Legislature(2001 - 2002)

05/11/2002 05:50 PM FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                  HOUSE FINANCE COMMITTEE                                                                                       
                        May 11, 2002                                                                                            
                         5:50 P.M.                                                                                              
                                                                                                                                
TAPE HFC 02 - 109, Side A                                                                                                       
TAPE HFC 02 - 109, Side B                                                                                                       
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair Williams called the House  Finance Committee meeting                                                                   
to order at 5:50 P.M.                                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Bill Williams, Co-Chair                                                                                          
Representative Eldon Mulder, Co-Chair                                                                                           
Representative Con Bunde, Vice-Chair                                                                                            
Representative Eric Croft                                                                                                       
Representative John Davies                                                                                                      
Representative Richard Foster                                                                                                   
Representative John Harris                                                                                                      
Representative Bill Hudson                                                                                                      
Representative Ken Lancaster                                                                                                    
Representative Carl Moses                                                                                                       
Representative Jim Whitaker                                                                                                     
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
None                                                                                                                            
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Representative Fred Dyson; Josh  Govaars, Staff, Senator Dave                                                                   
Donley;  Gwendolyn  Hall,  Staff, Senator  Pete  Kelly;  Chip                                                                   
Wagoner, Alaska  Catholic Conference;  William Craig,  Alaska                                                                   
Independent Blind,  Sitka; Helen Craig, Sitka;  Nancy Weller,                                                                   
Division  of  Medical  Assistance,  Department  of  Health  &                                                                   
Social Services                                                                                                                 
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Dr.   Colleen   Murphy,   Anchorage;   Dr.   John   Middaugh,                                                                   
Epidemiology  Section,   Department  of  Health   and  Social                                                                   
Services, Anchorage                                                                                                             
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
SB 180    An  Act  implementing  pay differentials  based  on                                                                   
          geographic areas for certain state employees and                                                                      
          for members of the Alaska State Defense Force; and                                                                    
          providing for an effective date.                                                                                      
                                                                                                                                
          HCS CS SB 180 (FIN) was reported out of Committee                                                                     
          with a "do pass" recommendation and new fiscal                                                                        
          notes  by  Department  of  Administration  and  the                                                                   
          Alaska Court System.                                                                                                  
                                                                                                                                
SB 206    An Act relating to registration  plates and parking                                                                   
          permits  for  persons   with  disabilities  and  to                                                                   
          illegal  use  of parking  spaces  for persons  with                                                                   
          disabilities.                                                                                                         
                                                                                                                                
          HCS CS SB 206 (FIN) was reported out of Committee                                                                     
          with  a  "do  pass" recommendation  and  with  zero                                                                   
          fiscal  notes,  #2  by  the  Department  of  Public                                                                   
          Safety and #3 by the  Department of Administration.                                                                   
                                                                                                                                
SB 247    An   Act   making    capital   appropriations   and                                                                   
          reappropriations,  and  capitalizing funds;  making                                                                   
          appropriations   under   art.   IX,   sec.   17(c),                                                                   
          Constitution  of  the  State  of Alaska,  from  the                                                                   
          constitutional  budget reserve fund;  and providing                                                                   
          for an effective date.                                                                                                
                                                                                                                                
          SB 247 was HEARD and HELD in Committee for further                                                                    
          consideration.                                                                                                        
                                                                                                                                
SB 252    An   Act  renaming   the   Alaska  Human   Resource                                                                   
          Investment   Council   as  the   Alaska   Workforce                                                                   
          Investment  Board and  relating to its  membership;                                                                   
          repealing   the  termination  date  of   the  state                                                                   
          training   and  employment  program;   relating  to                                                                   
          employment  and training activities;  and providing                                                                   
          for an effective date.                                                                                                
                                                                                                                                
          CS SB 252 (RLS) was SCHEDULED but had not arrived                                                                     
          to the Committee.                                                                                                     
                                                                                                                                
SB 359    An   Act  relating   to  organization  grants   for                                                                   
          mergers, consolidations,  or unifications involving                                                                   
          third class boroughs.                                                                                                 
                                                                                                                                
          CS SB 359 (RLS) was SCHEDULED but the House                                                                           
          Majority was still working on the work draft.                                                                         
                                                                                                                                
SB 364    An  Act  relating  to medical  services  under  the                                                                   
          state Medicaid program.                                                                                               
                                                                                                                                
          SB 364 was HEARD and HELD in Committee for further                                                                    
          consideration.                                                                                                        
                                                                                                                                
CS FOR SENATE BILL NO. 247(FIN)                                                                                               
                                                                                                                                
     An   Act   making  and   amending   appropriations   and                                                                   
     reappropriations;  making appropriations under  art. IX,                                                                   
     sec. 17(c),  Constitution of  the State of  Alaska, from                                                                   
     the constitutional  budget  reserve fund; and  providing                                                                   
     for an effective date.                                                                                                     
                                                                                                                                
Co-Chair Williams explained his  intent regarding the capital                                                                   
budget amendment process.   He asked if there  was any public                                                                   
testimony.    There  being  no  one on  line  or  present  in                                                                   
Committee to testify, public testimony was closed.                                                                              
                                                                                                                                
SB 247 was HELD in Committee for further consideration.                                                                         
                                                                                                                                
#SB180                                                                                                                        
CS FOR SENATE BILL NO. 180(FIN)(efd fld)                                                                                      
                                                                                                                                
     An   Act  implementing   pay   differentials  based   on                                                                   
     geographic  areas for  certain state  employees and  for                                                                   
     members of  the Alaska State Defense Force;  relating to                                                                   
     cost-of-living   differentials    for   state   aid   to                                                                   
     municipalities.                                                                                                            
                                                                                                                                
Co-Chair  Mulder MOVED  to RESCIND previous  action taken  on                                                                   
adopting Amendment #2.  There  being NO OBJECTION, the action                                                                   
was rescinded.                                                                                                                  
                                                                                                                                
Co-Chair Mulder MOVED to WITHDRAW  Amendment #2.  There being                                                                   
NO OBJECTION, the amendment was withdrawn.                                                                                      
                                                                                                                                
Co-Chair Mulder  MOVED to report HCS  CS SB 180 (FIN)  out of                                                                   
Committee  with  individual  recommendations   and  with  the                                                                   
accompanying fiscal notes.  There  being NO OBJECTION, it was                                                                   
so ordered.                                                                                                                     
                                                                                                                                
HCS CS SB 180 (FIN) was reported  out of Committee with a "do                                                                   
pass"  recommendation  and  with  new  fiscal  notes  by  the                                                                   
Department of Administration and the Alaska Court System.                                                                       
                                                                                                                                
#SB206                                                                                                                        
CS FOR SENATE BILL NO. 206(TRA)                                                                                               
                                                                                                                                
     An  Act  relating  to registration  plates  and  parking                                                                   
     permits  for persons  with disabilities  and to  illegal                                                                   
     use of parking spaces for persons with disabilities.                                                                       
                                                                                                                                
JOSH GOVAARS,  STAFF,  SENATOR DAVE DONLEY,  stated that  the                                                                   
committee substitute  for SB 206  (TRA) would help  to insure                                                                   
the  availability  of  priority parking  for  truly  disabled                                                                 
Alaskans and  was intended to  prevent many of  the instances                                                                   
of  abuse  that  currently  exist  in  our  State's  disabled                                                                   
parking system.  The bill would  accomplish that by improving                                                                   
the  issuing   process  for  disabled  parking   permits  and                                                                   
cracking down  on individuals convicted of  illegally parking                                                                   
in disabled parking  areas or convicted of  misusing disabled                                                                   
parking permits.                                                                                                                
                                                                                                                                
To provide better  access to disabled parking  spaces for the                                                                   
truly disabled,  the State of  Washington toughened  its laws                                                                   
to  combat widespread  abuse  of disabled  parking  placards.                                                                   
Other states  have also tightened  up their disabled  parking                                                                   
laws.                                                                                                                           
                                                                                                                                
Mr.  Govaars noted  that it  is often  difficult to  identify                                                                   
whether or not  individuals who have parked  an automobile in                                                                   
a disabled parking space are disabled.   Working closely with                                                                   
the Division of Motor Vehicles  (DMV), it has been determined                                                                 
that their  computer system  indicates whether an  individual                                                                   
has been  issued a  disabled parking  placard and/or  license                                                                   
plates.    The Division  was  able  to make  the  information                                                                   
available to troopers  and police officers when  they perform                                                                   
a  records check  on either  a  license plate  or a  person's                                                                   
identification.   That would allow law  enforcement officials                                                                   
to determine  if a  placard or license  plate was  being used                                                                   
fraudulently.                                                                                                                   
                                                                                                                                
Mr. Govaars added  that under current law, anyone  might park                                                                   
in a disabled  parking space as  long as their vehicle  has a                                                                   
disabled  placard or  license plate.   The legislation  would                                                                   
clearly define  whom "may park"  in a parking  place reserved                                                                   
for  disabled  individuals.     A  new  provision  was  added                                                                   
specifying that  the person issued  a special permit  must be                                                                   
occupying  or  operating  the  vehicle; or  that  the  person                                                                   
operating  the  vehicle  was  doing so  for  the  purpose  of                                                                   
transporting a  disabled person and that the  disabled person                                                                   
must actually exit or enter the vehicle.                                                                                        
                                                                                                                                
Mr.  Govaars concluded  that the  legislation would  increase                                                                   
the  penalties for  illegally  parking in  a disable  parking                                                                   
space  and  for misusing  a  disabled  permit  to park  in  a                                                                   
disabled parking  space.  Under  existing law,  violators are                                                                   
fined $100 dollars  if they are convicted of  either of those                                                                   
offenses.     Under  the   bill,  individuals  convicted   of                                                                   
illegally parking in a disabled  parking space would be fined                                                                   
$125 dollars for the first offense                                                                                              
                                                                                                                                
Representative  Croft inquired  what the current  requirement                                                                   
was.                                                                                                                            
                                                                                                                                
Mr. Govaars explained  that as statute is now, if  there is a                                                                   
permit in  the vehicle, any person  has the right to  use the                                                                   
space.   The proposed  legislation guarantees  that  only the                                                                   
person actually issued  the permit is able to  use the space.                                                                   
To use it, the person must get in and out of the vehicle.                                                                       
                                                                                                                                
Representative Croft asked what was being corrected.                                                                            
                                                                                                                                
Mr. Govaars responded  that there have been  people caught in                                                                   
Anchorage with someone  else's permit in their  car, which is                                                                   
legal under current statute.  The bill would change that.                                                                       
                                                                                                                                
Representative Hudson asked if  the disabled person had to be                                                                   
the driver.                                                                                                                     
                                                                                                                                
Mr. Govaars  responded  that in  order to use  the spot,  the                                                                   
disabled has  to be in the  vehicle and must either  enter or                                                                   
exit the vehicle when it is parked.                                                                                             
                                                                                                                                
Representative  Hudson suggested  that the legislation  could                                                                   
be "over" restrictive.                                                                                                          
                                                                                                                                
Discussion following  between Mr. Govaars  and Representative                                                                   
Hudson regarding  a particular  situation with a  handicapped                                                                   
friend of his.                                                                                                                  
                                                                                                                                
Vice-Chair  Bunde   noted  that  the  legislation   would  be                                                                   
establishing a new standard.                                                                                                    
                                                                                                                                
Representative Davies  asked if consideration had  been given                                                                   
to how many spaces were available at each lot.                                                                                  
                                                                                                                                
Mr. Govaars  responded  that federal law  mandates a  certain                                                                   
number  and size  of spaces  to  be allocated.   The  persons                                                                   
owning the lot decide the number of spaces.                                                                                     
                                                                                                                                
Representative  Davies  understood   that  all  the  handicap                                                                   
spaces were open and that the  driver could remain in the car                                                                   
to guarantee that the space remains available.                                                                                  
                                                                                                                                
Mr. Govaars clarified that the  legislation would not account                                                                   
for people  borrowing a  spot, which  would be considered  an                                                                   
inappropriate use  of that spot.  The disabled  parking spots                                                                   
are designed for those people that need to have access.                                                                         
                                                                                                                                
Representative   Davies   pointed    out   that   there   are                                                                   
circumstances in which no other  parking places are available                                                                   
outside of  those designated.   He thought it  was reasonable                                                                   
that as long as  there were spaces available and  there was a                                                                   
driver in the car, it should be okay to park there.                                                                             
                                                                                                                                
Mr. Govaars  did not know how  to make the  legislation "fit"                                                                   
into that example.                                                                                                              
                                                                                                                                
WILLIAM  CRAIG,  ALASKA  INDEPENANT BLIND,  SITKA,  spoke  in                                                                   
favor of the bill and urged that it pass from Committee.                                                                        
                                                                                                                                
HELEN CRAIG, SITKA, testified  in support of the legislation.                                                                   
                                                                                                                                
Representative  Croft  referenced  Page  4; the  phrase  used                                                                   
throughout,  "is  operated by  or  used  for the  purpose  of                                                                   
transporting a person with a disability".   He noted that the                                                                   
problem exists that  Section 2 adds, "The person  who has the                                                                   
special permit  actually exits  or enters  the vehicle".   He                                                                   
stated that language should address the concern.                                                                                
                                                                                                                                
Representative  Croft MOVED  to  DELETE language  on Page  4,                                                                   
Lines 11  & 12, "and  the person who  has the special  permit                                                                   
actually exits or enters the vehicle".                                                                                          
                                                                                                                                
Vice-Chair  Bunde  OBJECTED.    He  stated  that  the  person                                                                   
driving does  not need  the special space.   The  person with                                                                   
the disability would  not be inconvenienced if  they were not                                                                   
getting into or exiting the vehicle.                                                                                            
                                                                                                                                
Representative  Hudson referred  to a  personal situation  in                                                                   
which his friend  remained in the car but he had  parked in a                                                                   
designated space in order to take  care of her pharmacy needs                                                                   
from that  establishment.  He  understood that he  could have                                                                   
backed out and parked in another space.                                                                                         
                                                                                                                                
Vice-Chair Bunde  reiterated that  if the driver  is capable,                                                                   
they should not use the designated handicap spot.                                                                               
                                                                                                                                
Representative  Davies interjected  that  there are  handicap                                                                   
persons that are mobile that might only need assistance.                                                                        
                                                                                                                                
Vice-Chair Bunde commented that  person would be driving with                                                                   
handicap plates or a handicap sticker.                                                                                          
                                                                                                                                
Discussion followed between Vice-Chair  Bunde, Representative                                                                   
Davies  and  Representative  Croft   regarding  the  handicap                                                                   
plates and ticketing potential.                                                                                                 
                                                                                                                                
Representative  Davies  thought  that  "handicap"  should  be                                                                   
clarified.                                                                                                                      
                                                                                                                                
Vice-Chair Bunde pointed out that  the legislation stipulates                                                                   
that  the  handicap person  must  either  enter or  exit  the                                                                   
vehicle.   The person does not  have to do both to  avoid the                                                                   
ticket.                                                                                                                         
                                                                                                                                
Co-Chair Mulder voiced concern  with language written on Page                                                                   
4  and  the  number  of  points   charged  for  a  non-moving                                                                   
violation.   He  stated that  he did  not object  to a  fine,                                                                   
however, the  points affect the  amount that person  pays for                                                                   
insurance.   He  reiterated that  would  be an  inappropriate                                                                   
point  charge.   He referenced  Lines  22-31, recommending  a                                                                   
conceptual amendment  which would double the  fine and delete                                                                   
language regarding  the points  against the person's  driving                                                                   
record.                                                                                                                         
                                                                                                                                
Co-Chair Mulder MOVED to ADOPT that conceptual amendment.                                                                       
                                                                                                                                
Representative  Foster MOVED to  report HCS  CS SB  206 (FIN)                                                                   
out  of Committee  with individual  recommendations and  with                                                                   
the accompanying fiscal notes.   There being NO OBJECTION, it                                                                   
was so ordered.                                                                                                                 
                                                                                                                                
HCS CS SB 206 (FIN) was reported  out of Committee with a "do                                                                   
pass" recommendation  and with zero  fiscal notes, #2  by the                                                                   
Department  of Public  Safety  and #3  by  the Department  of                                                                   
Administration.                                                                                                                 
                                                                                                                                
CS FOR SENATE BILL NO. 252(RLS)                                                                                               
                                                                                                                                
     An  Act renaming  the Alaska  Human Resource  Investment                                                                   
     Council  as the  Alaska Workforce  Investment Board  and                                                                   
     relating  to its  membership; relating  to repayment  on                                                                   
     promissory  notes  for work-related  items  paid for  by                                                                   
     grant programs;  extending the  termination date  of the                                                                   
     state  training  and  employment  program;  relating  to                                                                   
     employment  and training  activities; and providing  for                                                                   
     an effective date.                                                                                                         
                                                                                                                                
Co-Chair Williams  noted that CS  SB 252 (RLS)  was SCHEDULED                                                                   
but had not yet arrived into the House Finance Committee.                                                                       
                                                                                                                                
#SB359                                                                                                                        
CS FOR SENATE BILL NO. 359(RLS)                                                                                               
                                                                                                                                
     An  Act relating  to  organization  grants for  mergers,                                                                   
     consolidations,  or unifications  involving third  class                                                                   
     boroughs;  and relating to  identification by  the Local                                                                   
     Boundary  Commission of  areas that  meet the  standards                                                                   
     for borough incorporation.                                                                                                 
                                                                                                                                
Co-Chair Williams stated that  CS SB 359 (RLS) was SCHEDULED,                                                                   
however,  the  House  Majority  was working  on  a  committee                                                                   
substitute.                                                                                                                     
                                                                                                                                
SENATE BILL NO. 364                                                                                                           
                                                                                                                                
     An  Act relating  to medical  services  under the  state                                                                   
     Medicaid program.                                                                                                          
                                                                                                                                
GWENDOLYN  HALL,  STAFF, SENATOR  PETE  KELLY,  noted that  a                                                                   
majority of  Alaskans agree that  it is inappropriate  to use                                                                   
State funds to provide elective  abortions.  Despite the many                                                                   
efforts  of the  Legislature, the  State has  been unable  to                                                                   
implement  the will  of the people.   All  attempts to  bring                                                                   
Alaskan  Medicaid  funding  under  federal  standards,  which                                                                   
prohibit funding  abortions except for rape,  incest and life                                                                   
of  the mother,  have  been thwarted  by  the Alaska  Supreme                                                                   
Court.                                                                                                                          
                                                                                                                                
Ms. Hall stated  that the Alaska Administrative  Code defines                                                                   
therapeutic abortion as:                                                                                                        
                                                                                                                                
     "The termination of a pregnancy, certified                                                                                 
     by a physician as medically necessary to                                                                                   
     prevent the death or disability of the woman,                                                                              
     or to ameliorate a condition harmful to                                                                                    
     the woman's physical or psychological health."                                                                             
                                                                                                                                
"Medically necessary"  has proved  to be too broad  language,                                                                   
allowing elective abortions to  take cover under the umbrella                                                                   
of  protection.   She suggested  that any  form of  emotional                                                                   
discomfort  a  woman  may  experience  from  pregnancy  could                                                                   
warrant a "medically necessary"  termination.  Ms. Hall noted                                                                   
that SB 364  would define "medically necessary",  restricting                                                                   
Medicaid funded abortions to those  cases that fall under the                                                                   
Hyde Amendment guidelines.                                                                                                      
                                                                                                                                
REPRESENTATIVE  FRED DYSON explained  that Senator  Kelly has                                                                   
attempted to narrow down the definition  of what is medically                                                                   
necessary for  emotional and psychological problems.   SB 364                                                                   
makes  a clear provision  that  the woman must,  in order  to                                                                   
maintain  emotional  and  psychological   stability,  take  a                                                                   
powerful  drug,  which  would  not endanger  the  child,  and                                                                   
currently  is allowed.    The bill  would  "tighten" up  that                                                                   
language.                                                                                                                       
                                                                                                                                
He pointed out  that in 1998, when the  Legislature tightened                                                                   
up the language  on "medical necessity", the  number of State                                                                   
funded  abortions dramatically  decreased.   That court  case                                                                   
was overturned  and it now  appears that more  abortion cases                                                                   
are being paid with State dollars.                                                                                              
                                                                                                                                
Representative  Dyson  advised   that  all  polls  in  Alaska                                                                   
indicate that  the public is  not interested in  using public                                                                   
money to fund abortions.                                                                                                        
                                                                                                                                
Representative  Davies  asked   the  definition  of  "medical                                                                   
necessity" used in the State of Michigan.                                                                                       
                                                                                                                                
Ms.  Hall  read the  list  of  complications listed  in  that                                                                   
report:                                                                                                                         
                                                                                                                                
     ·    Shock                                                                                                                 
     ·    Uterine Perforation                                                                                                   
     ·    Cervical Laceration                                                                                                   
     ·    Hemorrhage                                                                                                            
     ·    Allergic Response                                                                                                     
     ·    Death                                                                                                                 
     ·    Infection                                                                                                             
     ·    Retained Products                                                                                                     
     ·    Other complications                                                                                                   
                                                                                                                                
Representative  J. Davies pointed  out that no  psychological                                                                   
sections had been added.                                                                                                        
                                                                                                                                
Ms. Hall acknowledged that was true.                                                                                            
                                                                                                                                
Representative  Whitaker  asked  for clarification  that  the                                                                   
bill  would  not  restrict the  Supreme  Court  decision  Roe                                                                   
versus Wade and the woman's right  for an abortion.  He noted                                                                   
that the legislation  only restricts what the  State will pay                                                                   
for.                                                                                                                            
                                                                                                                                
Representative Dyson agreed.                                                                                                    
                                                                                                                                
DR.   COLEEN   MURPHY,   (TESTIFIED    VIA   TELECONFERENCE),                                                                   
PHYSICIAN,   ANCHORAGE,  testified   in  opposition   to  the                                                                   
proposed bill  stating that it  is important that  Alaska not                                                                   
compare itself  to Michigan.   The Alaska State  Constitution                                                                   
has a greater right to privacy  than Michigan State one does.                                                                   
                                                                                                                                
Dr. Murphy stated  that previous testimony indicates  how lay                                                                   
people confuse  indications for incomplete abortions.   There                                                                   
is a  difference between  evacuating a  uterus for  a uterine                                                                   
preparation and an  incomplete product of conception.   It is                                                                   
important  to  understand  those distinctions.    At  present                                                                   
time,  legislators  are  attempting   to  provide  what  they                                                                   
determine a  "clear" provision  of what constitutes  "medical                                                                   
necessity" for termination of a pregnancy.                                                                                      
                                                                                                                                
Dr. Murphy  noted that  she is  a practicing medical  doctor,                                                                   
who currently provides reproductive  health services to women                                                                   
in  need.   The  language of  the  bill is  not  clear.   She                                                                   
commented   that  the   bill  attempts   to  meddle   in  the                                                                   
relationship   between  a   doctor  and   their  patient,   a                                                                   
relationship which should remain private.                                                                                       
                                                                                                                                
Dr. Murphy  explained that  when she  talks with women  about                                                                   
their  pregnancies, she  requests an  informed consent  about                                                                   
that pregnancy.   Each  woman signs  certain conditions  that                                                                   
are acceptable.                                                                                                                 
                                                                                                                                
Dr.  Murphy   provided   hypothetical  pregnancy   situations                                                                   
questioning   if  they   were   considered  appropriate   for                                                                   
consideration of "medical necessity".   She acknowledged that                                                                   
she  personally could  not make  that  determination for  any                                                                   
woman  and that ultimately  that  must be their  choice.   It                                                                   
should be a very private discussion.                                                                                            
                                                                                                                                
Dr.  Murphy voiced  concern that  when a  woman is  depressed                                                                   
that they  should be medicated  during their pregnancy.   She                                                                   
reminded  members   of  the   Committee  that  Andrea   Yates                                                                   
experienced  multiple  signs  of  depression  throughout  her                                                                   
pregnancy preceding the murder  all her children.  She warned                                                                   
members that  the patient's doctor  should make  the ultimate                                                                   
choice regarding medication.                                                                                                    
                                                                                                                                
Dr. Murphy stressed  that pregnancies, where  the woman wants                                                                   
a  termination, are  high-risk  pregnancies.   Right now  the                                                                   
State  Medicaid  program  costs  $450  dollars  for  a  State                                                                   
termination  of pregnancy.   If  those pregnancies  go on  to                                                                   
full  term, basically,  the  State would  be  paying out  $75                                                                   
dollars for  every prenatal visit  and $1500 dollars  for the                                                                   
delivery services.   She emphasized  that if the  State wants                                                                   
to save  money, give women  what they  want and do  not judge                                                                   
them for their  choice.  She reiterated that  women should be                                                                   
able to decide for themselves.                                                                                                  
                                                                                                                                
                                                                                                                                
TAPE HFC 02 - 109, Side B                                                                                                     
                                                                                                                                
                                                                                                                                
Representative Croft asked if  defects of the fetus would fit                                                                   
into the definition.                                                                                                            
                                                                                                                                
Dr.  Murphy advised  that some  of the  highest risk  medical                                                                   
conditions  for women  are associated  with  a 50%  mortality                                                                   
rate.     She   addressed  primary   pulmonary   hypertension                                                                   
conditions associated  with up to a 50% mortality  rate.  She                                                                   
pointed out  that nothing  is 100%  guaranteed.  Doctors  can                                                                   
access good  pictures of  what the fetus  looks like  but the                                                                   
ultimate outcome cannot be determined until birth.                                                                              
                                                                                                                                
Dr. Murphy commented  that the legislation gives  doctors too                                                                   
much credit  about their  ability to  predict outcomes.   She                                                                   
stressed,  ultimately  the  decision   is  a  private  choice                                                                   
whether  a woman  wants to  continue  a pregnancy  associated                                                                   
with  long  term  disabilities.    Those  costs  are  usually                                                                   
shifted from the family to the State.                                                                                           
                                                                                                                                
Dr.  Murphy discussed  the number  of  uninsured people  that                                                                   
live in the State of Alaska.   Many of those uninsured people                                                                   
qualify for  the State Medicaid  Program for their  pregnancy                                                                   
care.   She  added that  she was  disturbed that  there is  a                                                                   
partial solution  for some of  the unwanted pregnancies,  the                                                                   
prescription equity  bill.  She stated that  bill should have                                                                   
been  addressed with  the legislation  before the  Committee.                                                                   
There are  women that  do not  receive contraception  options                                                                   
through  their current  insurance provider.   She noted  that                                                                   
contraception works and prevents unintended pregnancies.                                                                        
                                                                                                                                
Dr.  Murphy  mentioned  that   the  rate  of  termination  of                                                                   
pregnancies  in  Alaska  is lower  than  most  other  states.                                                                   
There are tremendous access issues  compared to other states.                                                                   
The  most  recent   statistic  in  Alaska  is   that  16%  of                                                                   
pregnancies result  in termination as compared to  34% in all                                                                   
other states.  The epidemic in  this State is uninsured women                                                                   
seeking reproductive health.                                                                                                    
                                                                                                                                
Vice-Chair Bunde  commented that medicine  is more of  an art                                                                   
than it is a  science.  He claimed there is  a "public policy                                                                   
issue" regarding  women that use abortion for  birth control.                                                                   
He questioned how often that occurs.                                                                                            
                                                                                                                                
Dr.  Murphy replied  that there  is  national data  regarding                                                                   
that  concern  with  50%  of   women  using  a  contraceptive                                                                   
technique  and  50%  not  using  a  contraceptive.    Despite                                                                   
efforts to  have reliable  contraceptive devices,  there will                                                                   
continue to be contraceptive failures.   One out of two women                                                                   
that  come  in  for a  termination  of  pregnancy  have  used                                                                   
contraceptives.   The  other 50%  of women,  who did not  use                                                                   
contraceptives, have an opportunity  to prevent the pregnancy                                                                   
by  using "Emergency  Contraception".   Most  women are  very                                                                   
responsible.   She challenged  that the  Committee provide  a                                                                   
companion bill, which legislates  the sexual behavior of men.                                                                   
                                                                                                                                
Vice-Chair  Bunde asked  if out of  100 performed  abortions,                                                                   
would 25 of those result from  accidents using birth control.                                                                   
                                                                                                                                
Dr. Murphy spoke to the elective  abortion.  Invariably every                                                                   
woman  contemplates  the  risk   factors  involved  with  her                                                                   
pregnancy.   There  is nothing  elective  about those  risks.                                                                   
Abortion is  not a  procedure that most  women want  to under                                                                   
go.  They would prefer to avoid it.                                                                                             
                                                                                                                                
DR.   JOHN   MIDDAUGH,   (TESTIFIED    VIA   TELECONFERENCE),                                                                   
EPIDEMIOLOGY  SECTION,   DEPARTMENT  OF  HEALTH   AND  SOCIAL                                                                   
SERVICES, spoke in opposition to SB 364.                                                                                        
                                                                                                                                
Dr.  Middaugh explained  that  the legislation  has  language                                                                   
problems   with  regard   to   the  physician   and   patient                                                                   
relationship.   The absence of  a fair understanding  and the                                                                   
meaning  of   the  language,  physicians  would   have  great                                                                   
problems   meeting   the  certification   required   by   the                                                                   
legislation.     The   terms   "serious,  adverse,   physical                                                                   
conditions"  could seriously aggravate  the physical  health.                                                                   
That language  would need  to be  interpreted to enforce  the                                                                   
statute.                                                                                                                        
                                                                                                                                
The language also has problems  in the areas of psychological                                                                   
illness that require  medication.  He pointed  out that there                                                                   
are  many  serious  psychological   illnesses  that  are  not                                                                   
treated by  medication.   Because of  the wording,  women who                                                                   
have  a serious  mental  problem would  not  be eligible  for                                                                   
funding.  Dr. Middaugh proposed  to delete "would" and insert                                                                   
"could" or "might".   Rarely, if ever, can  physicians make a                                                                   
prediction  to 100%  accuracy.   By requiring  a standard  of                                                                   
"would", implies a certainty that  almost could never be met.                                                                   
                                                                                                                                
Dr. Middaugh pointed out that  the bill omits coverage in all                                                                   
instances in  which a pregnant  woman bearing an  infant with                                                                   
horrible congenital malformations,  even if they are known to                                                                   
be incompatible with the mother's life.                                                                                         
                                                                                                                                
Dr.  Middaugh  reiterated  that   there  is  no  epidemic  of                                                                   
abortions in  Alaska.  He pointed  out that Alaska  ranks #33                                                                   
of all the states  for the number of average  abortions.  The                                                                   
State's policy does not pay for elective procedures.                                                                            
                                                                                                                                
In summary,  Dr. Middaugh urged  that the bill not  be passed                                                                   
and offered to answer questions of the Committee.                                                                               
                                                                                                                                
Vice-Chair  Bunde asked  if the statistic  for Alaska's  rate                                                                   
was based on per capita or total numbers performed.                                                                             
                                                                                                                                
Dr. Middaugh  replied that the  rate was based on  the number                                                                   
of abortions for 1000 women between  the ages of 15-44 years.                                                                   
In 1997, the national  rate was 22 women per  thousand and in                                                                   
Alaska that rate was 12 per thousand.                                                                                           
                                                                                                                                
Vice-Chair  Bunde  inquired  the   difference  in  comparison                                                                   
between Michigan and Alaska.                                                                                                    
                                                                                                                                
Dr. Middaugh responded  that the numbers quoted  for Michigan                                                                   
were based  on Michigan  State law  that was restrictive  and                                                                   
enabling payment  only for  saving the life  of a woman.   He                                                                   
advised  that  law has  been  held unconstitutional.    Using                                                                   
those figures today would be inaccurate.                                                                                        
                                                                                                                                
Representative    Hudson   asked    about   Dr.    Middaugh's                                                                   
recommendation  on Page 2 replacing  "would" with  "could" or                                                                   
"might".                                                                                                                        
                                                                                                                                
Dr. Middaugh advised that "would"  implies that you know that                                                                   
something is  going to happen  with 100% certainty;  however,                                                                   
medicine  is always about  probability.   The physicians  can                                                                   
only inform patients of probable outcomes.                                                                                      
                                                                                                                                
Vice-Chair  Bunde  asked  if   it  would  be  medically  more                                                                   
accurate to say "would more likely".                                                                                            
                                                                                                                                
Dr. Middaugh  recommended  using "could"  or "might".   Using                                                                   
"would more likely" would eliminate  the eligibility of women                                                                   
who  should  have a  therapeutic  and  indicative  procedure.                                                                   
Those women would fall outside that category.                                                                                   
                                                                                                                                
Vice-Chair  Bunde   commented  that   "could"  was   far  too                                                                   
permissive  and  agreed  that  "would"  allows  little.    He                                                                   
inquired if there was any middle ground.                                                                                        
                                                                                                                                
Dr.   Middaugh   pointed   out    that   for   three   years,                                                                   
Representative   Rokeberg   attempted  to   define   "medical                                                                   
necessity"  in the  patient's  bill of  rights  and in  those                                                                   
efforts, he  was unable to  do so.   All the efforts  lead to                                                                   
additional problems  and basically  do not take  into account                                                                   
the  unique circumstances  and  problems that  happen in  the                                                                   
practice  of medicine.   Dr. Middaugh  reiterated that  there                                                                   
are not a large number of abortions  occurring in Alaska, and                                                                   
that  in  fact  there  is a  high  bar  related  to  limiting                                                                   
procedures  to those  that are  medically needed.   He  noted                                                                   
that information  should only be decided between  a physician                                                                   
and a patient.                                                                                                                  
                                                                                                                                
WILLIAM  CRAIG, ALASKA  INDEPENDENT  BLIND,  SITKA, spoke  in                                                                   
support  of  the  legislation.     He  commented  on  various                                                                   
individuals  that have  had developmental  disabilities  that                                                                   
went on to become important people in society.                                                                                  
                                                                                                                                
HELEN  CRAIG, SITKA,  commented  that sexual  abuse and  rape                                                                   
would be reasons for a woman to  be able to have an abortion.                                                                   
She admitted  that babies  are priceless  and the  ultimately                                                                   
the  decision should  be left  to  the woman  and her  higher                                                                   
power and  the doctor.   Ms. Craig  stated that the  decision                                                                   
comes down to moral choices.                                                                                                    
                                                                                                                                
CHIP  WAGONER,  ALASKA CATHOLIC  CONFERENCE,  JUNEAU,  stated                                                                   
that there  is nothing  in the  bill that interferes  between                                                                   
the   doctor   and   the   patient's   relationship.      The                                                                   
communication  between  the physician  and  the patient  will                                                                   
continue just as  before, and the decisions  made between the                                                                   
doctor and  the patient  will continue just  as before.   The                                                                   
only difference  is that if  the bill passes,  State Medicaid                                                                   
funds  would  no longer  be  used  to  pay for  the  abortion                                                                   
procedure.                                                                                                                      
                                                                                                                                
Mr. Wagoner continued, the reason  that the statute is needed                                                                   
is because  there is no other  medical procedure paid  for by                                                                   
Medicaid  funds for  purely elective  reasons.   He  stressed                                                                   
that the issue was the payment.                                                                                                 
                                                                                                                                
He added that an additional issue  is the language of "would"                                                                   
verses "could".  Using "would"  modifies the word "aggregate"                                                                   
and would be  dangerous.  To change "would"  to "could" would                                                                   
basically  gut  the bill  because  everything  "could" be  an                                                                   
opportunity.  He  emphasized that if "would" was  not used in                                                                   
the  bill, there  would  be no  reason  for the  legislation.                                                                   
There  is  an additional  safeguard  in  the  bill.   It  was                                                                   
impossible  to  write the  bill  to take  into  consideration                                                                   
every circumstances;  that is  why there are regulations  and                                                                   
that is  why the bill authorizes  the Department of  Health &                                                                   
Social Services  to adopt regulations.   He recommended  that                                                                   
the  Department should  have a  review  process to  determine                                                                   
medically necessary cases.                                                                                                      
                                                                                                                                
Mr.  Wagoner spoke  to the  "uncomplicated" legal  abortions,                                                                   
which were  performed  that were unnecessary.   He  addressed                                                                   
the unwanted pregnancies.  Diagnosis  codes should be closely                                                                   
scrutinized.   State  funds  should be  used  outside of  the                                                                   
State  determined necessity  and that  Medicaid funds  should                                                                   
not be used for those abortions.   Mr. Wagoner noted that the                                                                   
Alaska Catholic Conference strongly supports the bill.                                                                          
                                                                                                                                
NANCY WELLER,  DIVISION OF MEDICAL ASSISTANCE,  DEPARTMENT OF                                                                   
HEALTH AND  SOCIAL SERVICES, offered  to answer  questions of                                                                   
the Committee regarding  the bill.  Ms. Weller  distributed a                                                                   
handout:  "Complications of  Pregnancy,  Childbirth, and  the                                                                   
Puerperium".  (Copy on File).                                                                                                   
                                                                                                                                
She stated  that the  list of  diagnostic codes for  abortion                                                                   
procedures are  very specific and  do not correlate  to those                                                                   
suggested by previous  testimony.  The diagnosis  codes used,                                                                   
determine if there are complications  to the woman and/or the                                                                   
baby.    Ms.  Weller  offered  to  answer  questions  of  the                                                                   
Committee.                                                                                                                      
                                                                                                                                
Vice-Chair Bunde  asked about  the code, which  addresses the                                                                   
psychological problems of the mother.                                                                                           
                                                                                                                                
Ms. Weller  replied that  the codes do  not indicate  why the                                                                   
abortion  is performed,  but  rather  indicate  what type  of                                                                   
abortion   it  is   such  as   a   spontaneous  abortion   or                                                                   
miscarriage.                                                                                                                    
                                                                                                                                
Representative  Croft asked if  "complicated" meant  that the                                                                   
medical  procedure was  complicated by  some other thing  and                                                                   
not a justification of why it needed to be done.                                                                                
                                                                                                                                
Ms. Weller agreed that was correct.                                                                                             
                                                                                                                                
Representative  Hudson referenced  the court case  definition                                                                   
previously referenced  and asked  if the language  "medically                                                                   
necessary" was essential.                                                                                                       
                                                                                                                                
Ms.  Weller explained  that the  Division  was following  the                                                                   
court  order under  the language  that the  Court put  forth.                                                                   
She noted that she could not judge  from the fiscal note what                                                                   
physicians might do in reaction  to the court order.  She did                                                                   
not know how the current regulations  were being interpreted.                                                                   
                                                                                                                                
SB 364 was HELD in Committee for further consideration.                                                                         
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
The meeting was adjourned at 7:17 P.M.                                                                                          

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