Legislature(2005 - 2006)BUTROVICH 205


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* first hearing in first committee of referral
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Moved CSHB 185(FIN) Out of Committee
Heard & Held
Scheduled But Not Heard
+ Bills Previously Heard/Scheduled 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  Pubic 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                                                               
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                                                               
DR.  MANDSAGER  responded  it is  unrelated  to  data  collection                                                               
CHAIR DYSON  asked whether data  on diabetes is just  as accurate                                                               
today as  it was  ten years  ago when the  big jumps  in diabetes                                                               
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                                                          
     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                                                                    
     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                                                                    
     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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