Legislature(2005 - 2006)BUTROVICH 205

02/08/2006 01:30 PM HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Immediately Following Session --
*+ SB 251 POSTSEC. STUDENT MENINGITIS IMMUNIZATION TELECONFERENCED
Scheduled But Not Heard
*+ SB 252 DEFINITION OF CHILD ABUSE AND NEGLECT TELECONFERENCED
Moved SB 252 Out of Committee
+= SB 235 SCHOOL PERFORMANCE BONUSES TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
          SB 252-DEFINITION OF CHILD ABUSE AND NEGLECT                                                                      
                                                                                                                                
CHAIR DYSON announced SB 252 to be up for discussion.                                                                           
                                                                                                                                
2:13:56 PM                                                                                                                    
                                                                                                                                
JOANNE  GIBBENS,  Program  Administrator,  Office  of  Children's                                                               
Services (OCS), Department of Health  and Social Services (DHSS),                                                               
introduced herself  and Stacie  Kraly of  the Department  of Law.                                                               
Ms. Gibbens  explained that  the intent  of SB  252 is  simply to                                                               
comply  with federal  law.   In  2003, the  Keeping Children  and                                                               
Families  Safe Act  amended a  federal  law known  as CAPTA,  the                                                               
Child Abuse Prevention  and Treatment Act.  An  amendment to that                                                               
federal law  now requires states  to have  in place a  process to                                                               
investigate, provide  services and  look into cases  where health                                                               
care providers have reported issues  to child protective services                                                               
regarding illegal substance abuse and its effect on children.                                                                   
                                                                                                                                
She   said  this   bill  therefore   ensures  that   health  care                                                               
professionals report  to the child protective  service agency any                                                               
infants  affected  by  abuse  of a  controlled  substance  or  by                                                               
withdrawal  from prenatal  exposure  to  a controlled  substance.                                                               
Other parts  of the federal law  require that OCS develop  a plan                                                               
of care and so forth.   All requirements in the federal amendment                                                               
are things  OCS does  already, including  receiving reports  on a                                                               
regular basis from hospital personnel  if, for example, a baby is                                                               
born  who   generates  a  concern  about   cocaine  or  marijuana                                                               
exposure.   The  key piece  of  the legislation  is putting  into                                                               
statute  the requirement  that health  care providers  make those                                                               
reports.                                                                                                                        
                                                                                                                                
2:16:05 PM                                                                                                                    
                                                                                                                                
SENATOR ELTON referred to an  e-mail from the Alaska Primary Care                                                               
Association expressing concern that  the bill may discourage some                                                               
people from going to a community health clinic.                                                                                 
                                                                                                                                
MS.  GIBBENS acknowledged  that  people who  fear being  reported                                                               
might  not  go to  a  health  care  provider for  prenatal  care.                                                               
However, this  bill, and  the federal intent,  is to  ensure that                                                               
it's the health  care providers involved in the  delivery or care                                                               
of an  infant who'll  make that  report.   She indicated  for OCS                                                               
it's  "safety first":   if  there  is concern  about an  infant's                                                               
health, the hope is that  it's reported so necessary services can                                                               
be provided.                                                                                                                    
                                                                                                                                
She  discounted the  notion that  OCS  would be  standing at  the                                                               
doorway, waiting  for the mother to  give birth.  She  noted that                                                               
hospitals and health care providers  have their own protocols for                                                               
determining when a situation has  reached a level where the state                                                               
should  be involved,  which is  why  OCS receives  calls now  and                                                               
responds  to them.   Although  not an  expert in  substance abuse                                                               
itself, she  emphasized that  the bill is  limited to  the health                                                               
care providers who  have the expertise to judge  whether there is                                                               
harm to an infant.                                                                                                              
                                                                                                                                
2:19:19 PM                                                                                                                    
                                                                                                                                
SENATOR  ELTON expressed  surprise  that there  wasn't already  a                                                               
statutory  requirement  because  of  requirements  for  reporting                                                               
instances of abuse.  He asked  whether perhaps the bill is needed                                                               
because some people in the medical field aren't reporting now.                                                                  
                                                                                                                                
MS.  GIBBENS responded  that she  doesn't  believe current  child                                                               
protection  statutes specifically  mention the  use or  effect of                                                               
illegal or  controlled substances on infants,  including prenatal                                                               
exposure or  withdrawal; she  deferred to  Ms. Kraly  for further                                                               
detail.   Ms. Gibbens said she'd  consulted with a number  of OCS                                                               
offices in  preparing for her  testimony, and  unanimously across                                                               
the  state those  calls are  being received.   Although  it's not                                                               
specifically in  law now, health  care providers see it  as their                                                               
obligation  to  call  so  that  OCS  can  be  there  to  make  an                                                               
assessment,  ensure the  children are  safe and  perhaps get  the                                                               
mothers  into treatment.    Thus she  didn't  anticipate a  large                                                               
increase in calls due to this bill.                                                                                             
                                                                                                                                
2:21:12 PM                                                                                                                    
                                                                                                                                
CHAIR  DYSON offered  his belief  that when  a parent  is abusing                                                               
illegal drugs, under  current statute the child  is identified as                                                               
a child in need of aid.   He asked Ms. Kraly whether detection of                                                               
cocaine in an infant might precipitate the mother's arrest.                                                                     
                                                                                                                                
STACIE  KRALY,  Chief  Assistant  Attorney  General  -  Statewide                                                               
Section  Supervisor,  Human  Services  Section,  Civil  Division,                                                               
Department of  Law (DOL), pointed  out that she  doesn't practice                                                               
criminal law.   She then opined that the  referral would probably                                                               
be  made  if  a  toxicology  report  showed  the  presence  of  a                                                               
controlled substance  in both the  baby and the mother.   There'd                                                               
be a  report of  harm and  also a referral  to a  law enforcement                                                               
agency in  order to determine  whether charges would  be brought;                                                               
those are  discretionary functions  of the district  attorneys in                                                               
the areas they  cover.  She acknowledged  the possibility, though                                                               
she wasn't sure how often it happened.                                                                                          
                                                                                                                                
CHAIR DYSON  referred to Senator Elton's  concern and highlighted                                                               
that  providers want  to get  care to  the right  people and  not                                                               
scare  off those  who need  it most.   He  asked what  happens if                                                               
prenatal   care,  including   amniocentesis,   raises  a   strong                                                               
possibility of cocaine use before the child is born.                                                                            
                                                                                                                                
2:23:35 PM                                                                                                                    
                                                                                                                                
MS. KRALY responded that DOL is  getting calls such as reports of                                                               
harm  relating  to  a mother's  consuming  controlled  substances                                                               
during a  pregnancy.  From  a jurisdictional  standpoint, neither                                                               
OCS nor DOL  has authority over an unborn child.   From a program                                                               
standpoint, however, the  family is referred to  OCS, [DOL] takes                                                               
the  report of  harm,  there is  an assessment  and  there is  an                                                               
effort to provide services and work  with the family prior to the                                                               
child's  birth  in order  to  ameliorate  difficulties or  issues                                                               
arising in the home.                                                                                                            
                                                                                                                                
2:24:48 PM                                                                                                                    
                                                                                                                                
CHAIR DYSON  noted that Senator  Green had joined the  meeting at                                                               
approximately 2:15 p.m.                                                                                                         
                                                                                                                                
SENATOR GREEN  referred to page 1,  line 9, and asked  whether it                                                               
is grammatically correct.                                                                                                       
                                                                                                                                
MS. KRALY agreed  it is a clumsy sentence.   She indicated DOL is                                                               
working on  an amendment to  a companion  bill in the  House with                                                               
the  chair of  the House  Health, Education  and Social  Services                                                               
Standing Committee to make it more readable.                                                                                    
                                                                                                                                
SENATOR ELTON  observed that the  bill is narrowly  written, only                                                               
applying to  a health care  provider involved in the  delivery or                                                               
care  of  an  infant.    It excludes  the  rest  of  the  medical                                                               
community, who also may be aware of circumstances.                                                                              
                                                                                                                                
MS. GIBBENS  related her understanding  that this  bill basically                                                               
repeats, verbatim,  what the federal  law requires;  she surmised                                                               
it is due to the level  of expertise of the health care providers                                                               
who are  at the delivery  or who provide care  to the baby.   She                                                               
noted, however,  that all health care  professionals are mandated                                                               
reporters for child abuse and neglect in Alaska.                                                                                
                                                                                                                                
2:27:47 PM                                                                                                                    
                                                                                                                                
SENATOR ELTON requested  that someone get back to  him to explain                                                               
why the bill  is so narrow.  He voiced  concern about the ability                                                               
of a medical professional to  report if that professional doesn't                                                               
fit the criteria but notices a problem.                                                                                         
                                                                                                                                
CHAIR  DYSON asked  whether anyone  else wished  to testify.   He                                                               
surmised that, in addition to  bringing the statutes in line with                                                               
current  practice  and  federal  requirements,  this  bill  would                                                               
affect federal funding.                                                                                                         
                                                                                                                                
MS.  GIBBENS or  MS. KRALY  concurred.   In  response to  Senator                                                               
Green, she said depending on how  the language is finessed in the                                                               
House Health,  Education and Social Services  Standing Committee,                                                               
she'd propose that the Judiciary committee conform the language.                                                                
                                                                                                                                
2:28:51 PM                                                                                                                    
                                                                                                                                
SENATOR GREEN moved  to report SB 252 from committee  with a zero                                                               
fiscal note and a note to  ask the Judiciary committee to look at                                                               
conforming  language.   Without  objection, SB  252 was  reported                                                               
from the  Senate Health, Education  and Social  Services Standing                                                               
Committee.                                                                                                                      

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