Legislature(2013 - 2014)BUTROVICH 205
02/19/2014 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB161 | |
| SB151 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 161 | TELECONFERENCED | |
| *+ | SB 151 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 161-AUTOPSIES AND DEATH CERTIFICATES
1:34:49 PM
CHAIR STEDMAN announced that the first order of business would
be SB 161.
1:35:18 PM
DAVID SCOTT, Staff, Senator Donny Olson, Alaska State
Legislature, Juneau, Alaska, explained SB 161 on behalf of the
sponsor. He said the bill was introduced to try to alleviate
some unforeseen difficulties for families in rural Alaska when a
loved one dies and the body must be transported to Anchorage for
an autopsy. There are misunderstandings created by forms that
are used resulting in high costs for funeral home expenses.
He noted new sections of the bill which would clarify that not
every death that requires an autopsy must be transported to
Anchorage. The bill also provides telemedicine options to try to
save the state money. The state currently uses general fund
dollars to transport remains from rural communities to Anchorage
and back.
1:37:34 PM
MR. SCOTT explained changes in the bill. In Section 1 on line
13, "may" was deleted and "shall" was inserted. On page 2, line
3, the sponsor requests a discussion of language he is ready to
remove. It says "by a policy of the transporting entity", which
means an airline could require embalming. The sponsor does not
believe the policy of a private company should affect what the
state does. He said the sponsor is willing to negotiate that
issue.
He said Section 2 adds two subsections so autopsies don't all
have to be conducted in Anchorage, but could be done by video
technology. Section 2 (g) is a new section of law which provides
that a person who is responsible for the burial of a body would
receive a form from the State Medical Examiner's Office.
Section 3 conforms to Section 4, which requires that if there is
no funeral director in a community, a person shall be designated
by the state registrar to file the death certificate and obtain
personal data from the next of kin or best qualified person.
Section 5 conforms to Section 6, which requires that the medical
examiner shall obtain a burial-transit permit before a body is
transported.
1:40:25 PM
MR. SCOTT noted a DHSS fiscal note and a draft form from the
State Medical Examiner's Office in members' packets. He
highlighted the first line of the form which states that there
is no legal requirement for the use of a funeral home.
He concluded that the bill is an effort to alleviate family
suffering during tough times.
CHAIR STEDMAN noted a DHSS fiscal note for $115,000 in general
funds to implement these changes.
He opened public testimony.
1:41:47 PM
RAEBELLE WHITCOMB, Director, Workforce Development Center,
Bristol Bay Native Association (BBNA), Dillingham, Alaska,
testified in support of SB 161. She said she is also testifying
on behalf of her family. She explained that from BBNA's
perspective, the legal requirement for the use of the State
Medical Examiner has caused additional burdens on families. She
related that BBNA provides burial assistance along with the
state. Many times BBNA has had to deal with costs of embalming
and air transportation. Limited funding has an impact on the
state and tribal organization.
She related that sometimes the requirements go against the
family's wishes and values. For example, embalming before
transportation is not a customary and traditional practice.
She shared a person story on behalf of herself and her family.
They were forced to pay for embalming costs at a funeral home in
Anchorage and the expense was a significant burden. Also, the
need to transport an individual out of state entails an extra
charge for a container and embalming. She said another issue is
that the body is not released until the bill is paid in full.
She concluded that the bill is important to people in rural
areas.
1:46:43 PM
JACKIE RUSSELL, Social Worker, Bristol Bay Area Health
Corporation (BBAHC), Dillingham, Alaska, testified in support of
SB 161. She concurred with the previous speaker and emphasized
how important the bill is to rural communities. She shared the
services available at BBAHC, such as telemedicine, and suggested
that they could cooperate with the medical examiner to cut
costs. She said she hopes the committee will pass the bill.
1:49:10 PM
KERRE SHELTON, Director, Alaska Division of Public Health,
Department of Health & Social Services, Safety, Anchorage,
Alaska, testified in support of SB 161. She stated that the bill
is very important to the Division, and the care of families in
Alaska is very critical to the Division and to the State Medical
Examiner's Office.
She related that the State Medical Examiner's Office is in
Anchorage and exists to determine cause and manner of death for
cases that are brought under their jurisdiction. There are
between 1,600 and 1,700 deaths per year in Alaska and only about
half fall under the Medical Examiner's jurisdiction. The
criteria for those deaths are set out in current statute.
Expected home or hospital deaths do not fall under the
jurisdiction of the Medical Examiner's Office.
She described what happens at the Medical Examiner's Office in
Anchorage. Autopsies can be internal or external or both, based
on the circumstances of the case. Various tests can be
performed. She said there are three forensic pathologists, one
position of which is vacant. There are also autopsy technicians
and investigators, making a total of 17 staff. The in-house case
load was 857 last year; another 775 cases were not brought in to
the office
MS. SHELTON reported that the Medical Examiner's Office relies
strongly on local law enforcement who collect scene information,
consult with the pathologist, and determine if the case should
be brought into the jurisdiction of the office. Next, the body
must be transported to Anchorage and processed as quickly as
possible and returned back to the family. The Medical Examiner's
Office recognizes the sensitivity and emotional nature of the
cases, especially unanticipated death.
1:53:48 PM
She shared policies that are in place regarding transporting the
body back to the home city. The office provides the burial-
transit permit when the body leaves. It also revised the
authorization of release-of-remains form to clarify issues
regarding funeral homes. The office attempts to do what is best
for the family and has no stake in funeral homes. The office no
longer does embalming because the law requiring it was abolished
in 2005. Funeral homes do embalming and cosmetology work.
1:56:35 PM
She indicated that are no other facilities that can perform a
forensic examination except for in Fairbanks and Anchorage.
Neither of those offices have telemedicine equipment. The state
caseload does not warrant another autopsy facility. An extensive
amount of equipment would be required to ensure that the exams
are legally defensible, medically appropriate, and meet the
standards.
She said there are no forensic pathology services in rural
communities. Forensic examinations must be legally defensible
and provide the same high standard of care for all cases. She
questioned the liability if someone else would perform a
forensic exam.
1:58:50 PM
MARCIA DAVIS, General Council, Senior Vice President, Calista
Corporation, Anchorage, Alaska, testified in support of SB 161.
She described the function of Calista Heritage Foundation, a
non-profit that is responsible primarily for educational
scholarships for shareholders. Calista also provides burial
assistance, funding some of the costs for transport and burial.
She discovered that the problem of high costs has been around
for a long time. There have been efforts to correct the problem
that have not met with success when dealing with state agencies.
MS. DAVIS stated that in order to find a solution, she studied
laws and had conversations with the Department of Health and
Social Services (DHSS), but got nowhere. She then went to the
State Medical Examiner's Office in search of a solution.
2:01:27 PM
She said in that meeting, she shared culturally sensitive issues
surrounding death in rural areas. She described issues with the
form families must fill out and the lack of communication
between the Medical Examiner's Office and rural Alaska. By
contrast, she shared how villages handle a death. She maintained
that the form must be revised; it is currently different from
what the law requires.
She concluded that too much cost is put on the family, and it is
unfair to hold a body hostage until the bills are paid. She said
she found a law in North Dakota where it is a crime to hold the
body for money. She emphasized that values are different in Bush
Alaska.
2:08:29 PM
She said Calista would like to see the Medical Examiner's Office
have the statutory authority to make changes to procedures and
to the form. She said the next step is to translate the form
into Yupik.
2:09:34 PM
CHAIR STEDMAN held SB 161 in committee.