 2012)SENATE FINANCE 532
02/15/2012 09:00 AM FINANCE
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SENATE BILL NO. 144 "An Act temporarily reinstating the child and adult immunization program in the Department of Health and Social Services; and providing for an effective date." SENATOR CATHY GIESSEL presented SB 144 and stated that the legislation would restore funding for the state's vaccine program and benefit every single Alaskan. She related a story about George Washington and the history of vaccination. She observed that although the older generation of Americans had all received a small pox immunization, children in America were not currently receiving that vaccination because the vaccine had eliminated that disease from the world. She stated that vaccine had a significant impact and discussed a 1925 incident in Nome that was referred to as "the great race of mercy." In 1925, diphtheria was sweeping through Nome, which only had one physician and four nurses. The physician in Nome at the time sent word out that the anti-toxin for diphtheria was needed; the only way to get the anti-toxin to Nome was via dog sled. She observed that the Iditarod Race celebrated the great race of mercy and noted that the anti-toxin had saved lives in the community of Nome. She discussed the symptoms of diphtheria and how it used to be treated. The diphtheria vaccination was combined with several other immunizations in the same vaccine, which also contained tetanus, also known as "lock jaw", and pertussis, otherwise known as "whooping cough." She discussed a 2009 outbreak of whooping cough in Juneau and related that it was a serious disease, particularly for young children because it impaired their ability to breathe. She shared that because of vaccine, whooping cough was able to be controlled and related that vaccines had nearly eliminated polio from the world. She stated that the late Senator, Ted Stevens, had secured funding for a universal vaccine program in Alaska that would provide vaccination for children and adults. She shared that there were two sources of funding for vaccines in Alaska; one source was for children's vaccines and was a secured source. She pointed out that other source of funding was from Section 317 of U.S. Public Health Code, but that this funding source was not secure and had been significantly decreased. The Section 317 funding used to equal $4.3 million, but Alaska would only receive $700,000 in the upcoming fiscal year. She related that the governor had already included $700,000 in his budget and that SB 144 would provide an additional $2.9 million. 10:46:13 AM Senator Ellis indicated that he had been contacted by a number of individuals regarding SB 144. He stated that people seemed to generally support the bill, but had questions as to why the program did not include the HPV and meningococcal meningitis vaccines. He mentioned that both vaccines were recommended for teenage boys and girls. Senator Giessel responded that her focus was to craft a bill that addressed the required vaccines for children who were entering school, as well as diseases that adults carry that are deadly or contagious to children. She stated that the Section 317 funding had been decreasing and that the cost-benefit ratio was lower on the HPV and meningococcal meningitis vaccines; the Division of Public Health had examined the cost-benefit ratio of different vaccines and had eliminated those two vaccines first, when the funding had begun to fall. She concluded that the bill's funding was "seriously" needed and that she had crafted legislation that was very likely to pass. Senator Ellis inquired if the exclusion of the HPV and meningococcal meningitis vaccines was purely based on funding or whether it was a political decision regarding HPV. Senator Giessel responded that the bill gave the power to add additional vaccines, should funding become available, to the commissioner of the Department of Health and Social Services. Co-Chair Stedman discussed a fiscal note from the Department of Health and Social Services in the amount of $2.9 million in general fund cost for the next three fiscal years. MARY SULLIVAN, COORDINATOR, ALASKA PRIMARY CARE ASSOCIATION, ANCHORAGE (via teleconference), expressed the association's strong support of SB 144, as well its companion bill in the House of Representatives. She stated that the association represented Alaska's community health centers, which served uninsured and underinsured individuals across the state. She related that one of the association's smaller clinics in Talkeetna would be in zero compliance with immunizations due to a lack of funding. She related that neither the association nor its providers had expressed a problem with the legislation's exclusion of the HPV and meningococcal meningitis vaccines. 10:52:23 AM AT EASE 10:52:29 AM RECONVENED ROSALYN SINGLETON, ALASKA NATIVE TRIBAL HEALTH CONSORTIUM, ANCHORAGE (via teleconference), testified in support of SB 144. She related that when she had started as a pediatrician in Alaska, more than 40 infants per year were hospitalized with hib meningitis; some of the infants died, while 30 percent were left with permanent brain damage or deafness. She shared that before vaccines, Alaska also had large epidemics of hepatitis A, but that an effective vaccine had been licensed and had nearly eliminated hepatitis A from Alaska. She shared that there had been no outbreaks of hepatitis A since the release of the vaccine in 1995 and that there had been a significant amount of money saved as a result. She mentioned that measles had been under control in Alaska since 1998. She offered that the legislation was a "stop-gap" effort to increase access to vaccines and that if the bill did not pass, the state immunization program would be unable to provide any vaccines to children outside of the federally funded vaccines for the uninsured, Medicaid users, and Alaska Native children. She concluded that when faced with the high cost of vaccines, many medical practices were not providing vaccines at all and that many parents were deferring vaccines until it was required for school; these factors represented an increased risk to Alaska's public health. GEORGE BROWN, ACADEMY OF PEDIATRICS ALASKA & ALL ALASKA PEDIATRIC PARTNERSHIP, spoke in support of SB 144. He stated that Washington and New Hampshire had programs in which pharmacists, the makers of vaccines, insurance companies, and the legislated public funds for vaccines were in one program that provided universal vaccines. He offered that vaccines clearly helped to contain the costs of healthcare. 10:57:21 AM WARD HURLBURT, CHIEF MEDICAL OFFICER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, DIRECTOR, DIVISION OF PUBLIC HEALTH, testified in support of SB 144. He related that when he had started practicing in Alaska in 1961, 25 out of every 1,000 children who were born died from "these diseases," but that currently, only seven children out of every 1,000 born died per year from all the causes of death combined.["These diseases" was made in reference to diseases that are preventable through vaccines.] He shared that 37 states put state money towards buying vaccines and stated that immunization was both an individual and a public issue. He observed that immunizing a person protected that individual from a disease, but that "herd immunity," which protected others, took place when there was sufficient immunization within a population. He discussed an outbreak of whooping cough in California, which had infected over 2,000 children and killed ten infants. He stated that the vaccines in the bill were selected with fiscal prudence and public health in mind. He pointed out that "quality adjusted life-year" was a term that referred to the cost of saving a year of a person's life and that the immunizations that were covered by the legislation were those that cost $25,000 or less per year; the vaccinations that were not selected in the legislation were those that cost $50,000 per year or more. Mr. Rose expressed the Association of Alaska School Boards' support of SB 144. 11:00:05 AM SB 144 was HEARD and HELD in committee for further consideration. Co-Chair Stedman discussed the following meeting's agenda.