Legislature(2019 - 2020)ADAMS 519
03/02/2020 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB127 | |
| HB159 | |
| HB182 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 127 | TELECONFERENCED | |
| *+ | HB 159 | TELECONFERENCED | |
| + | HB 182 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE FINANCE COMMITTEE
March 2, 2020
2:37 p.m.
2:37:46 PM
CALL TO ORDER
Co-Chair Johnston called the House Finance Committee
meeting to order at 2:37 p.m.
MEMBERS PRESENT
Representative Neal Foster, Co-Chair
Representative Jennifer Johnston, Co-Chair
Representative Dan Ortiz, Vice-Chair
Representative Ben Carpenter
Representative Andy Josephson
Representative Gary Knopp
Representative Bart LeBon
Representative Kelly Merrick
Representative Colleen Sullivan-Leonard
Representative Cathy Tilton
Representative Adam Wool
MEMBERS ABSENT
None
ALSO PRESENT
Representative Ivy Spohnholz, Bill Sponsor; Kasey Casort,
Staff, Representative Ivy Spohnholz; Representative
Jonathan Kreiss-Tomkins, Bill Sponsor; Kevin McGowan,
Staff, Representative Jonathan Kreiss-Tompkins;
Representative Geran Tarr, Bill Sponsor; Karla Ms. Hart,
Staff, Representative Geran Tarr.
PRESENT VIA TELECONFERENCE
Katrina Virgin, President, Alaska Dental Hygienists'
Association; Brenda Vincent, Medicaid Program Specialist,
Department of Health and Social Services; Dr. Suzanne
Allen, Program Director, WWAMI Program; David Kanaris,
Chief, Forensic Laboratories, Department of Public Safety.
SUMMARY
HB 127 DENTAL HYGIENIST ADVANCED PRAC PERMIT
HB 127 was HEARD and HELD in committee for
further consideration.
HB 159 MEDICAL EDUCATION PROGRAM
HB 159 was HEARD and HELD in committee for
further consideration.
HB 182 SEXUAL ASSAULT EXAMINATION KITS: TESTING
HB 182 was HEARD and HELD in committee for
further consideration.
Co-Chair Johnston reviewed the agenda for the day. She
intended to introduce the bills and set them aside.
HOUSE BILL NO. 127
"An Act relating to the practice of dental hygiene;
establishing an advanced practice permit; prohibiting
unfair discrimination under group health insurance
against a dental hygienist who holds an advanced
practice permit; relating to medical assistance for
dental hygiene services; and providing for an
effective date."
2:38:59 PM
Co-Chair Johnston invited the testifiers to the table.
2:39:18 PM
REPRESENTATIVE IVY SPOHNHOLZ, BILL SPONSOR, introduced
herself. She thanked the committee for hearing her bill
which would establish advanced practice permits for dental
hygienists. She explained that oral health was an important
part to an individual's overall health and wellbeing. Poor
oral health attributed to poor physical health. It was a
problem amongst some of the state's most vulnerable
populations. She reported that 62 percent of elementary
students had tooth decay. Low income individuals and
families that did not regularly seek oral health care due
to cost, apprehension of dental care, access, and trouble
finding a provider contributed to bad health outcomes. She
noted several negative health outcomes including heart
disease, Alzheimer's, osteoporosis, and poor nutrition.
Representative Spohnholz continued that HB 127 aimed to
increase access to oral healthcare to underserved
populations, specifically children, seniors, and
individuals with disabilities. The legislation created an
advanced practice permit for dental hygienists similar to
the certificate advanced nurse practitioners had which was
created in 1981 and implemented in 1984. Currently, dental
hygienists were able to practice in a dentist's practice or
semi-independently if they had a collaborative agreement
with a dentist similar to what physician's assistants did.
House Bill 127 created an advanced practice permit which
allowed dental hygienists to care for underserved
populations in senior centers, healthcare facilities,
daycares, schools, and for Alaskans who were eligible for
public assistance, homebound, or lived in an underserved
community. Dental hygienists who had a minimum of 4000
hours of clinical experience and who were approved by the
Alaska Board of Dental Examiners could be advanced practice
dental hygienists.
Representative Spohnholz indicated the bill laid out very
specific services that could be provided by permit holders
and the specific populations that licensed dental
hygienists could serve without supervision or the physical
presence of a licensed dentist. The permit was not a cart
blanch permit for practicing independently. The list of
services had been developed in consultation with the Alaska
Dental Society, the Board of Dental Examiners, and the
Alaska Dental Hygienists Association. Advanced practice
dental hygienists would have to maintain malpractice
insurance, provide a written notice of their service
limitations, and make a referral to a licensed dentist
nearby for a patient's dental treatment. The permit would
allow dental hygienists to practice to the full scope of
their training, credentials, and professional experience.
She noted that Alaska would not be the first state to make
such changes. Dental Hygienists were able to practice under
advanced practice permits or similar permits in six other
states: Colorado, Montana, Maine, Connecticut, and
California. She indicated 40 other states were considered
direct access states. The bill would mean that dental
hygienists could initiate treatment based on their
assessment of a patient's need without authorization or the
presence of a dentist. Alaska would not be breaking new
trail; it was something done in many other states. She
noted that since the prior year she had made some important
changes to the bill at the recommendation of the Board of
Dental Examiners and the Alaska Dental Association
including requiring permit holders to maintain patient
records for at least 7 years. It would ensure that the
Board of Dental Examiners had separately certified a dental
hygienist to administer anesthesia, and empowering DHSS to
make regulations related to the bill. She reported that her
aide had a PowerPoint Presentation and relayed the names of
available testifiers.
Co-Chair Johnston indicated Co-Chair Foster and
Representative Knopp had joined the meeting.
2:43:28 PM
KASEY CASORT, STAFF, REPRESENTATIVE IVY SPOHNHOLZ,
introduced the PowerPoint: HB 127: Dental Hygiene Advance
Practice Permit. She began with slide 2 to review the
importance of the bill. She spoke of there being many
unique barriers to accessing health care including dental
care in Alaska. She noted that 62 percent of Alaskan
elementary students had a high rate of tooth decay and, 43
percent of low-income Alaskans had trouble biting or
chewing. Both young adults and low-income adults across
American cited pain as their top oral health problem and,
low-income families in Alaska did not regularly seek oral
health care due to cost, access, or trouble finding a
provider. She asserted that Alaska needed all of its
qualified health professionals operating to the full scope
of their training, especially when it came to caring for
Alaskans with the greatest need.
2:44:27 PM
Ms. Casort continued to explain the importance of HB 127
turning to slide 3. Dental hygienists were state-
licensed health professionals who were trained to
provide education and care that focused on preventing
and treating oral diseases. However, under current
statute, dental hygienists were required to work under
the direct supervision of a licensed dentist or enter a
collaborative agreement where they remained under
general supervision. The requirements limited where and
when dental hygienists could practice and was a barrier
to preventative dental care for Alaskas seniors,
children, and adults living with disabilities.
Ms. Casort relayed with slide 4 that HB 127 created an
advanced practice permit that would allow experienced,
licensed dental hygienists to work independently to the
full scope of their credentials and professional experience
when they were caring for underserved populations.
Ms. Casort turned to slide 5. She indicated that
underserved populations were defined in U.S. Code under
the term "dental health shortage areas," which were
"geographic areas, populations, and facilities with too
few dental providers and services." In Alaska, it meant
an area with more than 5000 patients per 1 provider.
Ms. Casort continued that dental health shortage areas
in Alaska where an advanced practice permit-holder
could serve included geographic areas like the North
Slope Borough; facilities which primarily serve tribal
populations like Mt. Edgecumbe Hospital or Chief Andrew
Isaac Health Center; correctional centers like Goose
Creek Correctional Center; and federally qualified
health centers like the Bethel Family Clinic or Mat-Su
Health Services. House Bill 127 would allow hygienists
to care for Alaskans in need like elders living in
senior centers, underserved children in schools,
Alaskans who were eligible for public assistance, and
Alaskans with disabilities for whom oral care could be
a scary, uncomfortable experience. Increasing the
number of underserved Alaskans receiving preventative
care also meant that dental hygienists could catch more
acute problems earlier on when care was less costly,
painful, and inconvenient.
Ms. Casort concluded that HB 127 was the next step in
allowing dental hygienists to provide preventative care
to patients with the greatest need. Should would be
walking through the bill section-by-section.
2:46:35 PM
Ms. Casort presented a sectional analysis in a prepared
statement:
Section 1 amends the dental hygienists' scope of
practice to allow advanced practice permit holders to
provide specific services independently.
Section 2(a) allows the State of Alaska Board of
Dental Examiners to issue advanced practice permits to
hygienists with at least 4000 hours of clinical
experience.
Section 2(b) enumerates the services an advanced
practice permit-holder can perform without the
presence, authorization, supervision, or prior
examination of a licensed dentist (section 2(c)),
including
• providing oral health education,
• removing stains and deposits from the surface of
the teeth,
• applying preventative agents and sealants,
• taking and developing x-rays,
• screening for oral cancer,
• using local anesthesia if separately licensed to
do so by the Board,
• and performing preliminary charting and triage to
formulate a dental hygiene assessment and dental
hygiene treatment plan.
Section 2(d) requires an advanced practice permit-
holder to maintain liability insurance and provide
their patients or the patient's parent or legal
guardian with a written notice of the services the
permit allows them to perform. They must also help the
patient with referrals to see licensed dentists in the
area for more comprehensive dental care.
Section 2(e) allows an advanced practice permit-holder
to practice as an independent contractor.
Section 2(f) establishes that the advanced practice
permit is valid until the dental hygienist's license
expires and allows the permit to be renewed at the
same time as the license.
Section 3 amends the grounds for discipline,
suspension, or revocation of a dental hygienist's
license to allow them to provide the services listed
in section 2 independently without being punished.
Section 3 also empowers the Board to discipline
permit-holders who
• allow a dental assistant under their supervision
to perform procedures outside their scope of
practice,
• falsify or destroy a patient or facility record,
• or fail to maintain a patient or facility record
for at least 7 years, which is similar to the
requirement for dentists.
o This was added into the bill in House Labor
& Commerce, at the request of the Alaska
Board of Dental Examiners and the Alaska
Dental Society.
Section 4 amends Alaska Statue 08.36.346, Delegation
to dental assistants, to allow permit-holders to
delegate x-rays, application of topical preventative
agents or sealants, and other tasks specified by the
Board of Dental Examiners in regulation to dental
assistants under their supervision. The Board is also
tasked with specifying in regulation the level of
supervision required over the dental assistants.
Section 5 adds dental hygienists holding an advanced
practice permit to the list of providers who may not
be discriminated against. This prevents an insurer
from refusing to reimburse the appropriately licensed
provider on the basis of cost or on the basis of race,
religion, gender, etc.
Section 6 adds dental hygiene services to the list of
services which may be provided by the Department of
Health and Social Services.
Section 7 allows the Department of Commerce,
Community, and Economic Development, the Department of
Health and Social Services, and the Board of Dental
Examiners to adopt regulations necessary to implement
the changes made in this bill.
Finally, Sections 8 and 9 set an effective date of
July 1, 2020.
Ms. Casort indicated Katrina Virgin, President of the
Alaska Dental Hygienists' Association, was online as well
as others to answer any questions.
2:50:02 PM
Representative Sullivan-Leonard asked for information
regarding the educational requirements for dental
hygienists. She was seeing a correlation between a nurse
practitioner and an advanced dental hygienist.
Representative Spohnholz deferred to Ms. Virgin to answer
the question about education.
2:50:52 PM
KATRINA VIRGIN, PRESIDENT, ALASKA DENTAL HYGIENISTS
ASSOCIATION (via teleconference), responded that the
requirements for a dental hygienist to become licensed in
any state within the lower 48 and Alaska were that they
must graduate from an accredited dental hygiene school that
was a CODA [Commission on Dental Accreditation]
accreditation. School was typically 4 years. There were
some programs that were still in existence that were 2
years. However, even the University of Alaska Anchorage had
moved to a 4-year baccalaureate type program. It would take
about 3 to 4 years working consecutively under the
supervision of a dentist for a dental hygienist to meet the
4000 clinical hours requirement.
Representative Sullivan-Leonard asked for a comparison of
the requirements for an advanced nurse practitioner versus
an advanced dental hygienist.
Representative Spohnholz responded that a nurse
practitioner had more training than a dental hygienist.
However, a nurse practitioner had more authority. Nurse
practitioners in Alaska had full prescriptive authority
whereas, a dental hygienist would not. The training for a
dental hygienist was in line with the services they would
be providing.
Representative Sullivan-Leonard asked for the number of
years of training for an advanced nurse practitioner versus
an advanced practice dental hygienist.
Representative Spohnholz responded that a nurse
practitioner would have a 4-year undergraduate degree and
either a 2-year or 4-year graduate degree.
2:52:50 PM
Representative Tilton asked if the services could be billed
through Medicaid and whether a new category would be
created in Medicaid. She also asked if there would be an
increase or decrease in Medicaid services, overall.
Representative Spohnholz responded that a dental hygienist
would be able to bill Medicaid. Currently, they already did
under the supervision of a dentist or through a
collaborative agreement with a dentist. The legislation
would allow dental hygienists to practice independently.
Theoretically, there might be an increase in the number of
people receiving services. However, it was unclear because
eligibility or the number of services available would not
change. There was a finite number of people eligible for
Medicaid in the State of Alaska and a finite number of
services that could be provided. House Bill 127 would make
it easier and more cost effective for people to receive the
preventative care that dental hygienists provided as
opposed to the treatment options that dentists provided.
Frequently, people stated they were going to the dentist
when they were really going to a dental hygienist for a
routine cleaning or other prophylactic treatments used for
cavity prevention and the prevention of other more
expensive care.
2:54:25 PM
Representative Tilton asked if the bill sponsor thought
there was confidence in allowing a new category of advanced
practice hygienists. She wondered if people would be more
comfortable about getting preventative dental care. She
noted there were existing challenges in getting people to
receive preventative dental care.
Representative Spohnholz responded that the proposal was
structured to allow people to receive care where they
lived. They might be able to avoid going to an office to
receive dental care. They might be able to have a dental
hygienist go onsite to places such as nursing homes, day
care centers, elementary schools, and senior centers. She
thought some of the barriers would be reduced to getting
needed preventative care. She also thought the legislation
would increase access for people who were physically
challenged in going to the dentist's office.
2:55:49 PM
Co-Chair Foster asked if the bill sponsor had reached out
to any of the hospitals in rural areas. He wondered if she
had received any feedback from any folks from the rural
areas of Alaska.
Representative Spohnholz responded that she had not
received any feedback from providers or hospitals in the
rural areas. She surmised that the bill would be viewed
very favorably by the people in the rural areas, as the
bill would increase access to care. She was aware of huge
challenges in getting access to dental care in rural Alaska
which precipitated the creation of the dental health aide
therapist. They did amazing work in rural Alaska and
dramatically increased access to dental care. The bill
before the committee would be adding another level of
possible provider care in rural Alaska. Dental hygienists
would also be more affordable than would dentists, as they
had few university bills to pay off.
2:56:56 PM
Vice-Chair Ortiz referred to slide 4 and noted that in
order for a dental hygienist to receive an advance practice
permit they could only do so in underserved areas. He asked
how extensive the list was that was mentioned on the slide.
Ms. Casort noted she could provide the extensive list which
included many facilities across Alaska, but specifically
underserved areas. She could also provide how the
information was calculated which factored in the
patient-to-provider ratio, whether water was fluoridated,
and how long it took to access a dentist. She had outlined
the factors which were considered in scoring between 0 and
26. She would provide more detail to the committee.
2:58:15 PM
Representative Tilton asked if it was an appropriate time
to discuss the fiscal note.
Co-Chair Johnston indicated there would be another time
available for fiscal note questions.
Representative Wool had a couple of questions related to
the list of underserved populations. He had a letter from
Mary Cerney from Fairbanks which mentioned that the bill
would eliminate barriers to accessing care desperately
needed by many people. He thought one of the barriers to
care was that some people could not afford it. He wondered
if, by approving an advanced practice certificate for
dental hygienists, low-income people would have more access
just on the basis of being low-income as opposed to being
in a geographical area where the ratio was not as high as
in urban centers.
Representative Spohnholz responded that a person would have
to be low-income and receiving services in a dental
professional shortage area or in one of the facilities
listed on page 3 starting on line 2. The list included a
senior center, a hospital long-term care facility, an adult
foster home, and a residential care facility. The list was
long. The list continued to page 3, line 12 of the bill.
She informed the committee that the word "and" was
stipulated. A person had to meet the first 3 criteria and
receive services in one of the centers or live in a dental
health professional shortage area. The bill was not
designed to allow a dramatic expansion of those people that
would be providing services. The bill targeted a very,
specific, and under-served population.
Representative Wool noted that there were 703 dental
hygienists in Alaska. He supposed there were shortages in
some areas around the state. He asked if the bill sponsor
envisioned dental hygienists leaving their current
workplace to become an advanced dental hygienist and
exacerbating any shortages.
Representative Spohnholz reported that there was a shortage
of dental healthcare in Alaska, particularly in the
underserved populations. She did not believe creating the
advanced practice license would exacerbate the shortage.
She thought it would help redistribute access to dental
hygiene care, which was really important. Many of the
places where advanced practice dental hygienists would
practice would be in locations currently without
appropriate care. She reported that the Alaska Dental
Hygiene Association estimated that of the 703 dental
hygienists, approximately 5 percent would explore an
advanced practice license in order to practice
independently, which was on par with nurses. She indicated
there were about 5.5 percent of nurses in the State of
Alaska that were advanced practice nurses. She did not
think the legislation would change the total number. Rather
she thought it would help reallocate the resource to get it
to the people that needed it most.
Representative Wool suggested that 5 percent of hygienists
would equal about 3500 hygienists. The current population
of hygienists would go into advanced practice. He suspected
the model would be such that a practitioner would leave the
office they were currently in to go to an undeserved area.
He wondered about the potential for a practitioner to
continue working in their current office a couple of days
and on their own another couple of days per week.
Ms. Virgin offered that it was common for dental hygienists
to work in several facilities in a week. The goal would not
be to work in one location. The bill would allow for a
practitioner to work at multiple facilities and would open
up what services hygienists could provide.
Representative Wool asked if there was a dental hygienist
program currently in Alaska.
Representative Spohnholz responded affirmatively.
Ms. Virgin added that there was a degree program for dental
hygienists through the University of Alaska Anchorage. The
University offered a 4-year degree, a CODA approved dental
program. The University focused on public health
initiatives and going out to different rural areas to
provide treatment. The University wanted to see equal
access to care.
Co-Chair Johnston set the bill aside.
HB 127 was HEARD and HELD in committee for further
consideration.
HOUSE BILL NO. 159
"An Act relating to repayment conditions for medical
education program participants."
3:07:37 PM
Co-Chair Johnston reviewed the testifiers that were
available online.
3:08:09 PM
REPRESENTATIVE JONATHAN KREISS-TOMKINS, BILL SPONSOR,
explained that HB 159 would increase the repayment by a
WWAMI Program alumni from 50 percent to 100 percent if that
person did not return to Alaska to practice medicine once
completing medical school and a residency. Currently, if a
WWAMI participant did not return to the state to practice,
they were expected to pay 50 percent of the difference
between the cost of out-of-state tuition at the University
of Washington Medical School and the amount the state was
contributing to incentivize its young people to go to
medical school and return to practice in Alaska.
3:09:57 PM
Representative Tilton asked if he had an idea of the number
of people who utilized the WWAMI program who did not return
to Alaska. She asked for the criteria for residency.
Representative Kreiss-Tompkins deferred to his staff.
3:10:56 PM
KEVIN MCGOWAN, STAFF, REPRESENTATIVE JONATHAN KREISS-
TOMPKINS, reported that about 40 percent of students did
not return to the state. Dr. Suzanne Allen from WWAMI was
available online.
3:11:28 PM
DR. SUZANNE ALLEN, PROGRAM DIRECTOR, WWAMI PROGRAM (via
teleconference), responded that currently between 14-15 out
of 20 WWAMI students each year returned as physicians to
Alaska. In looking specifically at Alaskans returning to
the state, the number might be slightly lower, 12-13
students, as there were WWAMI students from the other
participating states, 4 in all, that end up practicing in
Alaska.
Mr. McGowan responded to the question about residency. A
person must be a resident for at least 2 years before being
allowed into the WWAMI Program.
Representative Tilton asked what would determine whether
someone was practicing in Alaska after completing their
studies.
Mr. McGowan replied that a student must practice for 3
years in a rural community or 5 years in an urban community
after completing the program to qualify.
Vice-Chair Ortiz asked whether implementing the bill would
change or dissuade the states talent pool from
participating.
Representative Kreiss-Tompkins spoke from the perspective
of the legislature. He thought the program was stellar. He
had several friends who had either gone through the WWAMI
program or were currently participating in it. He thought
it was important to remember the prestige of the program as
well. The University of Washington was one of the best
medical schools in the country and extremely difficult to
get into. He suggested there was a golden brick path for
Alaskans through the WWAMI program for the set-aside spots
that were highly sought after. He thought it was a
consideration that weighed heavily with many applicants. He
thought there might be a dissuasive effect for some
applicants. However, given some conversations and the
prestigious reputation of the University of Washington, he
thought it would be a relatively small factor.
3:17:23 PM
Co-Chair Johnston noted that Representative Knopp and
Representative Josephson had joined the meeting.
Representative Wool asked if scholarships were commonly
given out for medical school.
Representative Kreiss-Tompkins responded affirmatively. He
had friends that had attended medical school and who had
received merit and other scholarships. If the
representatives question related to whether WWAMI students
could receive other scholarships in addition to in-state
tuition through WWAMI, he was uncertain. He deferred to Dr.
Allen.
3:18:04 PM
Dr. Allen responded that Alaska WWAMI students were
eligible to receive scholarships. There were some
scholarships specific to Alaska WWAMI students and other
general scholarships. She elaborated that WWAMI students
received scholarships, federal grants, and loans to help
with tuition and living expenses during their 4 years of
medical school.
3:18:37 PM
Representative Wool asked if the scholarships were based on
need or academic performance.
Dr. Allen did not have the breakdown but both applied.
Representative Wool suggested that if a student was
accepted and was weighing more than one option, the
scholarship payback percentage might influence their
decision.
Representative Kreiss-Tompkins agreed that there was a
possibility of behavior changes with the passage of the
bill. However, it was difficult to assign a correlating
fiscal impact. The legislation would have a negative fiscal
impact on the budget which was part of the reason he had
pursued the bill. The impact would be about $600,000 per
year but, the figure assumed no behavior change. He
indicated that if the passage of the bill proved to be an
incentive for WWAMI participants to return to Alaska to
practice medicine, the negative fiscal impact of the bill
could be eroded. The fiscal impact could be $500,000 or
$400,000 per year. He thought it was difficult to determine
what behavior changes might occur as a result of the
legislation. He argued that it could be positive for Alaska
if a greater percentage of WWAMI alumni came back to
practice medicine in the state. He thought it would be
unreasonable to think there would be zero behavior change
on the front end, as he thought it would rebalance medical
school applicants decisions. Depending on a financial
package and the overall tuition of a school would influence
a students decision. He suggested students would be making
a slightly different choice with the passage of the bill
than without.
3:22:32 PM
Representative Wool supposed that if the program was
completely successful, all 20 students would come back to
the state and the state would have to reimburse all of
them. It would cost Alaska more money but, it would have
more practicing physicians.
Representative Kreiss-Tompkins responded that if 100
percent of alumni returned, it would be beneficial for
Alaska. He was unsure of the fiscal crossover point.
Co-Chair Johnston directed Representative Kreiss-Tompkins
to review the sectional analysis which she anticipated
would be brief.
Mr. McGowan reviewed the sectional analysis. Section 1 of
the bill amended AS.14.43.51(a) and increased the repayment
from 50 percent to 100 percent plus interest for students
that did not return to the state upon completing the WWAMI
Program. Section 2 of the bill specified an effective date
which applied to students who entered the agreement on or
after the effective date of the act.
3:25:11 PM
Representative Kreiss-Tompkins offered that the bill came
about in order to make a structural change to take pressure
off of the budget in the long term. At one point the WWAMI
Program was slated for a gubernatorial veto. It was a
compromise in response to a conversation he had had with
the governors chief of staff. The compromised allowed for
the placement of the WWAMI Program into a stable long-term
place. He wanted to provide context to the origin of the
bill.
Co-Chair Johnston set the bill aside.
HB 159 was HEARD and HELD in committee for further
consideration.
3:26:45 PM
AT EASE
3:28:33 PM
RECONVENED
HH
HOUSE BILL NO. 182
"An Act relating to testing of sexual assault
examination kits; and providing for an effective
date."
3:28:40 PM
Co-Chair Johnston asked the bill sponsor to begin her
presentation. She relayed the names of the testifiers
available online.
3:29:09 PM
REPRESENTATIVE GERAN TARR, BILL SPONSOR, began with slide 2
of the PowerPoint Presentation, "House Bill 182." She
provided some context for the incarnation of the bill. She
indicated that in 2014 she had received something from the
Joyful Heart Foundation, an organization founded by Mariska
Hargitay, the actress from Law and Order: Special Victims
Unit. During Ms. Hargitays time as an actress on the show,
she received several letters from individuals who were
survivors of sexual assault. The actress wanted to be
helpful. She started the effort with the Joyful Heart
Foundation specifically focused on ending the backlog
campaign. As a result, the representative was inspired to
begin work on HB 182.
Representative Tarr explained that there were six pillars
embodied by the Joyful Heart Foundation. She wanted to show
what she had accomplished to-date, as it was something that
everyone could feel good about. She was trying to
facilitate a lasting systemic change. The six pillars
included an annual statewide inventory, mandatory testing
of backlog kits, mandatory testing of new kits, a statewide
tracking system, a victims right to notice, and funding
for reform. She posed the question about where Alaska was
in the process.
Representative Tarr continued to slide 3 to discuss the
states current status. She conveyed that she first started
working on the project in 2014 with the statewide audit
which was required by the U.S. Department of Justice in
order to receive federal funding towards the effort. The
statewide audit was how the state learned that there were
approximately 3,400 untested rape kits in the State of
Alaska. The early work also led to the audit of the crime
lab where other deficiencies were discovered. The state had
been able to improve the process outside of legislation.
She believed people would feel very positive about the
happenings at the crime lab which Mr. Kanaris, the chief of
the forensics laboratory in Anchorage, would report on.
Representative Tarr detailed that some of the changes that
were made working with the crime lab included making sure
that each rape kit had a unique identifier to ensure a
chain of custody. Previously, all of the kits were prepared
in Anchorage and sent out to more than 200 law enforcement
agencies across the state, but with no unique identifiers.
It was impossible to tell whether a kit was used or unused
sitting on a shelf once it left Anchorage. The issue was
problematic; hence, a tracking system was established.
Representative Tarr reviewed some of the other legislation
that the state passed. The state supplied funding for the
mandatory testing of the backlog kits as well as
established the policy of storing all of the kits at the
crime lab in Anchorage. The funding also paid for the
installation of high capacity shelving. With the passage of
HB 49 [Legislation passed in 2019 Short Title: Crimes;
Sentencing; Drugs; Theft; Reports] all new kits were
required to be tested within 1 year and, the statewide
tracking system was put into place. The bill also
established a victims right to notice.
Representative Tarr indicated that the Joyful Heart
Foundation wanted to see a website established for
individuals to be able to follow the progress of their kits
using a unique identifier. The states current protocol was
that all kits would be sent to the crime lab within 30
days, tested within 1 year, and individuals would be
notified within 2 weeks of their kits being tested.
Eventually, she hoped the state could implement a more
sophisticated tracking system in which individuals could
track the progress of their own kits. She explained that it
was important for a victim to be able to track their own
kit because an individual was re-traumatized every time
they had to retell their story. Having to call an authority
to obtain information could be traumatizing, as they would
likely have to retell their story over-and-over again. She
thought the victim notification piece was a helpful step in
limiting the re-traumatization of victims.
Representative Tarr continued that currently, shortening
the timeline was the next right step and the reason for
HB 182. She had worked with Mr. Kanaris reviewing the
best-case scenario in terms of turnaround time for the
processing of rape kits. Mr. Kanaris had indicated 60 days
was the most reasonable timeline. He had done some research
about what other states were doing which provided the
reason behind 60 days as an attainable goal. However,
presently the most achievable goal was 6 months.
3:35:33 PM
Representative Tarr moved to slide 4 to discuss the timing
of the testing. The legislation was specifically to shorten
the time of the testing once kits were collected. Mr.
Mosley was allowed to be on the streets prior to his
arrest. The article referenced in the slide indicated that
he was allowed to be on the streets prior to his arrest.
The delay in testing his rape kit allowed a fourth woman to
be raped.
Representative Tarr continued to slide 5 which she read:
"The effect on the victims cannot be overstated. Some
of these women waited years to find out who their
assailant was. [One woman] moved back to her hometown
out of fear and shame. One of these women, after years
of suffering from infertility despite her best efforts
with her partner, became pregnant as a result of the
rape. The cruel irony of carrying the child of her
rapist after years of trying to have a child with her
partner had a significant impact on her. For each of
these women, they re-live the trauma of the rape and
recently endured having to tell a grand jury what
happened to them."
Representative Tarr relayed that the state might have
prevented some of these things from happening had it done
things in a timelier fashion. She reemphasized why timing
was so important. She had heard too many awful stories and
believed the state could do better.
3:37:09 PM
Representative Tarr continued to slide 6. She relayed that
the 6-month mark was the focus of the bill. She indicated
certain resources were necessary and were reflected in the
fiscal note. She reported that even if funding was made
available on July 1, 2020, it would take a number of months
to find the right staff, as the positions were very
technical. She also reported that because there had been a
national effort regarding the issue, there was a large
demand for qualifying professionals. She relayed that
specialized training was required for a person to be able
to process the kits. She listed off several of them.
Representative Tarr indicated that the fiscal note
reflected the challenges of the timeline and the effective
date. It would take some time for the lab to get properly
staffed, train personnel, and be compliant with the law
should the legislature pass the bill. She noted that when
she had discussed with Mr. Kanaris whether the state could
get to 60 days in the first step, he thought that it was
possible to get to 6 months if the resources were provided
in the legislation. Once everyone was fully trained and the
backlog was caught up, the lab would not need additional
resources to reach the 60-day mark. All processing would
improve with building capacity among staff. She reiterated
that the 2020 goal was to reach the 6-month mark and to
continue working with the crime lab to reach the 60-day
mark. She commended Mr. Kanaris for all of his work at the
crime lab and for the work he had done in researching what
other states were doing. He could speak to the return on
investment and investing in the type of work related to
HB 182.
3:40:33 PM
Representative Tarr played the movie trailer to a video
entitled, "I Am Evidence." [The committee watched the
video]
Co-Chair Johnston invited Mr. Kanaris to comment.
3:42:37 PM
DAVID KANARIS, CHIEF, FORENSIC LABORATORIES, DEPARTMENT OF
PUBLIC SAFETY (via teleconference), mentioned that the
positions the lab was requesting would move the Department
of Public Safety in the right direction in terms of
processing the 9-month backlog of sexual assault kits.
There were several national studies about the benefits of
testing the backlog kits. A paper was published in 2019
entitled, The Jurisdiction of Return on Investment from
Processing the Backlog of Untested Sexual Assault Kits.
The paper looked at all of the different factors and
benefits of processing kits. The benefits included
providing resolution for survivors, preventing repeated
assaults from serial rapists, and preventing societal costs
external to the people directly victimized. He reported an
estimated 9,000 percent to 64,000 percent return on
investment for each sexual assault test processed. The
disparity in the numbers depended on the number of kits
being processed.
Mr. Kanaris continued that the cost of processing per kit
in a large testing facility which processed several
thousands of kits per year was much less than in a smaller
facility. Alaska was on the low end of the spectrum and
would likely see a return on investment of 8,000 percent to
10,000 percent. Currently, the cost of testing in Alaska
was about $1500 per kit. The national average was between
$1400 and $1600 per kit. He reported a large uptick in
submission of kits to the lab. In 2012, there were 303 DNA
submissions to the lab across all case types, not just
sexual assault cases. In the previous year, 651 kits were
submitted to the lab. In the current year, the lab
anticipated receiving over 800 cases, 60 percent of which
would be sexual assault tests over 500 sexual assault
cases. He reported an increase of 34 percent in violent
crime rates in Alaska between 2013 to 2017. There was also
increased national attention on the sexual assault backlog
which had moved to the forefront of policy reforms. There
was also the issue that DNA had become a forensic panacea
resulting in more agencies submitting more items and
evidence for testing. The department was asking for funding
for 2 positions to get the lab to the 6-month mark.
Co-Chair Johnston asked Representative Tarr to present the
sectional Analysis.
3:46:45 PM
KARLA MS. HART, STAFF, REPRESENTATIVE GERAN TARR, relayed
that in Section 1 the timeline was changed from one year to
six months. In Section 2 the effective date was changed to
2021.
3:47:12 PM
Representative Josephson thought Representative Tarr's work
on the bill had been heroic. He offered that she could
count on his support of the bill. He asked if the reason
why the lab thought it could reach the 6-month mark was
that it would outsource testing until the 2 positions could
be hired. He asked the sponsor if she was comfortable with
the language in the bill, The agency shall ensure.
Representative Tarr responded that it was true that
outsourcing would be necessary to meet the 6-month
timeline. Concurrently, the lab would be staffing the
positions and rotating in the new employees.
3:48:17 PM
Representative Josephson relayed that, in his time as a
state prosecutor, a sexual assault would not typically come
to disposition in a 6-month window. With expedited testing,
a persons nature of defense would likely become obvious
sooner and would be the reason for a significant return on
investment.
Representative Tarr asserted that the law would help to
better understand who was involved in sexual assault crimes
and what to focus on in terms of prevention work.
3:49:34 PM
Representative Wool thanked Representative Tarr for her
presentation. He was looking at the backlog number in 2017
of 3,484 and in 2019 of 1,696. He clarified that the test
kits had been outsourced for processing to reduce the
backlog. He queried about incoming kits and the ability to
keep up with processing.
Representative Tarr responded the that backlog was all of
the untested kits when she started her effort in 2015
beginning with the audit. The kits had been cataloged,
prioritized, and sent out in batches. The funding that was
placed in the capital budget a couple of years prior was
being used to cover the backlog. The bill was addressing
the new incoming kits and the timeline for processing them.
There would be a period in which the staff would be
trained, and the kits would continue to be processed by a
third party.
Representative Merrick asked if the results of the kits
were entered into the Combined DNA Index System (CODIS) or
a similar database.
Representative Tarr responded affirmatively. She deferred
to Mr. Kanaris to provide further detail.
Representative Merrick asked Mr. Kanaris to provide
information regarding genealogical testing and furthering a
particular investigation.
Mr. Kanaris responded that everyone that was eligible would
be entered into CODIS. He reported that CODIS was strictly
governed by the Federal Bureau of Investigation (FBI).
There were certain eligibility requirements for which
samples could be entered. In order to be eligible a crime
had to have been committed. The lab worked with law
enforcement agencies to make sure each sample was eligible.
If a sample was eligible, it would be entered into CODIS.
In terms of genetics, it was not something that the state
dealt with directly, as the cases were very labor
intensive. Genealogical testing required a certain skill
set that the State of Alaska did not currently have. The
law enforcement agency submitted samples to Alaskas lab.
If a test did not generate a hit against a profile in
CODIS, law enforcement would make a decision in concert
with the lab about genealogical testing. The lab could
provide technical expertise in explaining what steps would
need to be taken. However, such work was not currently
being done in the crime lab.
Representative Merrick thanked Mr. Kanaris for all of the
great work he was doing at the crime lab.
Co-Chair Johnston set the bill aside. She reviewed the
agenda for the following morning. Amendments for HB 182
were due Wednesday, March 4th at 12:00 p.m.
HB 182 was HEARD and HELD in committee for further
consideration.
ADJOURNMENT
3:54:45 PM
The meeting was adjourned at 3:54 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 159 Sponsor Statement 1.31.20.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 159 |
| HB 127 v. M Sponsor Statement 2.28.2020.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 127 |
| HB 127 v. M Sectional Analysis 2.28.2020.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 127 |
| HB 127 v. M Explanation of Changes 2.28.2020.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 127 |
| HB 182 Sponsor Statement 2.28.20.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 182 |
| HB 182 DNA arrest KTVA 11 9.6.19.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 182 |
| HB 182 Explanation of Changes v. U 2.12.20.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 182 |
| HB 127 v. M Index of Letters of Support 3.1.2020.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 127 |
| HB 127 Slideshow 3.1.2020.pdf |
HFIN 3/2/2020 1:30:00 PM |
HB 127 |