Legislature(2005 - 2006)BUTROVICH 205
04/20/2005 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB185 | |
| SB162 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 185 | TELECONFERENCED | |
| *+ | SB 162 | TELECONFERENCED | |
| *+ | SB 177 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 162-REPORT STUDENT HEALTH/DISCIPLINE/SAFETY
CHAIR DYSON announced SB 162 to be up for consideration. He
advised that he worked on a bill called School Safety and
Behavioral Standards, which required that every school establish
its behavioral and safety standards with parents and community
leaders. Under the bill, schools were required to publish the
standards so that there would not be any controversy when they
enforced them. Five years later, the records of the Department
of Education show that few schools are complying with the bill.
A few additional requirements have been incorporated into the
current bill that he hopes will bring greater compliance on the
part of the schools.
1:51:33 PM
DR. MANDSAGER, Director, Division of Public Health, said he
would like to impart some of the data on obesity in the State of
Alaska. The department believes obesity contributes greatly to
both Medicaid expenses and to the general expenses of the state.
The problem of obesity is growing at an incredibly rapid rate in
the State of Alaska and in the nation. Currently 32 percent of
children in the Anchorage School District are overweight when
they enter elementary school and over 40 percent of Alaska high
school students are overweight or at risk of becoming overweight
by the time that they graduate. In the last five years alone,
the proportion of children in the Anchorage School district that
are of normal weight decreased from 65 percent to 60 percent of
the district's student population.
Obesity is a growing problem for adults in Alaska as well.
Between the years of 1991 and 2003 the proportion of Alaska
adults considered obese or overweight grew from 49 percent of
the total population in 1991 to 62 percent of the total
population in 2003. Today, 43 percent of Alaskan adults do not
meet the Center for Disease Control's (CDC) recommendations for
physical activity.
Today only 18 percent of high-school students participate in
daily physical education, 27 percent do not meet the CDC's
minimum recommendations for physical activity, 28 percent watch
three or more hours of television on an average school day and
only 16 percent consume at least 5 daily servings of fruits and
vegetables.
There have been recent significant changes in the food
environment of American children that have contributed to the
growing obesity problem. More children are consuming more meals
outside of the home and the portions of those meals are becoming
larger. Today 43 percent of American's elementary schools and 98
percent of its high schools sell low-nutrient, high calorie a la
carte and vending machine foods and beverages.
National trends are reflected in the nutrition environment of
Alaska schools. Today only 28 percent prohibit soda during lunch
and only 17 percent of Alaskan schools with vending machines
have policies regulating the content of these machines.
The Federal Woman, Infants and Children Act passed in 2004 will
implement requirements for schools receiving WIC funding during
the 2006-2007 school year. Its mandate will require schools to
establish goals for nutritional education and physical activity,
nutrition guidelines for foods available at school during the
day and the establishment of a plan for measuring the
implementation of a school's wellness policy. Currently 89
percent of Alaska school districts and 87 percent of Alaska
schools participate in the National School Lunch Program
provided through WIC funding.
SENATOR ELTON asked Dr. Mandsager whether the WIC requirements
would be applied to schools individually or to school districts.
DR. MANDSAGER did not remember.
SENATOR GREEN said she believes the bill would be applied to the
school districts.
2:03:33 PM
DR. MANDSAGER said overweight children are at a significantly
greater risk of developing high blood pressure, high
cholesterol, orthopedic disorders, type 2 diabetes and
psychological disorders. Overweight adults face an increased
risk of premature mortality, cardiovascular disease, Type 2
diabetes, musculoskeletal disorders, sleep apnea, gall bladder
disease, arthritis and certain types of cancer.
There is a tremendous controversy among scientists over the cost
of obesity. A year ago it was thought to be the number two cause
of death in American after tobacco. Last fall the Center for
Disease Control released information, in the presence of intense
internal scientific argument, reducing the estimate of obesity
related deaths from 400,000 to 375,000 deaths annually. It
recently lowered its estimate to 100,000 obesity related deaths
per year. These figures seem to indicate that nobody really
knows the death consequence of obesity.
Despite the controversy over the issue of death, the rate of
incidence of obesity related diseases, particularly Type 2
diabetes, and the financial cost of these diseases is better
known. Obesity costs Alaska $195 million annually in direct
medical expenses, $17 million of which is financed by Medicare
and $29 million that is financed by Medicaid. Diabetes in Alaska
has doubled in the past 10 years. Today five percent of Alaska's
adult population has been told by a doctor that they have
diabetes and diabetes is one of the top five causes of death in
the state. It is estimated that one in three children born in
the year 2000 will develop diabetes as a consequence of obesity.
2:11:47 PM
CHAIR DYSON asked whether the recent increase in the rate of
diabetes is due to recent improvements in data recording
methods.
DR. MANDSAGER responded it is unrelated to data collection
techniques.
CHAIR DYSON asked whether data on diabetes is just as accurate
today as it was ten years ago when the big jumps in diabetes
began.
DR. MANSAGER replied:
It is with one caveat. If you assume that the accuracy
of diagnosis and the codes are the same as they were
ten year ago, then your statement is valid.
2:16:41 PM
DR. MANDSAGER continued SB 162 would help to address the problem
by requiring schools to determine the average body mass index
(BMI) of their students. This would give schools information
from which to develop their own welfare and wellness policies.
He added:
There is an amendment that I would suggest be
considered if this bill is to move. On page 3 of the
bill, on line 29, current statute says that the
Department of Health and Social Services shall train
and certify public health nurses and school districts
to conduct hearing and screening tests. In fact, we
are not meeting that statute today. We are assisting
school districts when we are requested to train, but
we aren't certifying anybody and we clearly don't
train everybody.
We have submitted a zero fiscal note with the
assumption that we can come to an understanding that
the wording for that can be changed to say, "assist
the department of education and early development in
training school district employees." If this bill were
to be moved, that would be my suggestion for a change.
CHAIR DYSON understood Dr. Mandsager to have implied schools
that are proactive in addressing the problem would have a
greater chance of receiving funds to help facilitate their
efforts.
DR. MANDSAGER said the department has a proposal with Senator
Stevens to increase the funding for its obesity program and he
envisions using that money in partnership with schools. He said
the compilation of BMI data in the Anchorage school district has
encouraged the community, the mayor's office and the school to
discuss the problem.
CHAIR DYSON said:
So getting the information on the BMI gives the school
districts a baseline to decide if and where they have
a problem and a baseline to evaluate the effectiveness
of whatever they do. Having that baseline is going to
help them to convince the funding sources that there
is a problem that needs to be addressed.
DR. MANDSAGER said:
I would also argue that it gives information to
communities to decide what they, as communities, want
to do to address the problem.
2:21:42 PM
BEVERLY SMITH, Christian Science Committee on Publication,
Alaska, said:
The Committee on Publication for Alaska respectfully
requests an amendment on page 3 to add part C which
would say, 'Notwithstanding A of this section, a
person required to conduct a test or cause a child to
receive a vision, weight, height and hearing screening
under this section is exempt from this requirement if
the parent or guardian of the child objects to the
testing procedure on the grounds that the procedure
conflicts with the religious tenants or practices of
the parent of guardian.' The parent shall sign a
statement that the parent knowingly refuses the
examination and the person conducting the test or
causing the child to receive an examination shall have
a copy of this signed statement retained in the school
record.
Parents that use prayer and spiritual means for the
care and healing of their children can choose to
object to a vision, weight, height and hearing
examination. Christian Science is one of the religious
non-medical forms of treatment that relies on
spiritual means through prayer to heal illness,
injuries and other conditions.
2:25:01 PM
SENATOR GREEN said:
Over time the school has become the doctor's office
for many people and for people who prefer not to go to
a medical doctor, it becomes an end-run around their
choice. That is my concern with this bill. I think
that it goes too far and I think it creates an
incredible reporting burden for many schools and
people.
I think that Dr. Mandsager's stated lack of success
tying to change the diets of some of his obesity
patients demonstrates that we don't impact people very
well this way and I certainly don't want the
Legislature involved in it. This is a laudable goal,
but a strange way of going about it.
BARBARA TOMPSON, director, Division of Teaching and Learning
Support, DHSS, said:
I am here to speak to the fiscal note that we
prepared. It indicates that the costs related to the
bill are indeterminate at this time. We know that we
would have to draft and implement a number of
regulations related to the collecting and recording of
data that the school districts are required to provide
under this bill. We just don't know what they will
translate into cost-wise.
To speak to the amendment that was proposed, if the
language is changed to have the Department of Health
and Social Services assist the Department of Education
in Training, the fiscal note will have to be revised
because we did not account for the way that it will
affect the fiscal note.
2:32:51 PM
CHAIR DYSON asked whether the department has taken a position on
this bill.
MS. THOMPSON said the department has not taken an official
position on the bill.
CHAIR DYSON said he does not see how writing down the height and
weight of a kid on a chart is going to be especially difficult
for a school. Overweight children coming out of the schools
represent a great unfunded mandate upon the state and some of
that costs associated with it should be transferred to the
schools that are in part responsible for them.
2:36:56 PM
SENATOR GREEN said she was not referring to measurements of
height and weight, which she believes are already taken, but
rather to the costs that are associated with the collection and
analysis of the data. She asked if a "Body Mass Index" (BMI)
refers to a diagnosis.
2:38:21 PM
DR. MANDSAGER said the BMI is only a screen and not a diagnosis.
It is the best test for obesity that the schools can reasonably
be expected to administer.
2:43:14 PM
DR. OLSON remarked he would like to hear the position of private
schools on the bill.
CHAIR DYSON held SB 162 in committee. There being no further
business to come before the committee, he adjourned the meeting
at 2:45 PM.
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