Legislature(1997 - 1998)

03/05/1997 09:06 AM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
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          SB  99 HEALTH CARE DATA; BIRTH REGISTRATIONS                        
                                                                              
                                                                               
 Number 252                                                                    
                                                                               
  CHAIRMAN WILKEN  introduced  SB 99  as the next order of business            
 before the committee.                                                         
                                                                               
  AL ZANGRI , Chief of the Bureau of Vital Statistics for DHSS,                
 explained that Sections 1 and 2 of SB 99 establish civil immunity             
 for institutions and providers who report diseases and conditions             
 to the department as required under other portions of the statute.            
 Without SB 99, the department could lose $300,000 to $400,000 per             
 year in cancer grants.  Sections 3 and 4 clarify the language in              
 the Vital Statistics Act regarding the reporting requirements for             
 births and institutions as well as shortening the time period from            
 seven to five days.  There is also a language change in determining           
 how reports are made for moving conveyances.  Mr. Zangri noted the            
 most important change as being the elimination of a signature for             
 every birth certificate produced in a hospital.  This would allow             
 the bureau to operate its electronic birth certificate system.  All           
 but two hospitals in the state have electronic birth certificate              
 systems.  Currently, each hospital must send a paper copy of the              
 birth certificate with a hand signature.  SB 99 would allow                   
 electronic signatures or group signatures for all the births during           
 a week.                                                                       
                                                                               
   In response to Senator Green,  AL ZANGRI  clarified that SB 99 does         
 not release information.  SB 99 grants civil immunity to facilities           
 already required to report that information.  Current law requires            
 that providers report this information to the department, however             
 if the information has not been properly used then the individual             
 can be sued.  SB 99 grants civil immunity for providing that                  
 information unless the case is pure negligence.  Mr. Zangri pointed           
 out that this immunity is required under federal statutes if the              
 cancer grant is to continue.                                                  
                                                                               
 Number 318                                                                    
                                                                               
  DR. JOHN MIDDAUGH , Chief of the Epidemiology Section in DHSS,               
 explained that the immunity protection is only for those reporting            
 in compliance with state law.  The data is being reported to the              
 Division of Public Health.  The data is not disclosable under                 
 Alaska's public records law and can only be released if there is an           
 eminent and direct public health threat to another person.  Dr.               
 Middaugh noted that the data is provided with identifiers only so             
 that duplicate reporting can be eliminated.  Dr. Middaugh                     
 reiterated that the data is protected by the Alaska statutes                  
 regarding confidentiality.                                                    
                                                                               
  SENATOR GREEN  expressed concern with the sectional analysis of              
 Section 1 which says that, "This immunity protects the person                 
 reporting the information regardless of how the Department uses the           
 information."  Senator Green did not know if that accurately                  
 reflected the intent of the bill.  Senator Green wanted to be sure            
 that a medical provider would not be required to provide                      
 information that would not ordinarily be provided.                            
                                                                               
  DR. JOHN MIDDAUGH  said that the bill only provides protection for           
 the information required to be reported under Alaska statutes and             
 regulations.                                                                  
                                                                               
  CHAIRMAN WILKEN  pointed out that he had a list of the diseases              
 required to be reported on a daily basis.                                     
                                                                               
  SENATOR WARD  asked if this was necessary to receive the first of            
 five increments of $420,000; is this a new program?   DR. JOHN                
 MIDDAUGH  clarified that the grant was awarded in October of 1994.            
 During the first year, regulations were revised in order to be in             
 compliance with establishing the cancer registry component of the             
 reporting requirements.  The regulations went into effect in                  
 January of 1996.  The first year of collection of this information            
 on cancer statewide has been completed.  The other disease reports            
 for infectious disease in some cases go back to territorial days.             
 The funds received to establish the cancer registry are part of the           
 federal legislative program, the Cancer Registries Amendment Act,             
 which establishes uniform cancer registries in all 50 states.  Dr.            
 Middaugh noted that work to establish a cancer registry in Alaska             
 had been going on for 20 years; these funds allowed such a                    
 registry.  In order to maintain compliance of the requirements of             
 the federal law, these three provisions require statutory changes             
 and cannot be dealt with in regulation.  Dr. Middaugh informed the            
 committee that SB 99 has been endorsed by the Alaska Hospital &               
 Nursing Home Association, the Alaska State Medical Association, and           
 the Alaska Division of the American Cancer Society.                           
                                                                               
 Number 375                                                                    
                                                                               
  SENATOR WARD  asked if the program comes out of the $420,000 or is           
 this an additional program.  Are there matching funds?   DR. JOHN             
 MIDDAUGH  said that there are no matching funds involved.  This is            
 an ongoing grant which is now in the third year of a five year                
 project.  Without these additional statutory changes, there may be            
 a risk in losing the award.  Dr. Middaugh noted that this really              
 protects the data, the patients, and the providers.  In response to           
 Senator Ward, Dr. Middaugh replied that there has not been any                
 implication that the money would be withdrawn without the                     
 implementation.  However as part of the federal law and the grant             
 award, the department has to certify that efforts attempting to               
 comply with the federal legislation have been made.                           
                                                                               
                                                                               
  SENATOR WARD  inquired as to what portion of the funds goes towards          
 the cancer reporting.   DR. JOHN MIDDAUGH  specified that all of the          
 funds are used for cancer reporting.  All other diseases are                  
 required to be reported to the Division of Public Health for public           
 health protection.  Dr. Middaugh noted that the other diseases were           
 included due to the rationale for uniformity and protection for               
 patients, physicians, and the state.  In response to Senator Ward,            
 Dr. John Middaugh agreed that the inclusion of the other diseases             
 was not necessary to receive the funds.                                       
                                                                               
  DR. MIDDAUGH  reiterated the strong support for SB 99 from the               
 medical community.                                                            
  CHAIRMAN WILKEN  said that he would entertain a motion to report SB
 99 to its next committee of referral.                                         
                                                                               
  SENATOR WARD  moved to report SB 99 out of committee   with individua        
 recommendations and a zero fiscal note.  Without objection, it was            
 so ordered.                                                                   

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