Legislature(2005 - 2006)CAPITOL 124
02/02/2006 08:00 AM House COMMUNITY & REGIONAL AFFAIRS
| Audio | Topic |
|---|---|
| Start | |
| Department of Commerce, Community, & Economic Development | |
| HCR5 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HCR 5 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE COMMUNITY AND REGIONAL AFFAIRS STANDING COMMITTEE
February 2, 2006
8:09 a.m.
MEMBERS PRESENT
Representative Kurt Olson, Co-Chair
Representative Bill Thomas, Co-Chair
Representative Mark Neuman
Representative Sharon Cissna
Representative Woodie Salmon
MEMBERS ABSENT
Representative Pete Kott
Representative Gabrielle LeDoux
COMMITTEE CALENDAR
CONFIRMATION HEARING(S)
Department of Commerce, Community, & Economic Development
William C. Noll - Juneau
- CONFIRMATION(S) ADVANCED
HOUSE CONCURRENT RESOLUTION NO. 5
Relating to support of community water fluoridation.
- MOVED HCR 5 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HCR 5
SHORT TITLE: FLUORIDATION
SPONSOR(s): REPRESENTATIVE(s) SEATON
03/09/05 (H) READ THE FIRST TIME - REFERRALS
03/09/05 (H) CRA, HES
02/02/06 (H) CRA AT 8:00 AM CAPITOL 124
WITNESS REGISTER
WILLIAM C. NOLL, Commissioner
Department of Commerce, Community, & Economic Development
Juneau, Alaska
POSITION STATEMENT: Spoke as appointee to the position of
Commissioner of DCCED.
REPRESENTATIVE PAUL SEATON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Spoke as the sponsor of HCR 5.
TROY RITTER, Senior Environmental Health Consultant
Alaska Native Tribal Health Consortium (ANTHC)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HCR 5.
ARTHUR HANSEN, retired dentist
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HCR 5.
WILLIAM MARLEY, retired dentist;
Representative, Fluoride Committee
American Dental Society
Homer, Alaska
POSITION STATEMENT: Testified in support of HCR 5.
JIM TOWLE, Executive Director
Alaska Dental Society
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HCR 5.
SHELLEY HUGHES, Policy Analyst
Alaska Primary Care Association
(No address provided)
POSITION STATEMENT: Testified in support of HCR 5.
TOM BORNSTEIN, Director
Dental Services
Southeast Alaska Regional Health Consortium
Juneau, Alaska
POSITION STATEMENT: Testified in support of HCR 5.
BRAD WHISTLER, Dental Officer
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified that the department is supportive
of community water fluoridation.
ACTION NARRATIVE
CO-CHAIR BILL THOMAS called the House Community and Regional
Affairs Standing Committee meeting to order at 8:09:49 AM.
Representatives Thomas, Olson, Neuman, and Cissna were present
at the call to order. Representative Salmon arrived as the
meeting was in progress.
^CONFIRMATION HEARING(S):
^Department of Commerce, Community, & Economic Development
8:10:06 AM
CO-CHAIR THOMAS announced that the first order of business would
be the confirmation hearing for the appointment of William C.
Noll as commissioner of the Department of Commerce, Community, &
Economic Development (DCCED).
8:10:19 AM
WILLIAM C. NOLL, Commissioner, Department of Commerce,
Community, & Economic Development (DCCED), provided background
information, including that he originally came to Alaska in 1968
with the U.S. Army. Upon discovering that he loved the state,
he stayed, he related. He also related that the majority of his
private career was involved in developing coal exports. In
fact, coal is a possible bridge to the future during this time
of high oil and gas prices. Furthermore, he related that he
also had a public career when he served on the Seward City
Council for a couple of terms and when he was the Mayor of
Seward. He characterized the aforementioned time as some of the
most enjoyable days of his life and a great way to get in touch
with people and their needs. He noted that he has a bit of
experience in commercial fishing due to his former minority
investment in several boats. He also noted that for six to
seven years he owned a small tourism business that has ceased to
exist.
COMMISSIONER NOLL related that he has enjoyed the time he has
spent in the department in terms of what he characterized as a
very competent labor force with the state government.
Commissioner Noll said that he is looking forward to this
assignment and the challenges and opportunities that it holds.
He paused to answer any questions.
8:13:40 AM
REPRESENTATIVE NEUMAN highlighted the ongoing discussion
regarding saving money in the state, and asked if Commissioner
Noll intends on hiring more personnel for DCCED. If so, he
inquired as to [the positions] that would be filled and the cost
of such.
COMMISSIONER NOLL related his understanding that the current
budget proposes 12 new hires, each of which is funded completely
with or the vast majority of which with federal funds. For
example, the Alaska Aerospace Development Corporation is
proposing eight new hires, which would be completely funded with
federal funds.
8:14:39 AM
CO-CHAIR THOMAS inquired as to who pays for the retirement of
employees whose positions are funded by federal funds.
COMMISSIONER NOLL answered that those employees would be
included in the Public Employees' Retirement System (PERS), and
therefore the state would pay for the retirement. However, he
pointed out that those employees would be in Tier 4.
8:15:11 AM
COMMISSIONER NOLL, in further response to Co-Chair Thomas,
recalled that there are two positions proposed for village safe
water programs and the majority of the funds for these positions
are federal funds. There are also two other proposed positions
one of which is for the Regulatory Commission of Alaska (RCA)
and the other for the Alaska Industrial Development and Export
Authority (AIDEA), both of which receive federal funds as well.
8:16:16 AM
REPRESENTATIVE NEUMAN commended Commissioner Noll for seeking
federal funds to help pay for these new positions.
8:16:31 AM
REPRESENTATIVE CISSNA related that the health system in Alaska
is the number one employer in the state. She opined that
Alaska's health system has possibly one of the largest under
filled positions, particularly in rural Alaska. Therefore,
workforce development to try to fill those positions is
important. She then opined that the health system is an
economic force.
COMMISSIONER NOLL related his view that health care is so
untended nationwide. He confirmed that the department is very
interested in health care from various perspectives. He
recalled that in 2003-2004 the State of Alaska had 8,900 new
jobs of which more than half were in the health care sector.
Through 2005 there were 13,200 new jobs [in the health care
sector], which illustrates the huge growth in health care. How
to address health needs in rural Alaska as well as urban Alaska
is a huge challenge, in which he said he is interested.
Commissioner Noll related that he would be glad to work with the
committee and legislators on this matter. He then highlighted
the opening of the new Palmer hospital and the possibility of
using the old hospital as a training facility. However, he
expressed concern that nationally the cost of care hasn't been
accounted for.
8:21:40 AM
REPRESENTATIVE NEUMAN offered to assist Commissioner Noll with
any plans for the [old] Palmer hospital. He then asked if DCCED
contracts any services to the State of Washington.
COMMISSIONER NOLL answered that about half of the commercial
fishing fleet lives in the State of Washington. He noted that
the Alaska Seafood Marketing Institute (ASMI) has offices
located in the State of Washington as well.
REPRESENTATIVE NEUMAN expressed concern with the [contracts and
services] provided by those in the State of Washington. He
requested that Commissioner Noll review what the state is
spending in the State of Washington. He also suggested that
[the department] do what it can to keep as much [employment] as
possible in Alaska.
COMMISSIONER NOLL interjected that the ferry system is also
located in the State of Washington. He informed the committee
that he has had discussions regarding the Native tribal
associations in the State of Washington being a potential
business partner [with the State of Alaska].
8:23:51 AM
CO-CHAIR THOMAS discussed the location of a possible new ferry
terminal, which he suggested should be located on the Lumbee
Reservation that is north of Bellingham. Therefore, the State
of Alaska would have no alliance to the State of Washington.
8:24:40 AM
CO-CHAIR THOMAS recalled that Commissioner Noll was a member of
the four-man "Fish Cabinet" that managed a large segment of the
wild fish marketing effort.
COMMISSIONER NOLL explained that the "Fish Cabinet" received $50
million from the federal government. The following four
individuals were the "Fish Cabinet": Alan Austerman, Senior
Fish Advisor; himself, Department of Commerce, Community, &
Economic Development; Greg O'Claray, Department of Labor &
Workforce Development; and Kevin Duffy and Dave Bedford, Alaska
Department of Fish & Game. The group decided to place $15
million into capital marketing; $15 million into capital grants;
$5 million to beleaguered fishers through an income tax
approach; $7 million to communities impacted by tax receipts;
and the remainder went into research and to the university. He
explained that the aforementioned required matching funds.
Commissioner Noll opined that the "Fish Cabinet" has been one of
the most successful programs of the past three years. He
recalled that in 2004 exports of seafood products out of Alaska
amounted to $1.7 billion and he estimated an increase to $2
million in 2005. He attributed the large increases to applied
allocation of funds, better fishing techniques, and luck related
to timing of news regarding the health benefits of Alaska wild
salmon. He noted that there is money left in this program. In
fact, recently $1 million [in matching funds] for small vessel
upgrades was offered. All the money has been [distributed] and
the group is looking for more funds to offer, he mentioned.
8:30:26 AM
CO-CHAIR THOMAS informed the committee that there were 134
applications for this program, which he characterized as a good
program.
COMMISSIONER NOLL reiterated that the group is trying to find
more money for the [small vessel upgrades] program.
CO-CHAIR THOMAS informed the committee that a tribal government
in Haines tried to obtain a block grant such that the fishermen
could apply for funds through it. However, the [small vessel
upgrades program] doesn't allow labor to be counted for matching
funds if the fisherman does his/her own labor. If a fisherman
does the labor, he/she should be allowed a $25 per hour wage [to
match], he opined.
COMMISSIONER NOLL said he would look into that.
CO-CHAIR THOMAS complimented the commissioner on the training
program for merchant marines.
COMMISSIONER NOLL related the administration's commitment to
have opportunities for young people in Alaska.
8:35:55 AM
CO-CHAIR THOMAS then turned to the Local Boundary Commission
(LBC) and his view that it and other agencies don't move in the
direction specified by the legislature. He noted the complaints
being received in regard to the LBC. Co-Chair Thomas then
related his understanding that the goal was to maximize the
boundaries for a municipality. However, it seems that the LBC
is shrinking [the size of annexation requests]. The
aforementioned, he indicated, led to the introduction of
legislation to address the concerns with the LBC. In fact,
there is legislation, SB 248, providing incentives to form
boroughs, especially in locales where there is no state land
available [to annex and organize]. He inquired as to
Commissioner Noll's stance on the incentives to organize.
COMMISSIONER NOLL stated his support for [SB 248] and
incentives. He then related his belief that making land
available at the local level is paramount to create
opportunities for local people.
CO-CHAIR THOMAS related the concept of the administrative
borough, noting his preference to include language that would
allow communities to dissolve or opt-out of the administrative
borough if the LBC denies the [requested] boundaries. He
informed the committee that maps were sent to communities with
recommendations for the borough boundaries. However, there is
no land available in some areas and thus incentives are the only
way to go. He related that the Chatham and Glacier Bay Boroughs
are considering merging; the total land would be less than 400
acres because most of the available land is federal land since
the university already selected from what state land there was.
Therefore, the incentive funds would provide municipalities the
ability to purchase land.
COMMISSIONER NOLL noted his agreement [with Co-Chair Thomas] and
said that he would discuss these matters with the LBC.
CO-CHAIR THOMAS highlighted that the incentive [included in SB
248] is only available for four years.
8:42:10 AM
REPRESENTATIVE NEUMAN inquired as to whether Commissioner Noll
has any connection or oversight over the LBC.
COMMISSIONER NOLL explained that DCCED provides administrative
support to the LBC, which is a separately appointed authority
that operates independently.
8:43:27 AM
REPRESENTATIVE CISSNA moved that the committee forward the name
of William C. Noll to the full body for consideration during
joint session. There being no objection, it was so ordered.
8:44:16 AM
The committee took an at-ease from 8:44 a.m. to 8:45 a.m.
HCR 5-FLUORIDATION
8:45:29 AM
CO-CHAIR THOMAS announced that the final order of business would
be HOUSE CONCURRENT RESOLUTION NO. 5, Relating to support of
community water fluoridation.
8:45:38 AM
REPRESENTATIVE PAUL SEATON, Alaska State Legislature, sponsor of
HCR 5, related that HCR 5 would support community water
fluoridation, which is important to the health of Alaskans. He
informed the committee that Alaska cities with a population in
excess of 30,000 have fluoridated water. Fluoride, he
highlighted, has been identified as an effective tool in
addressing dental disease. Therefore, HCR 5 merely illustrates
that the legislature recognizes the importance of community
fluoridation and that all new village safe water projects should
design water systems such that fluoridation can be utilized, if
the community chooses to do so. The committee packet, he noted,
includes letters of support, including the letters from the
Alaska Native Tribal Health Consortium and various dentists.
8:49:08 AM
REPRESENTATIVE CISSNA recalled learning that life span is linked
to the presence of teeth. She also recalled that the clinics in
the Aleutians related to her that the largest reason for
Medivacs were related to dental problems. Therefore, she
inquired as to whether there are any studies specifying the
costs related to not taking care of teeth.
REPRESENTATIVE SEATON indicated that the committee packet
includes a number of studies, including one that specifies that
for every dollar spent on fluoridation, approximately $37 in
medical costs would be saved.
8:50:57 AM
REPRESENTATIVE SEATON, in response to Co-Chair Olson, said that
he has received little opposition and what opposition that was
received has been included in the committee packet.
8:52:07 AM
TROY RITTER, Senior Environmental Health Consultant, Alaska
Native Tribal Health Consortium (ANTHC), informed the committee
that his expertise is really in relation to the cost of
implementing the fluoride. He related that to implement
fluoride it costs approximately $1 per person per year, and
therefore most communities can be fluoridated for a year for
what filing one cavity would cost. He characterized the
aforementioned as a fairly good return, although he acknowledged
that there are very few public health interventions that save
more money than they cost.
8:53:09 AM
REPRESENTATIVE NEUMAN asked if the fluoridation system is a
simple injection system. He related his understanding that it
requires minimal infrastructure.
MR. RITTER replied yes. He noted that the delivery system for
fluoride is similar to that used for chlorine. He noted that
from an operation and maintenance standpoint, fluoride is easier
to deliver than chlorine because fluoride is chemically stable.
In further response to Representative Neuman, Mr. Ritter
explained that the type of fluoride injected [in Alaska] is a
powder form. He related the basic principle of toxicology that
the dose makes the poison. Therefore, operators use a
respirator that is similar to a dust mask. There haven't been
any problems experienced with the operators, he said.
8:55:32 AM
REPRESENTATIVE CISSNA returned to her concern with regard to the
costs of dental problems, and requested information regarding
the total cost of not taking care of dental needs.
MR. RITTER, from the best studies available and from his Alaska-
specific observations, related his belief that fluoridated
communities probably reduce dental disease by about 40 percent.
8:57:13 AM
MR. RITTER, turning to his prepared testimony, informed the
committee that he has worked within Alaska's tribal health
system for the last seven years. He also informed the committee
that ANTHC is the largest health organization managed by a tribe
in the nation. The ANTHC works with its partners to deliver
comprehensive health services. Mr. Ritter specified that he is
responsible for ensuring that his division's activities provide
maximum health benefits. Therefore, ANTHC strongly supports HCR
5. He highlighted that HCR 5 doesn't require fluoridation and
helps to align state, tribal, and federal efforts with regard to
this issue. Mr. Ritter opined that fluoridation has sometimes
been the subject of misunderstanding and misinformation.
However, in the mainstream health and public health communities
there is no controversy surrounding fluoridation, he further
opined. Therefore, passage of HCR 5 would allow the state to
say that it relies on credible, science-based information when
making health decisions. Mr. Ritter acknowledged that not
everyone agrees on fluoridation, but he expressed hope that
those communities that choose to fluoride should receive [the
state's] best efforts to keep [the residents] healthy and safe.
In conclusion, Mr. Ritter characterized HCR 5 as a win-win
situation in which public health professionals are provided a
tool to provide safer and healthier communities without
negatively impacting another area.
9:00:45 AM
ARTHUR HANSEN, retired dentist, noted that he has worked in the
villages. He related his support of HCR 5, and indicated that
fluoridation is the least expensive way in which to reduce decay
and dental problems.
9:01:57 AM
WILLIAM MARLEY, retired dentist; Representative, Fluoride
Committee, Alaska Dental Society, informed the committee that
the American Dental Association (ADA) publishes a booklet with
fluoride facts, in which it cites over 358 references to
scientific studies supporting the safety and efficacy of
fluoridating community water supplies. He related that fluoride
is endorsed by the Alaska Dental Society, the ADA, the Center
for Disease Control, the American Medical Association, the U.S.
Surgeon General, the National Institute of Cranial and Facial
Research, and over 100 other national and international
associations dealing with water and health. Dr. Marley stated
that fluoride has been found to be both safe and effective.
With regard to cost effectiveness, he related that for every $1
invested [the state would] receive $18 in return.
DR. MARLEY highlighted that fluoride has over 60 years of
experience in the U.S. and millions of years of natural
existence. In 1992 Alaska had 120 communities fluoridating
their water, but that has decreased to 37 communities at this
point. He then pointed out that Article 7, Section 4, of the
Alaska State Constitution specifies that the legislature shall
provide for the promotion and protection of the public health.
Therefore, HCR 5 would be consistent with the constitution while
providing leadership and reducing the rate of decay and the
number of dentists that are needed.
9:08:07 AM
REPRESENTATIVE NEUMAN inquired as to why there has been such a
decrease in the communities that provide fluoridation.
DR. MARLEY said he couldn't answer.
9:08:49 AM
JIM TOWLE, Executive Director, Alaska Dental Society, stated
that the Alaska Dental Society supports HCR 5. He pointed out
that tooth decay is a chronic disease and the most common
chronic disease in children. He echoed Dr. Marley's comments
regarding the history of fluoride, which is naturally occurring.
Mr. Towle emphasized that community water fluoridation is a
public health measure that benefits individuals of all ages and
socio-economic groups. From the information he has, he related
that the average cost to fluoridate a community is around $.50
per person with the annual average per person cost being less
than one-third of the cost of an average dental restoration or
filling of a cavity. Mr. Towle informed the committee that
there are over 225 current peer-reviewed studies that recognize
the benefit of community water fluoridation. In 2004 Alaska
spent $19.3 million for Medicaid and Denali Kid Care dental
care, he mentioned.
9:11:24 AM
MR. TOWLE, in response to Representative Cissna, agreed to
supply the committee with the overall dental costs of the state.
9:12:41 AM
SHELLEY HUGHES, Policy Analyst, Alaska Primary Care Association,
related the association's support for HCR 5. She related that
the Alaska Primary Care Association, which represents 24 health
organizations throughout the state, recognizes that fluoridation
does benefit the health of residents. She concluded by
emphasizing that HCR 5 would be a positive step for the
betterment of the health of Alaskans.
9:13:59 AM
TOM BORNSTEIN, Director, Dental Services, Southeast Alaska
Regional Health Consortium (SEARHC), related his support of HCR
5 for all the reasons stated earlier.
9:14:27 AM
CO-CHAIR THOMAS inquired as to why the decrease in the villages
fluoridating their water.
MR. BORNSTEIN explained that in 1992 there was an overfeed
incident in a fluoride system in Hooper Bay. This tragic event
resulted in a review that determined one of the issues was the
inadequate monitoring of the village water system. The
aforementioned caused the Department of Environmental
Conservation (DEC) to promulgate new regulations concerning the
use of fluoride. Therefore, some of the communities that were
just barely able to comply with the current water fluoridation
rules were unable to meet the new standards, which were more
stringent. Thus, many of the fluoridation systems were taken
off-line.
9:16:17 AM
CO-CHAIR THOMAS inquired as to what happens to those who drink
water that has too much fluoride.
MR. BORNSTEIN confirmed that over fluoridation results in
sickness. However, he pointed out that it takes many times,
about 50 times the recommended dose over a brief period of time
before there is an acute effect. A chronic overfeed would
result in mottled teeth. He related his understanding that in
the Hooper Bay incident an individual who was sick became
dehydrated and was told to drink lots of water. That individual
ended up with 100 times the dose of fluoride and the individual
ultimately died. He characterized the incident as extremely
rare.
9:17:55 AM
REPRESENTATIVE CISSNA expressed the need to include in the
funding for these systems a training component.
MR. BORNSTEIN related that the implementation of these systems
require a level of training and monitoring as specified in the
regulations.
9:19:57 AM
REPRESENTATIVE SALMON inquired as to what causes the spots on
the teeth of younger kids in Fort Yukon where the water became
fluoridated in the 1970s.
MR. BORNSTEIN answered that over exposure to fluoride, that is
beyond the proper dose, can result in white
spots/decalcification on the teeth. White spots/decalcification
can also occur prior to decay. Therefore, he said that one
would need to review the specific case to make a determination.
9:22:20 AM
BRAD WHISTLER, Dental Officer, Department of Health and Social
Services (DHSS), related that DHSS is supportive of community
water fluoridation, which has a long-standing history in the
U.S. With regard to the white spots, he reiterated that it's
not always attributed to over fluoridation. In fact, in terms
of fluoride, he attributed the white spots mainly to swallowing
toothpaste, particularly with young children. Furthermore,
amoxicillin may also discolor teeth. The studies that have
reviewed long-term controls infrequently report that water
fluoridation results [in white spots].
MR. WHISTLER then turned to the costs related to fluoridation.
He informed the committee that Alaska would probably experience
savings between $37 and $140. With regard to total dental costs
in Alaska, he said he didn't know of a source from which to
obtain that figure. He agreed that there is a training and
capacity issue in rural areas. He also agreed that at very high
doses, fluoride isn't good for individuals and thus it needs to
be done in a safe manner and monitored. This resolution
recognizes that if fluoride is delivered properly, substantial
savings can be reaped in terms of dental costs, he said.
9:27:45 AM
REPRESENTATIVE NEUMAN recalled that when he ran a water system
monthly samples were sent to an engineer and the content of the
water was reported to DEC. Therefore, he assumed that the same
would be true for water systems using fluoride and thus over
fluoridation would only last for a month.
MR. WHISTLER informed the committee that water testing is
reported monthly but most of the systems are [tested] daily.
Therefore, he didn't believe over fluoridation would even last a
month. He opined that immediate action would occur if the
fluoride level reached four parts per million or more.
9:29:21 AM
REPRESENTATIVE CISSNA related her interest in the costs of
dental emergencies, particularly in relation to Medivac
situations.
MR. WHISTLER suggested that such information was available from
the Eastern Aleutian tribes who, upon reviewing their Medivac
services, found that adult dental emergencies were the most
frequent reasons for Medivacs into Anchorage.
REPRESENTATIVE CISSNA recalled that perhaps she heard it from a
tribe in Dutch Harbor.
9:30:39 AM
CO-CHAIR OLSON moved to report HCR 5 out of committee with
individual recommendations and the accompanying fiscal notes.
There being no objection, it was so ordered.
9:30:52 AM
ADJOURNMENT
There being no further business before the committee, the House
Community and Regional Affairs Standing Committee meeting was
adjourned at 9:30 a.m.
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